Written by James Coker | Reporter, European Medical Journal | @EMJJamesCoker
There is no doubt that 2017 was a year filled with fantastic advancements in research and innovations in healthcare, with individuals, private companies, and renowned healthcare institutions and organisations alike driving change and solutions that have and will improve the lives of millions of patients worldwide. Here at the EMJ we cannot wait to find and report on more of these in the coming year. There are so many to choose from, but here we have compiled a list of what we expect will be the 10 most pertinent areas in health during 2018. Please don’t hesitate to get in touch if you think we have missed any!
1. Cost of Healthcare
The goal of providing universal healthcare, often through socially-funded models such as the NHS in the UK, raises the issue of affordability, particularly in the context of rising and increasingly ageing populations in the Western world. Could digital technologies and artificial intelligence ease the burden? Or do we need a fundamental rethink of the way healthcare systems are organised and financed? Long-term solutions are required, and we believe that fundamental breakthroughs could be made in 2018.
2. Prevention Measures for Lifestyle-Related Diseases
Lifestyle-related conditions, such as Type 2 diabetes, liver failure, and cardiovascular disease, are a major burden on healthcare systems around the world,1 and increasing in prevalence.2There is likely to be a continued strong emphasis on promoting healthy living among the general public by governments and healthcare providers, and possibly major policy announcements, with initiatives such as minimum pricing for alcohol being brought in by some authorities in 2017.3 Could further policies be made this year?
3. Ageing Populations
With an increasing proportion of elderly people, particularly in the Western world, there are an increased number of age-related conditions that require treatment, including cancer, dementia, and musculoskeletal diseases. Leading on from this, there are also more people who require assistance with general daily living. While it is certainly great news that so many people are living well into old age, strategies need to be put in place for health services to cope with this trend. With many ideas and solutions proposed recently from various prominent organisations involved in healthcare,4 we look forward to seeing some of these begin to bear fruit, as well as witnessing the advent of fresh ideas and proposals. Additionally, we expect to see much more exciting research throughout the year on conditions linked to old age.
4. Patient Engagement
Taking into account the experiences of patients, and a greater emphasis on dual decision-making between patients and doctors when deciding upon treatment strategies, has been a major topic of interest recently, and this was never more so than at The Economist’s War on Cancer event in November, reported upon by the EMJ. Physicians and healthcare providers need to be able to make use of the huge amount real-world and big data available to them to tackle the issues most pertinent to patients. There are many aspects to this that need to be changed, such as the lack of time doctors are afforded in consultations, preventing them becoming fully immersed in the needs of patients, and quality of life measures generally not being measured during clinical trials. We hope to see further progress made in these aspects through the year.
5. Self-Management Technologies
There has been an exponential rise in innovative patient self-management technologies during recent years, which have had a significant impact on the lives of many patients. These range from devices to manage specific ailments to helping patients organise their treatment schedules, and we look forward to seeing even more of these technologies developed in 2018. Additionally, a subtopic to emerge from this has been how such innovations can be used in tandem with general medications and remedies, and complement the care given through the traditional patient–doctor paradigm. Last year, the EMJ spoke to two experts about these topics, and we hope to see this sector develop in conjunction with more conventional therapies this year.
6. Artificial Intelligence and Robotics
There is little doubt that artificial intelligence is transforming healthcare in many areas, and none more so than in surgery, radiology, and other complex procedures. These can substantially reduce the time and costs of providing healthcare. We cannot wait to see what new innovations will be seen along these lines in 2018! Another pertinent issue is whether the cost of such technologies can be lowered and made available to poorer regions around the world.
7. Improving Adherence
The issue of patients not taking the medications prescribed by their doctors correctly, or not at all, is one that healthcare professionals are becoming increasingly aware of, and can lead to devastating consequences. An increased emphasis on educating patients about following treatment programmes and establishing higher levels of trust between doctors and their patients is essential for making improvements in these respects. The EMJ looked at this issue in an article published in September last year, and we hope to see an even greater progress being made in the coming 12 months.
8. Data Sharing and Cybersecurity
The use of digital technologies has grown exponentially in healthcare, from the records held of patients by hospitals to the data patients upload about themselves via apps and other online tools. Despite the enormous benefits this brings, there are also the problems that emerge surrounding cybercrime and, in particular, the ability to keep highly sensitive and confidential data safe. Healthcare is now one of the most targeted sectors for this type of activity, partly due to the typically weaker security systems that are in place.5 Healthcare systems therefore must develop stronger defence mechanisms, and patients who record sensitive data about themselves need to be better educated about how to keep their information safe. There are likely to be advancements in this area in 2018.
9. Integrated Care
Over recent years there has been a trend towards health systems attempting to integrate their services, particularly for those patients that have complex and long-term conditions that contain a number of facets. A co-ordinated approach between various areas, such as physical and mental health, and health and social care, as well as between different care providers, is essential to reduce fragmentation and pressures on certain parts of the health service. A major example of such an initiative is within the NHS’s Five Year Forward View plan, which began in 2014.6 This year should witness even more progress being made in this regard across major health systems, and we hope to see some significant benefits for patients.
10. Palliative Care
Patients with incurable conditions are able to live for longer than ever before, due to progress in medicine. Yet it is believed by many that there needs to be a greater emphasis on improving the quality of life of such patients, as well as simply prolonging their lives as long as possible. This has become a particularly pertinent subject in the context of ageing societies. Understanding that palliative care is about much more than end of life care, and also about enabling people to have fulfilling lives, as well as enabling patients to die with as much dignity as possible, is crucial to this. The EMJ discussed the issue of metastatic breast cancer in an article last year, and we look forward to seeing a big push in such areas in the coming year.
References
- Hughes D. Illnesses associated with lifestyle cost the NHS £11bn. 2016. Available at: http://www.bbc.co.uk/news/health-37451773. Last accessed: 10 January 2018.
- Health Movement. Chronic Diseases and Prevention. Available at: http://healthmovement.eu/service/the-project/. Last accessed: 10 January 2018.
- Johnson S. 2017. Minimum alcohol price introduced in Scotland on May 1. Available at: www.telegraph.co.uk/news/2017/11/21/minimum-alcohol-price-introduced-scotland-may-1/. Last accessed: 10 January 2018.
- World Health Organization. Organizing integrated health-care services to meet older people’s needs. 2017. Available at: http://www.who.int/ageing/health-systems/icope/icope-consultation/ICOPE-Global-Consultation-Background-Paper-1.pdf. Last accessed: 10 January 2018.
- Kinross J. Cybersecurity and healthcare: how safe are we? 2017. Available at: http://www.bmj.com/content/358/bmj.j3179. Last accessed: 10 January 2018.
- NHS England. NHS Five Year Forward View. 2017. Available at: https://www.england.nhs.uk/publication/nhs-five-year-forward-view/. Last accessed: 10 January 2018.
- PACE – Palliative Care for Older People in care and nursing homes in Europe. Available at: http://www.eupace.eu/. Last accessed: 10 January 2018.
