There is a real sense that we are on the cusp of a diagnostics revolution. This has been spurred on by the pandemic, which at once underscored the tremendous power of mass testing as it became the fundamental basis for decision-making, from our own personal health to national policy. It also revealed gaps in terms of needing to drastically scale up testing capacity and invest in new and innovative digital diagnostics tools.
Innovation in diagnostics, however, is not just vital to advancing disease surveillance and early detection to help prevent the next pandemic. It will be the enabling tool towards a much more preventive and proactive approach to healthcare across the board, improving individual patient outcomes and the health and well-being of entire communities globally.
Why we need a preventive approach
Preventive healthcare represents a seismic shift in our approach to understanding and tackling disease, one that will be foundational to confronting many of the most pressing health challenges that we must address. Indeed, the biggest killers we face today are non-communicable diseases – responsible for 41 million and 71 percent of all deaths globally. That is far more than Covid’s highest peak and all infectious diseases combined.
These are illnesses such as cardiovascular and respiratory diseases, cancer, and diabetes, as well as genetic and lifestyle-related diseases, stemming from poor diets, smoking, and our growing sedentary lives. In virtually all cases, they are chronic – putting huge constraints on health systems and often resulting in early death – and are best treated through screening and early detection.
This is the pivotal role diagnostics will play, but not as it has mostly been known and used since these tools came into working practice. Blood tests, biopsies, and X-rays transformed medicine by allowing doctors and clinicians to look under the surface and better pinpoint the cause of a patient’s symptoms.
However, these tests are still mostly done after illnesses manifest and, in many cases, are already at an acute stage. The future of diagnostics will be pre-emptive. This means testing must be far more widespread, done in the pursuit of a more complete picture of health and to provide insight into the individual ailments and public health crises that may be coming down the track.
Embracing new digital diagnostics
Scaling up diagnostic testing to the levels required is not just about bringing more laboratories online, though this is still urgently needed. Investment is required in new digital technologies and upgrades to the informatics systems used to process and interpret the vast surge in data that will be created. Meanwhile, automating repetitive tasks will enhance laboratory efficiency and workflows, allowing laboratories to rapidly scale up capacity while improving diagnostic accuracy.
Laboratories also need to accelerate their move to the cloud, which will enable even more effective data management. This will help avoid the widespread industry problem of duplicate testing – estimated to be as much as 32 percent of all tests, 20 percent of which would not have been ordered if prior test results were known.
Moving to the cloud also makes it far easier for data sharing and collaboration across multi-disciplinary teams. The rise of new point-of-care testing infrastructure connected to the cloud also means tests no longer have to be done in a hospital but can be done from the office, the home, or really anywhere.
This not only drives a ubiquity of diagnostic testing but places it more deeply in communities, providing healthcare bodies and governments with a more real-time picture of public health to inform decision-making. An effective data management paves the way to unlocking the benefits of AI, which is already helping to generate event greater insights from results and identify meta-trends in diseases.
Creating a holistic picture of health
A preventive approach is also based on a more holistic understanding of health, looking at all the factors that influence it – both the obvious and more indirect. The scientific and medical community groups these into broad categories known as the ‘five determinants of health: genetics, behavior, social circumstances, environmental and physical influences, and medical care.
This means that in the realm of diagnostics, it will not just be pathology, radiology, and endoscopies that will help identify the causal factors behind diseases – though they will continue to be the first port of call. Indeed, the rapidly burgeoning field of genetics is already giving far greater insight into individuals’ predisposition to adverse drug reactions and hereditary illnesses, such as Huntington’s, Alzheimer’s and Parkinson’s, where treatment is best started early.
It also requires a mindset shift, as increasingly non-clinical diagnostic testing will be brought into the fold of healthcare. Fields such as toxicology, agriculture, and water quality testing will start to inform our understanding of the disease. For instance, research groups from Italy to Spain and the United States detected the SARS-CoV-2 virus in past samples of their wastewater supplies, some as far back as March 2019. This was long before Covid-19 showed up in clinical trials, giving hope that this could be used as an early detection signal.
Beyond this specific use case, our understanding of health will increasingly be about the water we drink, the food we eat, and the air we breathe. This will be the case as environmental and societal factors increasingly play an ever-more important and often deleterious role in health issues, especially non-communicable diseases.
The future of diagnostics, and the preventive health movement it serves, lies in harnessing the power of data. Technology and the digital transformation of laboratories and all our testing environments will be key to collating insights from all the touchpoints that make up our understanding of individual and public health. Putting the right tools in place now means we can realize this vision and the full potential of diagnostics to better fight disease.
About Michael Simpson
Michael is the CEO of CliniSys, a global provider of intelligent diagnostics informatics solutions supporting over 3,500 laboratories in over 30 countries, across healthcare, life sciences and public health. He served as CEO of Sunquest Information Systems until it merged with CliniSys in 2022. Previously, he founded Caradigm, a population health company population health analytics company dedicated to helping organizations improve care, reduce costs and manage risk. He has over 30 years’ of experience leading innovation projects and teams at the intersection of technology and health, including at Amazon Web Services, GE Healthcare and McKesson.