What if hospitals were paid to keep people healthy?

Global healthcare is at a crossroads. We are seeing unprecedented technological advancements with AI-based drug discovery, personalised cancer vaccines and machine learning tools that will assist with diagnosis and treatment management.

With these and other advancements, human lifespans are increasing – we are living 20 years longer than we did a century ago. The current average life expectancy is 78 years in the UAE and the proportion of those aged 65 years or older is set to rise from 9 per cent in 2020 to 23 per cent by 2100.

Then comes the bad news. We are sicker than ever.

Chronic disease is at an all-time high, with shocking projections ahead of us. The World Health Organisation predicts that by 2050, chronic diseases will account for 86 per cent of the 90 million deaths each year. Forty-four per cent of older adults are taking at least five medications regularly.

With the highest diabetes rates in the world, the Mena region suffers greatly from a steady stream of heart disease, obesity and strokes. The likelihood of dying from these diseases is 7 per cent higher in this region, compared to some other high-income countries. Sadly, doctors have little choice but to focus on mopping up after such a deluge of ill-health. They do a fantastic job with more advanced and robotic mops but who is turning off the tap?

Our current medical system is still stuck in the traditional fee-for-service reimbursement model in which hospitals and doctors get paid only when people are sick. This directs doctors in the region towards treating the consequences of these heavyweight diseases, instead of prioritising the promotion of healthy, illness-free years. Doctors are often frustrated at the feeling that this stream of illness keeps flowing faster and faster, but their tools only slow a patient’s decline.

Luckily, this arc can be redirected. Eighty per cent of premature heart attacks and strokes, and a whopping 90 per cent of diabetes cases can be prevented through lifestyle changes alone. In the Mena region, instead of the equivalent of the population of the entire UK – 67 million people – suffering from diabetes, we would have the equivalent of the population of Kyrgyzstan, that is 6.8 million. This can be achieved just by helping patients improve their diet, move more, quit smoking and sleep well.

The need of the hour is to bring technology and expertise in to better treat those affected. At the same time, we must identify high-risk patients and prevent them from getting sick in the first place.

So, what do doctors need? Better access to tools for personalised care, more emphasis on prevention, and encouraging the health system to incorporate the precision medicine technologies found in the private sector into traditional health care. Imagine if hospitals were paid to keep people healthy? What if they were able to incorporate technology to streamline care to get the right patient, the right treatment by the right doctor in an efficient way?

Advancements in precision medicine have changed the way we view the treatment of disease. Instead of a one-size-fits-all approach, precision medicine has made it possible to fine-tune treatments for highly individualised solutions. This brings a comprehensive and personal approach to health, taking into account environmental, socio-economic, psychological and biological determinants, and not merely the label of a specific disease.

With the progression of AI and machine learning, precision-medicine research can be fast-tracked for clinical applications. Machine learning algorithms can offer better diagnostic accuracy when compared to traditional methods. By identifying patients at higher risk, AI can help healthcare providers prioritise screening and prevention efforts. According to a 2020 report from McKinsey and Company consultants, the effective use of AI in healthcare could result in an annual savings of $300 billion in the US alone.

Preventive lifestyle medicine can change the game for current healthcare issues. Only a quarter of human longevity is attributed to one’s genetic makeup, with lifestyle and environmental factors being the big players that can transform one’s health status.

According to the WHO last year, a poor diet has been the leading driver of premature death and chronic disease globally. A wealth of evidence has demonstrated that a healthy, unprocessed diet consisting mostly of plants can provide numerous benefits such as a reduction in one’s risk for Type 2 diabetes, body mass index and waist circumference as well as improvement in one’s cardiometabolic profile such as blood cholesterol and blood sugar levels.

With advancements in precision nutrition, dietary recommendations can be further individualised to ensure that the foods one consumes are the best match for one’s taste buds, health and cultural preferences.

Other lifestyle interventions can also contribute to healthy longevity. Research has shown that exercise can positively target every hallmark of ageing. Regularly getting good-quality sleep has been associated with almost a 50 per cent lower risk of mortality.

Once the healthcare system encompasses lifestyle interventions on a prescription basis, chronic illnesses can be prevented, treated better and often reversed, which will reduce the global burden of disease and healthcare spending. For context, a 2020 study in the US found that lifestyle modifications to reduce haemoglobin A1c by 1 per cent can lead to a 13 per cent reduction in diabetes-related healthcare costs.

What excites me about the healthcare system now is the emphasis on full-spectrum care, from precision prevention to highly complex treatments, adopting a precision medicine approach that incorporates the newest technology and looks at simple solutions that empower people to take control of their own path toward healthy longevity.

Conferences such as the coming Department of Health sponsored Abu Dhabi Global Healthcare Week encourage knowledge sharing and facilitate open dialogue. The healthcare sector has a long way to go to reverse the damage and both build better mops and turn off the tap. Fortunately, with both the right leadership and resources we have all we need to achieve this.