Imagine facing an infectious disease That it cannot be cured with medicine. Or you were finally diagnosed with a disease that explained all your symptoms, but it was too late to treat. How can medical practice change to address these challenges?
More than 100 Harvard faculty and leading practitioners from the Massachusetts General Brigham (MGB), the nation's largest hospital system-based research organization, gathered in late September to address the most urgent and demanding challenges in health care today. “What needs do we have that we don't have?” result? A list of 10 urgent priorities that shed light on the future of health care and the challenges ahead.
“This is a roadmap for the future,” said Jose Flores, a professor of clinical medicine at Jackson College. “It can inform discussions across the healthcare and investment ecosystem about where we should go.”
Among the 10 priorities: developing a more integrated understanding of the interconnectedness of human disease and chronic disease, and improving the accuracy of clinical data. and create better strategies to address and care for underserved and changing populations. These priorities were compiled from interviews with Harvard MGB clinicians, researchers, and faculty.
Three key themes emerged: difficulties in early disease detection, the growing threat of antibiotic resistance, and the complex needs of an aging population. Each reflects deeper questions about how health care is structured and where it needs to evolve to meet the challenges of modern medicine.
Breaking down silos with systems-level thinking
In medicine as practiced today, expertise is often divided into specialties such as cardiology, neurology, and oncology, each of which operates independently. Although specialization has led to remarkable advances in the treatment of specific diseases, it limits physicians' ability to address systemic problems.
“We are entering a new phase,” said HMS neurology professor Stephen Greenberg, a clinical neurologist and neuromuscular expert at Brigham and Women's Hospital. “It’s about systems integration, looking at how different parts of the body and different diseases are related. We no longer focus on just one organ or system. You can't.
To make progress, experts say, we need to reorganize medicine around the body's interconnected systems. For example, stress doesn't just affect your mental health. It also affects cardiovascular health and immune function. Solving these complex problems requires greater collaboration between disciplines that traditionally worked independently.
How data and technology are reshaping healthcare
In recent years, advances in data science and artificial intelligence have created new possibilities for understanding and treating diseases. General Brigham, for example, has built a massive biobank that combines clinical data with patients' genetic information.
But figuring out how to use this vast amount of data to improve care has proven difficult. “We need to leverage AI to segment patient populations and identify the most vulnerable and underrepresented patients,” Flores said. By more effectively analyzing data, such as within electronic health records, healthcare providers can personalize treatment and improve outcomes.
However, AI is not a panacea. If not carefully integrated, existing health care disparities may widen. Ensuring that these technologies benefit everyone, not just those with the most access to care, will be key to success.
enable early detection
Despite advances in medical technology, detecting diseases in their early stages remains a major challenge. Although certain cancers are now being diagnosed earlier, diseases such as Alzheimer's disease, pancreatic cancer, and neurodegenerative diseases often go unnoticed until they are too advanced to be treated effectively.
“We have been looking for more sensitive biomarkers for years,” said Jean-François Formella, partner at biotech investment firm Atlas Venture and member of the MGB Innovation Advisory Board. “We are not yet at the stage where we need to be.” Early detection remains one of the top priorities in medical research, as late diagnosis reduces treatment options and worsens outcomes.
The 'silent pandemic' of antibiotic resistance
While the world's attention is largely focused on the coronavirus pandemic, another “silent pandemic” is creeping in: antibiotic resistance. “By 2050, more people will die from antibiotic-resistant infections than from cancer,” warned Nicole Davis, a biomedical communications consultant who previously worked at the Broad Institute.
Overuse and misuse of antibiotics is accelerating the rise of resistant bacteria, said Francis Levy, professor of medicine and chief of pulmonary and critical care medicine at Brigham and Women's Hospital. Without new antibiotics and better diagnostic tools to identify resistant infections, routine surgeries and minor injuries could become deadly again.
Consideration for an aging society
An aging population poses even greater challenges to health systems. Levy said that by 2050, the number of adults 65 and older in the United States is expected to double. This demographic shift results in an increase in age-related diseases such as diabetes, heart disease, and dementia. These diseases often require multiple health issues to be managed simultaneously. After age 60, more than 95% of people live with at least one chronic disease. And 75% have at least two, Levy said.
But the challenges go beyond physical health. Mental health concerns, particularly depression and dementia, are on the rise among older adults but are often overlooked in health care plans. As the population ages, healthcare systems will also need to adapt. It not only meets the physical needs of elderly patients, but also addresses general health conditions.
“In geriatrics and medicine, we need to think more critically about endpoints and regulatory strategies,” said John Lepore, CEO and partner at Profound Therapeutics, who previously served as senior vice president and director. “We're seeing progress in that they're able to do that, and they're becoming a little more flexible in their thinking.” GlaxoSmithKline research results.
Aiming for precision medicine
As highlighted by Lepore, Florez, Formela, and colleagues, as healthcare moves toward precision medicine (tailoring treatments to an individual's genetic profile and creating more personalized treatment plans), cancer and rare There are increasing expectations for better results in the treatment of diseases such as genetic disorders.
The goal, Formella said, is to create a “Manhattan Project of data sharing,” where public data, private data, genetic data, longitudinal data, and other data are shared across an interconnected system of health and care. The idea is to make the data pool available. In this way, researchers, healthcare professionals, regulators, and systems can more effectively deliver care in the 10 areas identified by Harvard MGB faculty.
