The future of healthcare is deep

I'm on my way to give a blood sample. It's not something I enjoy. At all. After a nasty experience with the removal of a cannula as a child, I've tried to avoid needles wherever possible. Though I grin and bear it and do my best to look brave for all my jabs in front of the kids.Just writing about it, I'm getting squeamish. I have a physical reaction where I don't even like the sensation of my fingers touching each other. I have to splay them out for a few seconds until it subsides. I'm doing this in between typing sentences.So if i hate it so much, why am I getting an entirely voluntary blood test?

Our Future Health

It's for a programme called Our Future Health. This is a private initiative running the UK's largest ever health research programme. The goal is to better understand some of the key diseases that blight our health - cancer, diabetes, heart disease etc - by screening huge numbers of people down to a genetic level. Its goal is to reach five million volunteers, and it has already crossed the 100,000 threshold.Right now some people are screaming at the screen. "Why are you giving your personal health data to a private company?" "What about privacy?" etc. These are all valid concerns and ones that I have weighed up, alongside my squeamishness, before I decided to volunteer. So why did I do it?Because I believe that our current models of healthcare are unsustainable. We need to radically reinvent the way we manage lifelong health if we are not to regress. What we need, is Deep Healthcare.

A Growing Problem

Most healthcare interventions today start with a symptom. That might lead us into an acute care pathway (if the symptom is that you just lopped your finger off with a chainsaw) or a chronic care pathway (if the symptom leads to tests and a bad diagnosis). Or a different type of pathway altogether - for example, prenatal care. The largest expenditure today in terms of treated conditions is mental health, including dementia.Exactly what we spend on health and care is somewhat hard to calculate. Each country breaks things down differently, and has different systems. Totting up all the chunks of central and local government spending along with private spending across sports, medicines, care and treatment is time consuming. People can debate what should (a packet of painkillers?) and should not (gym membership?) be included. What we can say is that government spending is typically over 10% of GDP and in some cases closer to 20%. Add in private spending and it's a very large number indeed.Not only is that number large, it's growing. In spite of - in fact, because of - many advances, we now live longer lives. Things that would have cut our lives short in the past can now be treated or at least their symptoms can be ameliorated. In developed economies, our populations are ageing and population growth is slowing. In the second half of the century, it will decline. This will undermine the economics of many healthcare systems and leave us with critical issues around staffing, unless we can find a new way to deal with disease. An approach that extends everyone's healthy, happy lives at a cost that we can afford to bear.

Deep Healthcare

The idea that prevention is better than cure is not new. The debate about shifting investment towards preventative measures has been raging for a long time, with much debate about whether it would actually save money, or whether we ought to do it anyway for other reasons (life improvement). For example, one preventative measure is screening: catch an illness early and its treatment can be both more effective and much cheaper. But screening can be expensive - potentially costing more than the savings from the early treatment. So is it right to direct a limited health budget towards screening when there are always other demands? This is where we get into utilitarian arguments about the value of life and units like 'qualys' - quality-adjusted life years.Deep Healthcare is what happens when these arguments intersect with one great pressure and an incoming trend.The pressure comes from our ageing population, as mentioned above. Not a new phenomenon globally but one that is going to become increasingly acute for a growing percentage of countries over the rest of this century.The trend is technological. In the next few years, our ability to screen for health issues, and create targeted programmes of treatment, will increase dramatically. It will be driven by multiple scientific and technological advances:

• The application of our growing understanding of genetics
• Low-cost, high resolution, connected sensors
• Rapid processing of vast data sets
• Machine learning systems that can extract and present answers
• Rich, personalised digital communications

Deep Healthcare is a lifelong approach to maintaining your good health. It will be based on your unique genetics and your environment, and be tailored throughout your life based on physiological monitoring. It should mean fewer trips to the doctors. It should mean fewer hospital visits and less chronic illness. It should mean people can be healthy and active later into their lives. And that those lives should be extended.

Signs To Look For

What signals might we see that Deep Healthcare is coming?One to watch for is increasing investment in public health campaigns. As government concern about ageing and persistent issues like obesity, you will see more information campaigns and more nudge measures like taxes to try to change population behaviour. Alcohol will be a likely target.You will see more rich sensing technology aimed at consumers. I've been talking about smart sensing toilets for years now, and sure enough, one of the biggest names in consumer health electronics launched something along those lines at CES this year. There will be more to come.And you'll see more experimental screening programmes like the one I'm taking part in, enriching our understanding at a population level and helping to finesse the maths of where screening money will be best spent.

Problems With Deep Healthcare

The challenge to Deep Healthcare programmes come from issues of privacy and liberty. In the US particularly, you're likely to see very negative reactions to a system that seeks to monitor you, and to government attempts to change our behaviour. There will be lots of problems around insurance. And difficult questions about where the data goes and who owns the value in it, if private companies are involved - as they are with Our Future Health.Nonetheless, I think this is the obvious direction of travel. There will be problems along the way. But we need a new approach, and I'm willing to support the experiment.