Moving from a cure-based system to a prevention-based one

According to the World Health Organisation (WHO) in 1948, prevention is “the range of measures aimed at preventing or reducing the number and seriousness of diseases, accidents or disabilities”.

There are three types of prevention:

  • Primary prevention: is the range of actions directed towards decreasing the incidence of a disease in a population and to reducing, as far as possible, the risk of new cases emerging.
  • Secondary prevention: seeks to reduce the prevalence of a disease in a population. This stage covers action designed to take effect when the disease or disorder first appears in order to arrest its development or to eliminate any risk factors.
  • Tertiary prevention: comes in when it is important to reduce the prevalence of chronic conditions and recurrences in a population and to reduce complications, disabilities and relapses caused by the disease.

In 2012, only 2.4% of healthcare expenditure in France was for prevention initiatives, which demonstrates that even now our healthcare system still prefers to take a curative approach to care. However, increasing interest is being shown in prevention initiatives and countries in which the healthcare system is less robust than ours are paving the way in this regard. Digital technology is one of the building blocks of moving from a curative model to a preventative one.

Key figures:

  • 88.5% of healthcare expenditure in France in 2012 was for the treatment of patients.
  • 2.4% of healthcare expenditure was spent on prevention in 2012.
  • The personalised treatment and monitoring available using mobile technology would make it possible for that technology alone to help 141 million patients to improve the pace of their lives and their lifestyles.
  • 3.4 billion people worldwide will have smartphones and half of these will use mobile health apps by 2017.

   

Digital technology: the cornerstone for dissemination of prevention initiatives

Technological innovations change the context in which disease is prevented and treated. In many developing countries, electronic applications are already widely used in the field of healthcare.

PwC recently stated that mobile healthcare could save one million lives in Sub-Saharan Africa by 2017. In fact, mobile phone penetration is very high in this area. A mobile phone, an easily-used personal device is, therefore, a powerful tool for improving access to healthcare. All the more so since the countries concerned are vast and healthcare facilities are often located far away from the patients that need them most. Due to the range of services offered, the mobile phone is becoming the most effective way of accessing healthcare and public health information.

And so SMS messages are widely used by the Ministries of Health to inform people about how they should behave if an epidemic breaks out. They also help to improve treatment compliance, especially for patients receiving antiretroviral therapy, and make it easier to remind patients about appointments and when to take their medication.

Healthcare professionals use mobile phones as a working tool, and so there have been examples of dermatological diagnoses being made remotely on the basis of photos sent by SMS, or of epidemiological data being uploaded via mobile phone.

Orange Healthcare is strongly committed to helping the African healthcare systems to develop solutions that use the 600 million mobile phones in circulation on the continent to their best advantage.

In Cameroon, for instance, Orange customers have access to My Healthline, an anonymous SMS hotline they can use to ask a team of healthcare professionals questions on all their health concerns, and receive a personal response.

Mobile phones are also used in the fight against malaria in Kenya, Senegal, Burkina Faso, Ghana and Tanzania. A big pharmaceutical company can also monitor the side effects of their new vaccine in 40,000 children and confirm that this is a suitable treatment in Africa.

 

Big Data, personalised medicine and microinsurance: a digital turning point for health insurance

Preventative medicine strives for prevention rather than cure. For developed countries, this notion also has a cost implication, with the potential reduction in healthcare expenditure that prevention could help to generate.

But the real sea-change in this field involves innovative uses to which the data is put. The more data we have on behaviours, lifestyles and genetics, the easier it is to predict risk, in individual patients or in the population as a whole, and, therefore, to take preventative action. This technological advance in data analysis and data processing, also known as Big Data, opens up new ways of planning prevention measures and gives us access to ever more personalised, “bespoke” medicine.

These practices and this new vision of medicine reflect a real turning-point in the very idea of healthcare, from a multi-disciplinary perspective, in which the patient’s overall environment is taken into consideration and where prevention plays a significant role. This is going to change the professions and it will have a huge impact on mutual associations and insurance companies.

In fact, in the face of this hyper-personalisation, the question of the care offered by the insurance systems will be one of the major issues of the future. And even now, many insurance companies are developing connected healthcare devices to encourage their customers to adopt a preventative approach to their health. In this way, they are playing a new role; that of healthy lifestyle coach.

The field of insurance is also being revolutionised in Africa, where we are now seeing the spread of health microinsurance, taken out by mobile phone. Bima, a specialist in this sector, offers health insurance cover that is taken out directly from a mobile phone and paid for with daily micro-payments.

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Prevention terms

It is defined as the degree to which the behaviour of the patient matches the recommendations made by their therapist. Compliance covers actions and prescribed treatments but also the behaviours of those involved: taking incorrect doses, not taking the full course of medication, not renewing prescriptions.

Specifically, this covers all services that in any way involve health, which are continuously available via a mobile device connected to a network; the most popular of these with the general public are smartphones or, more recently, tablets. In other words, mHealth could also be called eHealth that is accessed via a mobile phone or tablet.

Personalised medicine consists of adjusting treatment to suit the characteristics of the patient and their illness. It means offering the right treatment to the right group of patients at the right time.

Means data sets that are so huge that they are difficult to work with using traditional database management or information management tools.

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