Shift focus from treatment to prevention

Preventing disease has never before been a realistic goal. We have never before
understood medical
conditions and their underlying causes like we do now. Complex phenomena like the biology of cancer or the causes of
diabetes have been documented for the first time in the past few decades by analyzing the ever growing amount of
medical data. But the general population has a hard time sifting through the tons of health advice to find reliable
advice on living a healthy life. Many are still unaware of well-understood, unhealthy habits like a mostly sedentary
lifestyle, the lack of exercise, or excessive alcohol consumption. Changing behavior has proven difficult. We just
need to look at how enduring smoking is in much of the world, even after it has been proven to be a strong
cancer-causing habit.

But prevention is finally achievable because of new wearables and other health sensors. Wearable,
ingestible, and digestible sensors stand to provide access to real time, high fidelity data on each individual’s
health, helping anyone understand their health. Even more important, this understanding has been shown to fuel
behavior change. Gamification can drive healthy habits – like how the Wellapets app changed asthma monitoring for
kids by making it a game instead of a chore.

We tend not to use the biggest resource in healthcare – the patients themselves.  Lucien
Engelen

However, for this technology to be truly transformative, it must mature. Quantified health
technology is still a fad that few can afford or take advantage of. Only 16% of US adults used some kind of wearable
in 2015, and only a fraction of this number use it in less developed countries. Part of the reason is price, but
prices are expected to drop over time. The bigger issue is that current technology only provides raw data, often
requiring a trained physician to understand and analyze.  As it is, wearables cannot drive decision making and
behavior change. About half of all FitBit users stop
using their device as they don’t find it useful enough. But there are promising signs that wearables will
grow into a transformative trend if it actively pushes users to live healthily. L’Oréal, for example, released a
wearable that alerts its user when exposure to unhealthy radiation from the Sun is too high.

To truly shift focus to prevention, regulators and employers must start subsidizing it at least as heavily
as they do treatment. Even simple preventive measures such as daily aspirin use, tobacco cessation
support and alcohol abuse screening can potentially save 2 million lives and nearly $4 billion annually. With
healthcare expenses predicted to grow unmanageable in many developed countries, as 395 million people will live to
be 80 worldwide by 2050, this will make prevention a primary area to invest in for health agencies. Today, being
proactive by using health sensors to generate more data is not rewarded in the healthcare system. A great example
for a country taking prevention seriously is Norway where the medical association is pressing the government to back
its proposal for a ban on tobacco sales to citizens born after the year 2000. Others could follow. Employers or
insurers could also save serious resources by subsidizing prevention and healthy living. Omada Health provides a
service to employers that helps employees live a healthy life, cutting diabetes-related health costs in half in just
2-3 years for the employer.

My mission as the Medical Futurist is making prevention popular by promoting the
idea of quantifying health. Millions of preventable deaths are caused by lifestyle choices such as tobacco smoking,
poor diet, and physical inactivity, and alcohol consumption. Having measured my health data like vital signs and
stress levels for over a decade has opened new possibilities in my life. I wish to make patients and physicians
aware of the possibilities; and push both innovators and regulators to make sure health trackers are accurate, using
them is rewarded and algorithms deliver quality information.