Future of Healthcare – How can we build a healthy society?

There is a saying that the future is already here but not evenly distributed. Nowhere is this more apparent than in healthcare. In one part of the world, people are exposed to the latest advancement in science and discoveries in healthcare, and in another part of the world, people are deprived of basic health support. Within the same country, access to quality healthcare changes dramatically between geographic location and where a person is in society.

That is probably the biggest failure of our civilization. While we are making remarkable progress in spaces, equipping ourselves to see any corner of the world from our home by satellites, we have not solved how to provide clean water or basic medicines to billions on this earth. 

In this article, I will cover two areas. First, the key trends in healthcare innovation and second, future of healthcare in Bangladesh.

Innovations in healthcare are the holy grail. Making our body immune to diseases and old age will be the ultimate achievement of science. 

Here is what is happening in this area:

DNA editing: Most of the diseases can be traced back to our DNA. We have now achieved a breakthrough to edit DNA composition. While not perfected on the human body yet, once done, this technology will help us to cure most of the deadly diseases we know today - from cancer to other hereditary illnesses.

Artificial Intelligence/Machine learning: The use of AI will impact almost all areas of our lives. One such area is diagnostics. It is now a statistical fact that AI can read pathology reports and identify diseases better than doctors. The use of this capability will be much wider than what is now currently.

Doctor on your wrist: Getting healthcare data accurately and on time is critical for the delivery of healthcare. With the proliferation of IoT devices, we are getting closer to be in the Goldilocks zone, to collect important data when we need it and share it with the healthcare professionals.

The above list is just a glimpse of what is coming down the pipe. We are seeing an extraordinary proliferation of cross-discipline advances including robotic surgery (doctors based out of Europe using robots to perform surgeries in Africa) and implanted chips in human body to collect vital data 24*7.

So where do we stand in Bangladesh?

Before that, let me refer to a recent study by McKinsey about the impact of digital healthcare on the overall health ecosystem. The study revealed that in developing markets like India, 50% of primary care will move to consultation over phone by 2025. Electronic Health Records and use of machine intelligence will significantly improve evidence-based healthcare and reduce overall healthcare costs.

I believe a similar impact is possible in Bangladesh if we can build the ecosystem properly.

Bangladesh's healthcare challenge is more on public healthcare delivery. Our doctor to patient ratio is one of the lowest for primary care and more acute for specialists. Pharmacies are not equipped properly and adherence to medicine is still some way to go. To make things worse, non-communicable diseases (NCDs) like diabetes, cardio or kidney problems are becoming a major challenge in the public health space. While we made commendable progress in communicable diseases, we are yet to go a long way to address the NCD challenges.

The following trends that will have an impact on the healthcare landscape in Bangladesh in coming years:

Video/remote consultations: With the introduction of new bandwidths and decreasing cost of smartphones, we will see video consultations with doctors become mainstream. This trend is already becoming popular in developed markets of Europe and the USA. Bangladesh will follow the same arc. It will help to address one of the perennial issues of a low doctor/patient ratio as well as access to quality healthcare to remote parts of the country.

Improved primary care: We will see more integration of data in primary care. Many companies/startups are working on a low-cost solution for diagnostics and initial screenings. It will not be far when clinics at different corners of the country will have access to these low-cost options and collect proper diagnostics data. This, combined with remote consultation will materially improve primary healthcare quality.

Interoperability: Electronic Health record, coupled with interoperability technology, is important for proper patient experience across different touch-points. An electronic health record is important to implement evidence-based healthcare across different stages. However EHR, without proper interoperability, where different hospitals and clinics have access to patient's health records, will not bring much value.

Tertiary care: We do not have many well-equipped hospitals. The few we have are based in major cities like Dhaka and usually lack the capacity. I do not see this materially changing in the coming years. One of our biggest drags in improving overall healthcare will be a lack of specialist hospitals and providing access to those at a lower cost.

Health financing: The system that keeps the healthcare wheel moving is the financing around it. Different countries are pursuing different routes, from government-funded options like those in Europe to broadly private funded options like in the USA. Very little has happened in this space in Bangladesh, so far. Most of the primary clinics provide discounted service but for tertiary care, we need health financing options like mandatory health insurance, a national health insurance policy, etc..

We are sitting on a healthcare time bomb. Overall lifestyle, food habits, lack of qualified doctors all is contributing to a NCD nightmare that is waiting to happen. We need to build a healthcare system that is equipped to address this emerging issue. A strong private/public partnership and extensive use of technology to bring efficiency, improve access and customer experience is critical to make this happen. 

Sajid Rahman is founder and CEO of a digital health company serving millions in Bangladesh.