The building blocks of personalised health and care
Nowadays citizens around the globe are living longer and, according to the WHO, by 2050 the world’s population aged 60 years and older is expected to total 2 billion, up from 900 million in 2015. As a result of ageing populations, chronic diseases are also on the rise bring increasing burden on our society, for which we are currently not prepared. This trend challenges the sustainability of healthcare systems, which need to deal inefficiencies in care settings, affordability of innovative treatments and end of life care with lesser resources.
In this context, we have to move towards a more precise, evidence-based approach to health that is tailored to the individual needs, that improves health outcomes and experience in a way that can be managed by health systems over the long-term.
Personalised health and care have the potential to overcome the above-mentioned challenges by moving away from a one-size-fits-all treatment of disease and applying the right health interventions, including prevention, for the right person at the right time. Advances in genomics, understanding of health behaviours, data science and digital technologies can play a key role when it comes to empower patients to monitor their own health, improve care, and optimize the allocation of resources. However, as any paradigm shift, also the uptake of personalised health and care requires a substantial redesign of the health system.
In the last few years, several countries started to lay the groundwork for personalised health and care through national strategies on genomics, digital health and cancer control. As part of the FutureProofing Healthcare initiative, I have been working with other experts to analyse different countries’ approaches and to identify the building blocks that are needed to create the right environment for a successful personalised approach. Some key takeaways from our analysis can be found below:
- Despite the widespread aim of person-centred care, only a few plans dig deeper into the necessity of behavioural change, change management and advanced communication efforts.
- Few strategies consider the links across all technologies and how these can optimally be connected to inform better health decisioning.
- An integrated approach to personalised healthcare is often lacking, as human, financials and technology aspects are covered in different plans, reducing the impact of personalised healthcare and preventing people from seeing its full benefits.
I am a firm believer that there should be a systematic effort to connect the dots across existing or planned strategies and provide guidance on using these in a coordinated manner. The country I am coming from, the Netherlands, can share some good practices in this respect: we have examples of integrated diabetes care approaches, which connect all relevant care providers and with a single point of entry into the programs, provide a coordinated, multi-disciplinary approach and bundled payment for diabetes.
The integration of care pathways can unleash the potential of personalised health and care, and ensure that patients as well as the whole society can benefit from its value. I am committed to continue the discussion on the personalized healthcare building blocks and do hope that such conversation could inspire upcoming strategies from national or regional governments, as well as global and supra-national initiatives.
Dr. Nick Guldemond PhD DSc (med) is a member of the Building Blocks Expert Panel. He is a Senior Researcher at Leiden University Medical Center and a Visiting Professor at I.M. Sechenov First Moscow State Medical University.