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Consider the simple home pregnancy test. Not long ago, a woman questioning whether she might be pregnant needed to go to a doctor’s office, then wait anxiously for days while a laboratory processed her sample and relayed the results back to her. Now, any pharmacy stocks an inexpensive kit that lets her find out at home, instantly and with complete privacy.
That difference reflects the social and technological upheaval occurring in the healthcare infrastructure. For centuries, as medicine’s dependence on specialized drugs and procedures grew, the responsibility for keeping individuals healthy drifted away from the individuals themselves and instead collected in physicians and the hospitals, pharmaceutical makers, insurers, policymakers and other partners supporting them. But now that balance of power is tipping back again, decentralizing that control and lending individuals greater governance over their own health.
Technological advances are driving part of that shift: the expanding shelf of over-the-counter tests, drugs and other tools gives today’s medical consumers more autonomy; physicians can perform tests for which they once needed outside laboratories; commercial labs can do what only research facilities could formerly do, and so on. But this transition also comes from the Internet’s role in lowering barriers to knowledge. Patients can turn to their physicians for information but also to online medical archives, consumer health Web sites, patient support groups and other sources. Data mining techniques sifting through medical databases around the world can find clues to better therapies, making truly personalized medicine a reality.
This publication helps to bring these changes into focus. If the healthcare enterprise is to be more effective at saving and improving lives, everyone with a hand in shaping it needs full awareness of the technological, administrative and financial possibilities that might affect outcomes.
Managing this reinvention intelligently is crucial because the health challenges are evolving along with global demographics. Millions of people are rising out of poverty and can finally afford better healthcare. As they do, however, populations that once succumbed while young to infectious diseases and other acute ailments are suddenly more likely to see old age and suffer from chronic illnesses, such as diabetes and Alzheimer’s disease. The world’s health services need to retool accordingly.
Moreover, as the expense of healthcare goes up, every cent spent needs to yield an acceptable return. Figuring out how to attain that level of cost-effectiveness is complex, and the demand for answerability that goes with it threatens to unbalance further the traditional status quo among physicians, drug makers, insurers, policymakers and the public.
Nevertheless, smart solutions are out there. Discussion and sharing information are the keys to finding them. Let the insights of the contributors on the following pages kick off the conversation.
Shifts in global demographics—including population, age and distribution of disease—are redefining health challenges and priorities.
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