The Shift from Reactive to Proactive Healthcare

November 14, 2019


Amir M

Proactive healthcare gives patients and clinicians earlier and easier access to critical health information that can be used to manage conditions before symptoms appear, crises occur, and the prognosis is poor.

Reactive healthcare leaves patients and clinicians waiting until after symptoms appear, crises occur, and the prognosis is already poor to take steps to manage conditions. Proactive healthcare applies consumer innovations like wearables, mobile apps and AI to enable early detection of risk factors and engage patients by giving them the tools they need to make lifestyle changes, reducing their risk of chronic illness.

Reactive healthcare leaves patients in the dark and reduces them to a passive role, unaware of what diseases they might be at highest risk for with no good way of accurately measuring what’s happening in their body, waiting for their health to get worse before taking steps to make it better. Proactive healthcare is about using data to look at the bigger picture, including factors like housing, income, and employment that play a large but under appreciated role in shaping health outcomes at the population level.

Reactive healthcare is about damage control that leaves care teams and medical systems treating illnesses on a case by case basis with little insight into the root causes.  

Unfortunately, healthcare today is still largely reactive.

You go to the doctor when you constantly feel tired and can’t figure out why. You rush to the emergency room when you feel a sharp pain in your chest. You reach for the Buckley’s when your nose starts to run. Symptoms appear, a crisis occurs, then we react. We’ve long known that this state of affairs is less than ideal. Since almost every disease is easiest to manage in its earliest stages, it’s far more effective to avert a health crisis than it is to react to one. An ounce of prevention is indeed worth a pound of cure.

But our ability to act more proactively is often thwarted by our lack of visibility into our own health. We don’t have the information we need to do better, and neither do our clinicians.

Did you know a third of Americans with diabetes don't know they have it? Or that 1 in 13 Americans suffer from a rare, undiagnosed condition? Or that 4 in 5 Canadians don’t get enough physical activity? Or that, according to some estimates, up to 75% of Americans don’t drink enough water?

Do you know if you’re drinking enough water or getting enough exercise? Or whether your genetic makeup and current biomarkers put you in the prediabetic range or at a heightened risk for various illnesses? Do you have hard data to support it? Would your doctor?

As digital software has continued eating the world, more and more useful healthcare data gets created by the day. But lots of that data is still not being collected, analyzed, shared, or otherwise put to good use. As ONC chief Don Rucker has argued while pushing for greater interoperability, “the inferable data about health is vastly larger outside of what is in electronic health records than what is in electronic health records.” Sometimes the information is still too hard, too costly, or too time-consuming to acquire. Sometimes it’s being captured, but then left to languish in a silo somewhere when it could be cross referenced with other patient data to produce valuable insights. Sometimes consumers don’t even know what’s possible. Almost always patients and their care teams are left relying on vague signals, subjective feelings and gut instincts, rather than evidence-based data on the state of their health.

But the shift to a more proactive approach is already underway.

With healthcare’s continued evolution towards more digital, value-based, and customer-centric delivery models, the signs of earlier and easier access to medical information are everywhere.

Increased use of wearables is one obvious example. According to Deloitte, “the number of consumers tracking their health data with wearables has more than doubled since 2013.” This matters because all that data can provide a quantitative window into patient health by measuring things like exercise and sleep patterns. Google paid $2.1 billion for Fitbit because all that data is valuable. And Singapore’s Health Promotion Board recently partnered with Fitbit to provide all their citizens with health trackers because wearables can help push individuals toward healthier behaviors. The anonymized data they collect can also provide a population level snapshot that the health system can use to refine its outreach programs.

Or look at the increased uptake in at-home testing. Thanks to genetic testing companies like 23andMe and AncestryDNA, “as many people purchased consumer DNA tests in 2018 as in all previous years combined,” according to the MIT Technology Review. Those tests can reveal genetic variants that indicate an increased risk for cancer, Parkinson’s, Alzheimer’s disease and other conditions. This empowers consumers to undertake preventive screenings and, if necessary, medical procedures or lifestyle interventions to reduce their risk factors.

Similarly, Modern Fertility is making it cheaper and easier for women to test their fertility, measuring reproductive-hormone levels with a simple finger-prick sample. Imaware™, an at-home blood-testing company we work with here at Blackcreek, uses a combination of capillary-blood testing, microarray testing and multiple biomarker analysis to help patients catch conditions like celiac disease and rheumatoid arthritis earlier, and track their progress over time.

And these are, of course, just a select few examples. The list of startups using big data and artificial intelligence to tackle a wide variety of healthcare challenges could go on for days. (Like this CB Insights infographic does.)

In all, McKinsey estimates that better leveraging big data could save the US healthcare system alone anywhere from $300 to $450 billion in the years ahead.

To be clear, a lot of work remains to be done to continue moving healthcare in the right direction. Concerns around privacy, efficacy and compliance always remain and meaningfully progress will be hard fought and certainly not made overnight.

But healthcare is slowly but surely becoming more proactive. Leading healthcare companies are making it more possible than ever to stay one step ahead of disease and more consumers are taking that step every day.