By Sanjiv Goyal with Ajay Gupta

The healthcare sector has a paradoxical relationship with technology. In some areas, medicine is racing ahead by introducing revolutionary new drugs and devices, while in others, it lags almost embarrassingly far behind. Surgeons can perform arthroscopic repairs through an inch long incision, but most doctors’ offices still rely on paper files and fax machines.

Where is the future of the healthcare industry headed? What can we count on to shift and what will remain the same? Where are the entrepreneurial opportunities for growth and innovation? I sat down with Ajay Gupta, Senior Partner at McKinsey & Co. and IIT Delhi alumnus, to answer these very questions.

Big Pharma: The Last Forty Years

To understand where healthcare trends are headed we have to look at their history. In terms of pharmaceutical advancements, the eighties produced breakthroughs in medicinal chemistry. In the nineties developments revolved around molecular agents. Now we are in the third wave of innovation that started in the early two-thousands: biologics.

The Next Trend in Big Pharma

While the first two waves involved synthetically derived products, today the top drugs are biologics, drugs derived from humans, animals, or microorganisms. The next frontier is cell and gene therapy and it will have sweeping implications for immunology and oncology.

These are areas you can expect to see massive growth in the next twenty years. The technology is multiplicative, meaning it builds on itself. Thus we will see even more innovation and change in the next two decades than we did in the past two.

The Healthcare Sector is Primed for Innovation

Where is there room for improvement and status quo disruption? here are the areas to monitor:

• Surgical advancements
• Miniaturization
• Materials science
• Medical devices
• Chronic disease management
• Gene therapy and CRISPR
• Adding an intelligence layer that supports clinical decisions through shared data systems
• Value-based reimbursement in the insurance sector
• Microbiome based personalized healthcare
• Evidence-based drug and procedure adoption

These are areas where even small scale improvements could provide massive benefit and minimize costs, thus changing the face of healthcare as we know it.

Health Care Game Changers Yet to Be Invented

For the entrepreneurial minds out there, here are a few problems that, if solved, could potentially shape the medical industry as much as vaccines or antibiotics:

• Finding a way to make colonoscopy a minimally invasive, less costly, or irrelevant procedure.
• Finding a substitute for bone tissue with the exact bone-like properties
• Building an intelligence layer of diagnostic AI to help doctors make clinical decisions.
• Building self-regulating devices to manage chronic disease.

The Problem With Primary Care

What else will change? Primary care. With a trend toward specialization in healthcare, primary care has become more of an administrative role. Primary care physicians have been relegated to gatekeeper status in a referral-based system. There’s an opportunity to completely reinvent this role, and companies and governments globally are innovating what primary care should be.

The Complex Economics that are Holding the Healthcare Industry Back

The role of insurance is one of healthcare’s biggest limiting factors because it complicates a basic economic model. A typical economic system is made up of producers and consumers; it’s a two-player system. There is a need, the consumer goes to the producer, money is exchanged, and the consumer goes home with the goods.

In the medical industry, what is normally a two-way transaction becomes a four-way transaction when you factor in the insurance company. A medical transaction usually involves the buyer, the provider, the person deciding what the buyer buys, and the person actually paying for the goods.

It’s easy to imagine how complicated purchasing something like a phone could get if there were this many moving parts. In the near future, there will be a push toward creating a better system that frees healthcare from the traps of the current economic incentives. How the role of insurance companies will shift remains to be seen and will be affected by future legislation.

Advice for Future Graduates and generations

These are all wonderful problems for the intellect to turn over and they are the challenges facing our young people today. The Pandemic has forced us to focus on global solutions to the problems that are facing us all, regardless of our industry, age, or country. The reality is that our youth will be tackling these issues throughout their lifetimes.

For anyone who is just graduating or at the start of their career, we offer this advice:

Now is the time to explore. Life is like rafting down a river; take every turn as it comes. You have the privilege of a great education. There is no need to feel worried or insecure. Choose the opportunity that is the most exciting to you and let the journey evolve from there. Take it from us, it will be a wild ride, either way, why not choose the most joyful and thrilling option?

Dream big. You never know where the most exciting choice will take you.

Conclusion

Our healthcare system is going to undergo revolutionary changes in the next twenty years. The advancements we make in the near future will dwarf those of the past. AI and Medtech will shape the face of the healthcare system as we know it. Policy changes around healthcare data sharing and economic incentives will be integral in creating a more efficient healthcare system. Primary care will be redefined and insurance is a wild card. We are all facing global issues caused by COVID 19. Let’s bring these questions to the great minds that can solve them. Our message to the 2020 grads from IIT and beyond: choose the path that is most interesting to you and enjoy the ride!

For more conversations like this or to watch the entire interview on youtube.