July, 20208 HOWIS REVOLUTIONIZINGDIGITAL TECHNOLOGYIn 2018, the US spent $3.65 trillion, or 16.9 percent of its GDP on healthcare. Despite spending more than all other countries, it ranked 37th in WHO's ranking of overall health system performance. This discrepancy is as much an indictment of the inefficiencies of the US healthcare system, as a general warning that spending more may not mean getting better results. Singapore, which has one of the best healthcare systems globally, spends about 5 percent of its GDP on health. Needless to say, the growth in healthcare spending has been deemed to be unsustainable, with projections that this could triple by 2030.In the same year, the number of persons aged 65 or above outnumbered children under five globally for the first time in human history. Lower fertility rates and increased longevity means the number of seniors is expected to double to 25 percent by 2030 in Singapore.An ageing population increases healthcare demands, particularly long-term care for chronic and degenerative conditions. As healthcare spending outstrips economic growth, critical questions emerge around its sustainability, efficiency, and value. Advances in technology can disrupt healthcare delivery. Biotechnology has introduced new approaches to therapy, such as precision medicine, cell, and immune therapy and gene editing, giving doctors the potential to cure the "incurable", but it has also raised new benchmarks for medical spending. Data and AI will redefine how doctors make decisions, how patients make choices, as well as how healthcare is delivered and paid for. What is less understood is whether a system as complex as health, with its layers of competing stakeholders, bureaucracies and rising concerns about patient rights and confidentiality, is fully able to capitalize on the opportunities and avoid the pitfalls. We highlight a few areas where digital innovations can affect and potentially disrupt healthcare and health spending.Big Data in MedicinePrecision medicine accounts for a combination of genetic, lifestyle, and environmental factors to determine an individual's disease risk and treatment options. This ongoing revolution is driven by our capacity to generate and to make sense of more and more data. Stanford Medicine's Health Trends Report estimated that 2,314 exabytes of healthcare data will be produced by 2020, compared to 153 exabytes in 2013,driven by electronic medical records, wearable devices, and commercial DNA testing. Progress in analytics and machine learning have greatly improved what we can learn from these observational datasets, but implementation of precision medicine will be mired with policy, regulatory, funding and ethical considerations. Furthermore, the majority of the world's populations are underrepresented in the research necessary to bring precision into the clinic. There are initiatives by various global and national organizations to tackle some of these thorny issues, but we will continue to see a lag in wider adoption.BY BENJAMIN SEET, DEPUTY GROUP CEO, NATIONAL HEALTH GROUPBenjamin SeetDATA, DIAGNOSTICS, DRUGS & DOCTORSIN MY V EW
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