{"id":76965,"date":"2020-09-10T13:37:17","date_gmt":"2020-09-10T13:37:17","guid":{"rendered":"https:\/\/www.alj.com\/?post_type=perspective&p=76965"},"modified":"2021-05-17T11:09:50","modified_gmt":"2021-05-17T11:09:50","slug":"investing-in-health-tech-and-digitizing-healthcare","status":"publish","type":"perspective","link":"https:\/\/alj.com\/en\/perspective\/investing-in-health-tech-and-digitizing-healthcare\/","title":{"rendered":"Investing in health-tech and digitizing healthcare"},"content":{"rendered":"

Health technology is transforming the way we can diagnose, treat and prevent disease, and has the potential to radically improve access to healthcare on a global scale.\u00a0 But technology alone is not the panacea in itself.\u00a0 It is only part of a larger ecosystem of innovators, investors, clinicians, governments, regulators and, of course, patients.\u00a0 To truly capitalize on the potential of healthcare technology; to improve outcomes for patients across the globe, requires new ways of collaborating, new models of service delivery and most crucially, new channels of investment.<\/em><\/p>\n

It is an interesting juxtaposition.\u00a0 We are living longer, more prosperous lives than ever before, with access to better housing, amenities, employment, education and healthcare facilities, as we become ever more urbanized.\u00a0 By 2050, the World Health Organization (WHO<\/a>) estimates that two-thirds of the global population will live in urban areas, driven mainly by increasing urbanization in Africa and Asia[1]<\/a>.<\/p>\n

Yet, these are the very factors that are putting more strain on our healthcare services.\u00a0 Our busier, more stressful lifestyles are affecting both our mental and physical health.\u00a0 According to WHO statistics[2]<\/a>, non-communicable diseases, which include diabetes, cancer, heart and lung diseases, are on the rise, accounting for 70% of deaths globally.\u00a0 It attributes the rise to factors such as poor diets, insufficient exercise, smoking, alcohol usage, the growing prevalence of mental health issues, and one of our biggest health threats, air pollution.\u00a0<\/p>\n

In fact, pollution has become the \u201cgreatest environmental risk to health\u201d, <\/em>says a WHO report, affecting nine out of ten people and killing an annual seven million people prematurely through non-communicable diseases.\u00a0 Between 2030 and 2050, climate change will lead to an additional 250,000 deaths every year, not just through pollution but also heat stress, diarrhea, malaria and malnutrition in the World\u2019s poorest countries[3]<\/a>.<\/p>\n

All these elements combined are putting increasing pressure on our healthcare systems, with rising treatment costs and burgeoning time pressure on medical establishments and clinicians. \u00a0<\/p>\n

Cramming more and more people into towns and cities where healthcare infrastructures are already creaking also has an indirect impact on healthcare risks, not least of which is rise of \u2018zoonotic\u2019 diseases \u2013 diseases which pass from animals to humans.\u00a0 Fresh in our minds, COVID-19, which continues to contribute to thousands of deaths worldwide, is itself, a zoonotic disease, and although the most recent and most devastating example, it is a far from an unusual case.\u00a0 According to the National Institute of Health, zoonotic diseases account for 60% of known infectious diseases and 75% of emerging contagions.\u00a0 Notable examples include Ebola, bird flu (H5N1) and the world\u2019s biggest killer \u2013 malaria, which affects 500 million people and kills 2.7 million every year[4]<\/a>.\u00a0<\/p>\n

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Health technology \u2013 the new game changer<\/h2>\n

The on-going battle against both communicable and non-communicable diseases, with few notable successes, demonstrates our patchy track record in stemming the tide of such global health threats.\u00a0 However, artificial intelligence (AI) driven advances in healthcare technology could be about to herald a new era in the fight against illness and disease, opening up new pathways to access high quality healthcare for those that most need it.<\/p>\n

The WHO defines \u2018health technology\u2019 as the \u201capplication of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives.\u201d<\/em>[5]<\/strong><\/em><\/a>\u00a0 <\/em>In other words, it involves a highly complex combination of different stakeholders and regulatory factors which, suggests global consulting firm McKinsey & Company, is perhaps why the healthcare industry currently falls behind other sectors in the pace of digital transformation.<\/p>\n

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Leading the way are AI and machine learning, which can turn vast amounts of patient health data into refined insights for treating, preventing and even predicting diseases[6]<\/a>.\u00a0 Programmed with a complex set of \u2018what-if\u2019 rules-based scenarios, AI can collate and organize global health data at a speed that was previously impossible.\u00a0 Through the results that emerge, clinicians can come to understand recurring patterns and develop treatment models based on specific patient attributes[7]<\/a>.<\/p>\n

There are already numerous relatively simple examples of how AI is being applied within the health industry.<\/p>\n

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Photocredit \u00a9 Empatica<\/figcaption><\/figure>\n

A smartwatch produced by Empatica and approved by the US Food and Drug Administration (FDA), for example, uses AI algorithms to measure temperature data and alert the wearer of infection before any symptoms are felt, which could potentially help in detecting early-stage viruses like COVID-19[8]<\/a>.<\/p>\n

IBM\u2019s Watson Health system combines human expertise with augmented intelligence to help health professionals and researchers build their knowledge and provide better care across hundreds of hospitals globally[9]<\/a>.<\/p>\n

For diabetes sufferers, for example, Watson Health can predict alterations in glucose levels up to three hours in advance of the onset. \u00a0And in the oncology field, its intelligent systems can analyze tens of millions of data points in just seconds and identify 300 alternative therapies for at least 12 cancer types, accounting for 80% of the global cancer incidences[10]<\/a>.<\/p>\n

Google\u2019s DeepMind AI platform is also supporting clinicians in providing improved patient outcomes[11]<\/a>.\u00a0 It has developed a technology for the early diagnosis of acute kidney injury which affects one in five hospital patients in the UK and US.\u00a0 In the UK alone, the condition costs hospitals more than US$ 1.2 billion every year[12]<\/a>.<\/p>\n

Another area where AI is already making a difference is in improving care for the elderly, where robots are being used to converse and socially interact with patients.\u00a0 Long periods in hospitals and care homes can be isolating, particularly for older patients. \u00a0Robotic interaction helps them remain independent for longer and reduces the need for hospitalization and care homes.\u00a0 This enhances their quality of life, helps to keep their minds sharp, and relieves the economic burden of healthcare systems within aging populations[13]<\/a>.<\/p>\n

Economics and personal health monitoring<\/h2>\n

The motivations for AI-driven healthcare lie as much in government economics as patient outcomes.\u00a0 In fact, the two are inextricable, as rising health issues place their own burden on government funds.\u00a0 Forbes estimates that by 2026, AI could yield annual savings of US$ 150 billion within the health sector and eventually address 20% of unmet clinical demand.\u00a0 By 2021, AI investment is expected to reach US$ 6.6 billion.<\/p>\n

The UK government alone has invested around US$ 306 million in a \u2018National Artificial Intelligence Lab\u2019 (NHSX<\/a>) to digitize its National Health Service (NHS).\u00a0 It is aimed at reducing 30 million outpatient appointments, saving more than US$ 1.2 billion that can be reinvested in front line care, and saving patients what is describes as unnecessary hospital journeys[14]<\/a>.<\/p>\n

AI-driven wearable technology is seen as another way of significantly reducing hospital visits and the growing time burden faced by clinicians.[15]<\/a>\u00a0 Allowing users to monitor their own health, exercise levels and sleep patterns, they can ultimately take a preventative rather than treatment approach to healthcare.\u00a0 On a broader scale, wearables give medical insurance companies a barometer through which they can now offer personalized cost packages to their customers, and incentives which will potentially lead to the behavioral change of policy holders[16]<\/a>. \u00a0Wearables also offer employers a way to vastly improve their productivity (lost work time through sickness can cost economies billions of dollars)[17]<\/a>.<\/p>\n

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Research by Business Insider<\/em> magazine in the US found that more than 80% of consumers are open to using a wearable.\u00a0 From the original fitness tracking devices that link up to smartphone apps, wearables have progressed into smart health watches that measure heart rhythms, ECG monitors that can measure an electrocardiogram and detect atrial fibrillation (irregular heartbeat and breath), and blood pressure monitors that can store, track and share data with physicians, gain insights into the wearer\u2019s personal habits and trigger behavioral change.\u00a0<\/p>\n

Research suggests that the health and fitness wearables market will continue to grow.\u00a0 Over the past four years, the market has more than tripled in the US alone and is predicted grow at an annual 10% to surpass 120 million users by 2023[18]<\/a>.\u00a0 This represents more than a third of the country\u2019s 330 million population.<\/p>\n

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Along with wearables, another trend is towards developing smaller devices to make diagnostics more available and accessible.\u00a0 One example is a handheld device which uses 9,000 sensors to perform ultrasound procedures \u2013 without the harmful radiation implications associated with traditional ultrasound machines.\u00a0 It is also thought to be a way of providing affordable diagnosis to the two-thirds of the world\u2019s population with no access to ultrasound technology [19]<\/a>.\u00a0<\/p>\n

Leveraging the latest advances in AI technology to increase the availability and accessibility of effective diagnostic devices is a priority for healthcare providers, governments and NGOs, for both infectious and non-infectious conditions.\u00a0 Diagnostics influence around 70% of healthcare decisions, yet diagnostic tests currently make up only 3% to 5% of healthcare spending[20]<\/sup><\/a>.<\/sup>\u00a0 Improving access to blood glucose measurements, for example, could help to improve diabetes detection among the 50% of people in low- and middle-income countries who do not know they have it, giving millions the chance of better treatment and improved long-term outcomes.<\/p>\n

For private investors, the current pace of innovation in healthcare technology promises the opportunity to capture real growth value.\u00a0 Google and Apple are two of the most well knownamong a plethora of companies that have invested in some of the latest wearable innovations.\u00a0 According to Forbes, 2019 saw billions of dollars invested into more than 100 digital health companies[21]<\/a>.\u00a0 Notable examples include Google\u2019s acquisition of fitness tracking wearable, Fitbit, and Amazon\u2019s purchase of Health Navigator, which uses big data analytical techniques to provide health coaching[22]<\/a>.\u00a0 Healthcare giant Optum has also expanded its offering of patient self-monitoring devices by acquiring Vivify Health, a cloud-based platform through which clinicians can provide remote care[23]<\/a>.<\/p>\n

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Virtual health<\/h2>\n

Equally, the possibilities of virtual health are expanding \u2013 where patients and clinicians can have \u2018virtual\u2019 consultations, in real-time, and from almost any location.\u00a0 In the US, virtual health or \u2018telemedicine\u2019 services are forecast to increase 16.8% between 2017 and 2023[24]<\/a>. \u00a0<\/p>\n

Through virtual health, clinicians can provide care and support at the time and location that best suits the patient \u2013 particularly where there are physical challenges in distance and accessibility to healthcare provision[25]<\/a>.\u00a0 The potential of virtual health is further driven by the data individual patients can collect and share with their clinicians through wearable technologies.\u00a0<\/p>\n

Clinical virtual health trials are already taking place all over the world, with participants never needing to leave their homes.\u00a0 Researchers from the Stanford University School of Medicine studied 400,000 people on how smart watches can safely identify \u2018atrial fibrillation\u2019 heart rate irregularities.\u00a0 Around 33 million people worldwide have the condition and up to 30% of cases go undiagnosed until life-threatening complications arise[26]<\/a>. \u00a0In the study, 80% of participants who received irregular pulse notifications through their smart watch were found to have atrial fibrillation. \u00a0Of these, 57% sought medical attention[27]<\/a>.<\/p>\n

Investing in possibilities<\/h2>\n

The Jameel family have long recognized the need to invest in healthcare as one of the key building blocks of the infrastructure of life<\/em>.\u00a0 Indeed, the late founder of today\u2019s diversified businesses and global family philanthropy was a founding member of a number of health-oriented initiatives in Saudi Arabia and across the region, including the Abdul Latif Jameel Hospital<\/a> for Medical Rehabilitation, established in 1995, the first non-profit rehabilitation hospital in Saudi Arabia, providing comprehensive care for adults and children.<\/p>\n

In 2018, the Abdul Latif Jameel Clinic for Machine Learning in Health, or \u2018Jameel Clinic\u2019 (J-Clinic<\/a>), based at Massachusetts Institute of Technology (MIT) was co-founded by Community Jameel<\/a>, and \u2013 as part of its mission \u2013 is today at the forefront of research into healthcare technology, with a focus on using AI to model biological data across modalities such as imaging, text and genomics, and making new discoveries in machine learning, biology, chemistry and clinical sciences[28]<\/a>.\u00a0<\/p>\n

Within the context of the current pandemic, for example, Jameel Clinic researchers successfully used AI to produce data-driven models to yield accurate predictions of how infection rates evolve, based on peoples\u2019 movement patterns and congregation behaviors[29]<\/a>.<\/p>\n

The Jameel Clinic also conducted a study to \u2018predict\u2019 if an individual was over-tired, rundown or stressed, thereby increasing their likelihood of falling ill, based on data collected from wearable sensors and smartwatches[30]<\/a>.\u00a0 The team plan to roll-out their research to look at viral infections, such as SARS-CoV-2, the virus that causes COVID-19[31]<\/a>.\u00a0<\/p>\n

In February 2020, another spectacular success for Jameel Clinic was the AI-based identification of a powerful new antibiotic compound<\/a>, Halcin. \u00a0The molecule picked out by the model \u2013 screened from more than a hundred million chemical compounds in a matter of days \u2013 was predicted to have strong antibacterial activity and a chemical structure different from any existing antibiotics. \u00a0Using a different machine-learning model, the researchers also showed that this molecule would likely have low toxicity to human cells.<\/p>\n

Another Community Jameel co-founded lab, the Abdul Latif Jameel Institute for Disease and Emergency Analytics, or \u2018Jameel Institute\u2019 (J-IDEA)<\/a> based at Imperial College London, is using data analytics to identify, map and prioritize preventable communicable disease risk and public health worldwide[32]<\/a>. \u00a0<\/p>\n

Out of the lab, into the community<\/h2>\n

It\u2019s not only a question of investing in R&D to develop new innovations and technologies, however.\u00a0 To make a lasting, sustainable improvement in healthcare means getting the technology out of the labs and out into the field to address the issues of access to healthcare and health-tech in the World\u2019s developing regions where it is sorely needed.\u00a0 That\u2019s why Abdul Latif Jameel is also partnering with leading health tech companies across the globe, with the aim of strengthening healthcare accessibility.<\/p>\n

In 2017, it partnered with Japanese health tech innovators Cyberdyne<\/a>, which specializes in pioneering spinal injury rehabilitation technology using robotic exoskeletons, in a first to bring this cutting edge technology to Saudi Arabia.\u00a0 The partnership was extended in 2019<\/a>, with the aim of rolling out Cyberdyne\u2019s Hybrid Assistive Limb (HAL\u00ae<\/sup>) technology across the Gulf region[33]<\/a> and establishing the Abdul Latif Jameel Hospital as a regional training center.<\/p>\n