6. Health

One of the most exciting trends in the field of healthcare is the development of individualised health. As a result of individualised health, along with technological developments, more and more health data are being generated. Collecting and analysing data will result in more efficient health services and promote preventive care. One major healthcare challenge is the aging population. Swedes are living longer, and the number of older people is increasing. Today the average life expectancy for men is almost 81 years and for women just over 84 years, and by 2028, the number of people aged 80 and older is expected to be 255,000 more than in 2018, an increase of 50 per cent.

Frida Lundmark, programme director, Vinnova.

For some time now, digital aids such as wearables (devices that are incorporated into clothing or can be worn on the body and can measure various health conditions through technology such as scanning or sensors) have enabled us to measure our own parameters and performance. Development of selftests has also made it easier and more common for people to learn about their genes and DNA. In the US, 12 million people have had their DNA analysed by companies such as 23andMe and AncestryDNA. In Japan, Nestlé launched a platform that provides customers with personal nutrition guidelines based on their dietary habits, DNA and blood test results. Users send photos of the food they eat to the service via an app, which assesses their susceptibility to common illnesses such as high blood pressure and diabetes based on DNA analysis and blood tests. They then receive personalised dietary counselling and specially formulated vitamin supplements. Another area that is driving developments in individualised health is the adoption of precision medicine. Precision medicine, also known as “individualised treatment" and “individualised medicine”, is based on the DNA of the individual and how genetic factors interact with environmental and lifestyle factors. In Swedish healthcare, major precision medicine initiatives are currently being implemented, such as Genomic Medicine Sweden, which will establish precision medicine in healthcare on a national level. Vinnova has contributed almost SEK 44 million to the initiative, which in total amounts to more than SEK 84 million. We talked to Frida Lundmark, who is project manager for the initiative at Vinnova, about developments in individualised health.

It’s a positive trend because it helps more people to gain insight into the state of their health and whether they are at risk of suffering from certain diseases, which enables them to monitor their health and act preventively to reduce the risk of becoming ill. Such information is complex and may be quite sensitive;

some people may not wish to know their results, which may also be difficult to interpret. For this reason, counselling and support need to be linked with the tests – both before, to ensure that individuals understand the implications of the results and have time to reflect and decide just how much they actually want to know, and afterwards, to provide an interpretation of the results along with appropriate counselling if needed.

Today, healthcare mainly involves helping people who are already sick. In many cases, it can take a long time to arrive at the correct diagnosis, which is stressful for the individual, while also costing considerable time and resources for the healthcare system. Precision medicine increases the ability to act preventively in the long term, thereby reducing the risk of becoming ill, while people who are already ill will receive the correct diagnosis faster, thereby facilitating correct treatment at an earlier stage. Hopefully, more patients will have a greater chance of receiving effective treatment, while saving time and resources for the healthcare system.

Precision medicine will mean major changes in how people work in healthcare. Vast quantities of data will be created, which in turn will require skills in data analysis and AI to build analytical models that can efficiently handle and analyse the data. Bioinformaticians will also be needed to interpret the data for doctors. I believe that skills in psychology, philosophy and ethics will become increasingly important for assessment of how data are to be handled. Examples include how to handle ethical issues and how to optimally present the information, based on the different circumstances of the individual. On a socio-economic level, health economics will become incredibly important in healthcare in the future, to be able to carry out health economic analyses of the effects of the implementation of precision medicine. In practical terms, it will be even more important to work closely in teams around the patient, to optimally leverage the specific skills and knowledge of each profession. Working in silos will not be appropriate; instead, a more teamwork-oriented approach encompassing all skills will be needed.