How to Avoid the Looming Healthcare CrisisHow to Avoid the Looming Healthcare Crisis

FROM THE EDITORS

We know that healthy living and preventive medicine, including early and appropriate use of medical diagnostics, will reduce healthcare costs in the long run. Now we finally have a figure quantifying how much could be saved: more than $1 trillion.

The Milken Institute (Santa Monica, CA) analyzed what a reorientation of the healthcare system toward prevention could mean for seven chronic conditions: cancer, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions. Its study released in early October found that such efforts could prevent 40 million cases of those diseases by the year 2023, which would translate to reduced expenses and productivity gains of approximately $1.1 trillion.

Device companies can be part of the solution. At least one has reorganized its business model to try to do so. On October 1, GE held an event for press at its GE Global Research headquarters, where the firm does its basic science before handing it over to a business division for development in Niskayuna, NY.

What's going on is a ton of effort in what the firm calls “early health.” That is, developing new technologies that will enable people to become aware of potential conditions long before they ever start showing symptoms and will help clinicians better predict who will respond to which treatments. Note the following examples:

GE Global Research and Eli Lilly announced a three-year collaborative research agreement to develop advanced in vitro diagnostics assays that could predict whether a cancer patient will respond to a certain treatment. The agreement covers two Lilly drug compounds but could be used for other compounds later if the technology works. Success in developing such a diagnostic technology would not only prevent waste by forgoing a treatment that would be ineffective, but could also lead to a much more streamlined clinical research process. If the potential clinical trial population were screened beforehand for likelihood of response to a therapy, such a large patient population wouldn't be needed to prove effectiveness.

GE Global Research showed off a prototype of a handheld ultrasound system. The state of the art today is a system about the size of a laptop. The next step, which the firm believes is less than 10 years away, is to make the system into something about the size of an iPod. And that could revolutionize how ultrasound is used and how standard physical exams are conducted. If priced appropriately, a primary care physician could use it as a screening tool, as commonly as he or she uses a stethoscope.

A new modality called optical imaging is being developed to better detect exactly where cancerous tumors begin and end. This could allow surgeons to excise them more precisely, reducing the need for second surgeries. A proprietary die allows the exact boundaries of the tumor to be seen in the near-infrared spectrum.

GE is positioning itself to be a major player in the transformation of the practice of medicine. Now the challenge is to get policymakers, clinicians, and patients to rethink how healthcare should work. That means changing reimbursement to reward early detection instead of chronic care, being open to trying new methods of diagnosis and treatment, and taking responsibility for one's own health.

“Early health means a focus on prevention and prediction, detailed patient information, early diagnosis, and targeted therapies,” said Joe Hogan, CEO of GE Healthcare. “Only by understanding the molecular makeup of a patient can we understand what really ails [that person]. We have to change the way we've managed illness for the last 200 years.” It will be fascinating to see how this plays out.

Erik Swain for the Editors