The future of personalised healthcareWritten by David Gray 20 May 2020
Will personalisation lead to unfettered proliferation or a more sustainable future?
Standardisation and complexity reduction have been at the heart of mass production techniques since the earliest days of the industrial revolution.
The lean manufacturing management philosophy, derived for the most part from The Toyota Production system, was designed to assist in the identification and steady elimination of waste to improve overall customer value. In healthcare, the ability to standardise and mass produce drugs such as Ibuprofen has been of immense value and utility to patients and healthcare professionals alike. Discovered in 1961 by Stewart Adams, a Boots employee, it is estimated that we now produce around 43,000 metric tonnes (36 billion daily doses) of Ibuprofen every year. Quite a legacy for a man who left school at 16 and began his career as a store apprentice, before being awarded a scholarship by Boots to study at University College, Nottingham.
The future of healthcare
Whilst Ibuprofen has undoubted benefits, it is not without its issues and falls far short of being an answer for all, even in the relatively narrow field of pain relief. As we learn more about human health it is becoming clearer that the twin bastions of traditional pharmaceutical and surgical intervention are increasingly less suited to a world more focused on wellness and wellbeing.
Nestlé Health Sciences, who focus on nutritional therapies, has for example, recently acquired Persona and the brand’s personalised vitamin pack program. Persona uses an online assessment to analyse 5 trillion possible combinations to create a customised supplement recommendation that can be delivered direct to your doorstep.
My own assessment suggested 7 different but complementary supplement products. That’s potentially a lot of domestic shipment packaging if the business really achieves scale.
How far can customisation go? DNA profiling is the process of determining an individual’s DNA characteristics, which are as unique as fingerprints. Might this point to a future of truly personalised, health and wellness programs covering every aspect of a person’s lifestyle, nutrition, medication and care? Will mass customisation be overtaken by genuine personalisation with all of the attendant complexities and potential negative impact on supply chain and the environment?
The organisation and monitoring of multiple medications or supplements and their diverse drug interactions and requirements (morning, night, with or without food) is complex. This could be revolutionised by the vast promise of 3D printing, the epitome of precision.
A 3D printed pill, unlike a traditionally manufactured capsule, can house multiple drugs or supplements at once, each with different release times. This so called ‘polypill’ concept has already been tested for patients with diabetes and is showing great promise. How long might it be before we can 3D print personalised medicines and supplements in hospitals, clinics and even at home? Recent breakthroughs in bioprinting and tissue engineering have seen the advent of printer technologies capable of creating human skin and replacement human organs from plasma and stem cells. The life-changing implications of this technology are endless.
What does future healthcare look like?
Gregory Unruh in his ‘Biosphere Rules’ series reminds us that the entire biosphere and the organisms that inhabit it are made from only a handful of elemental materials.
All organisms, including us, are expressions of a common underlying production platform that the biosphere leverages for massive scale, scope and information economies. Think of this in terms of human health and wellbeing. We are all made of the same elemental materials and human genetic diversity is substantially lower than many other species.
Could this apparent homogeneity point the way to the future discovery of a cure-all solution that will overturn the need for personalisation and its attendant complexity and make healthcare provision, simpler, more accessible and more sustainable for everyone?