A woman in her 20s waits with other runners at the starting line of a 10K race. She’s excited and a little nervous. She also has diabetes. She feels fine, but she wants to check her blood sugar level. Instead of pricking her finger for a blood test, as she did for years, she waves a device about the size of a small box of raisins over a tiny round sensor on her upper arm.
Farther back in the crowd, a man in his mid-30s is racing with a new appreciation for the simple joy of good health. He recently had his genome sequenced and learned he does not carry the gene mutation for a serious disease that runs in his family.
A third runner, a 66-year-old woman, jogs in place to warm her muscles. She never used to run during flu season, but a new vaccine designed especially for people over 65 has her feeling confident and secure.
Scenarios like these are happening every day, thanks to advances in medical science and digital technology that are transforming health care and redefining what it means to be a patient. Instead of waiting until symptoms develop before going to the doctor’s office or the hospital, feeling overwhelmed, scared and under-informed, more people are taking charge of their own care. A new set of empowering tools is on the horizon. Health care increasingly is being integrated into people’s daily lives, offering more ways to proactively self-direct their health journeys. Innovations in everything from smart phone apps to clinical trials to immunotherapy have put the individual squarely at the center of the health care equation.
The Changing Face of Care
In an ongoing revolution touching every part of the system, people today have the tools and information access they need to be full partners in their own care. They routinely work with physicians, nurses, nutritionists and other providers to develop personal wellness plans to stay as fit and healthy as possible. When diagnosed with an illness, they can research their disorder, participate in decisions about treatment, remotely view test results and electronic medical records and track and report on their daily progress during recovery. They can even search clinical trials of new treatments to participate in at ClinicalTrials.gov.
People with chronic conditions, such as multiple sclerosis, are able to self-manage their daily regimens, including medications, on their own, often with support from online communities and the companies that discover and develop their treatments. Companies also are partnering with academic researchers to gather and analyze behavioral data from large populations to develop data-driven health care strategies. In an especially proactive effort, some healthy people have their genes tested to learn if they are at increased risk for certain cancers and other diseases. And continued advances in treatments using an individual’s own immune system to fight disease—known as immunotherapy—offer new hope to a broad spectrum of patients.
In scope and impact, the changes happening daily in health care are profoundly shaking up the old order. At Sanofi, a leader in global health care, innovation and change are a constant, driven by a single goal. “It all comes down to addressing patients’ unmet needs,” said Sanofi senior director Karen Chandross. “In addition to improving upon what we’re already doing—developing innovative treatments for patients—we’re also researching new technologies and developing new strategies for better outcomes.”
Tech Drives Better Health and Wellness
With a growing emphasis on wellness and prevention, today’s health care is as much about getting and staying healthy as it is about treating illness. And digital technologies, which make it easier and even fun to stay in shape, are playing an ever bigger and more important role. There are more than 165,000 health-related apps now available, and this year alone manufacturers worldwide will ship more than 100 million wearable devices, a number that’s climbed steadily for several years. The latest generation of devices may even provide the kind of health information once available only from a doctor’s office visit. They not only count steps and calories and record heart and respiratory rates; they also can compute a personal cardio fitness score, measure maximal oxygen consumption (called VO2 max) and track sleep patterns throughout the night.
Paired with apps, the devices can stream real-time data to smartphones, tablets and computers, letting doctors and other providers develop a more complete picture of an individual’s health behavior and lifestyle. The more popular devices have large online communities (the biggest, Fitbit, has more than 23 million active users) so people can share their health journeys and even compete in fitness challenges with family, friends and other like-minded individuals.
Mobile technologies also bring fresh new approaches to some enduring public health issues, among them smoking, alcohol abuse and obesity. More than one-third of U.S. adults are obese, with an estimated annual medical cost of $147 billion. Devices that track physical activity (and, by default, inactivity) make it easy to measure food intake and offer “unprecedented opportunities for innovation in obesity prevention and treatment,” according to a paper in Current Obesity Reports. “Through wearable and deployable sensors…behaviors can now be tracked ubiquitously and continuously, with little or no effort from the user.”
Digital technology also is changing the way researchers conduct clinical trials, the all-important pre-approval tests of new drugs on groups of volunteer patients. Companies today can recruit informed and engaged participants from online communities. Empowered patients can track their responses to medications on smartphones or other devices using software designed for their specific trial. Body temperature and other key data can be recorded with wearable sensors and transmitted remotely to researchers. Digital data management helps researchers spot patterns and anomalies, including adverse events, faster.
New Ways to Meet Daily Challenges
For many people, living a healthy life means managing a chronic condition, such as multiple sclerosis (MS), that requires daily attention. Patients must take medications as directed, watch what they eat, get the right amount of sleep, ration their energy and cope with occasional setbacks. It can require a lot of physical and mental effort.
The good news is, no one has to go through this kind of treatment regimen alone. Patient-centered digital communities provide personalized support and offer a forum to share information and personal experience. In 2012, Sanofi, the fifth largest pharmaceutical company in the world, and currently a producer of two MS drugs, created MS One to One, an online program open to all patients with multiple sclerosis. It offers 24/7 nurse hotlines, interactive tools for tracking symptoms, app reviews, patient stories, news about MS treatments and much more.
“MS is a very distinct and unique disease for every person who experiences it,” said Sanofi executive Christy Rossi, who oversees the company’s MS efforts in North America. “We talk about it as kind of like a fingerprint. No person’s experience of MS is going to be the same as another’s. And we try to bring that unique and customized approach to the way we deal with patients.”
Leah Bowling, now 30, was diagnosed with MS at 21. She has been part of the Sanofi MS One to One support program since being prescribed a Sanofi MS treatment. This program has provided support for her and her journey, and the follow-up, which continues for years, includes regular calls from Sanofi nurses, which makes Bowling feel far from alone. “They actually care about the patients that are taking their medications,” Bowling said.
Sanofi also is focusing on areas other than direct patient support. On the tech side, the company is using big data to better understand how people with chronic conditions deal with their medications. Taking the right amount of a drug at the right time is critical, and, incredibly, research shows approximately 50 percent of patients do not take their medications as prescribed. Working in partnership with the Duke University Clinical Research Institute and the Massachusetts General Hospital Center for Assessment Technology and Continuous Health, Sanofi is tracking and analyzing the behavior of thousands of people with Type 2 diabetes. The project’s goal is to find ways for people living with diabetes to engage more proactively with their treatment to improve medication adherence and outcomes.
The large-scale data and patient insights gathered will also play a role in drug development and clinical trial design. Digital technology has already improved the way Sanofi develops and tests vaccines. In the past, patient records and other paperwork for a single vaccine clinical trial could fill dozens of tractor trailers. Managing it all was as unwieldy as it was costly. “Today, we do dozens of clinical trials with hundreds of thousands of subjects around the world,” said John Shiver, global head of research and development for Sanofi's vaccine division. “And all of those records actually become opportunities for big data assessment. They help us identify trends that may not become apparent by more conventional means.”
The power of personalized care
One of the most promising health care shifts—with the potential to prevent or even cure cancer and other major diseases—is personalized medicine, which the American Medical Association describes as care “informed by each person’s unique clinical, genetic and environmental information.” Also referred to as precision medicine, it involves treatments and strategies tailored to the individual and is based in part on the ever-expanding knowledge of the workings of human genes. People already are making critical decisions about their health based on genetic profiles. While only five to ten percent of all cancers are believed to be caused by inherited gene mutations, for people who suspect they are at risk for one of these “family cancers,” knowledge is power. Some healthy women with a strong family history of breast cancer, for example, opt for surgery to remove their breasts after learning they carry one of the genetic mutations linked to the disease. It can be a difficult choice, but making it reduces their risk by 90 percent.
Patients today also benefit from a new generation of cancer drugs that target the genetic characteristics of the tumors themselves. Advanced diagnostic tests can identify people with the specific sub-types of cancer the drugs were designed to treat. Matching patients and drugs this way improves chances for success and helps avoid costly and ineffective therapy.
Immunotherapy, a form of personalized medicine that ramps up an individual’s natural defense system against disease, is an emerging area of research and development. One type of this technology involves altering the genes of certain blood cells. Another more widely-used approach is modeled on the action of natural antibodies that circulate in the blood and eradicate bacteria and other foreign bodies. Patients receive special lab-created “monoclonal” antibodies designed to attach themselves to specific disease-causing cells circulating in the blood. This then triggers the immune system to attack and destroy the targeted cells. The method has been effective against a variety of disorders, with fewer side effects than traditional treatments like chemotherapy. Sanofi is currently investigating 13 new monoclonal antibody drugs in various stages of development, including six potential cancer treatments.
Mapping a health journey to a better future
The transformative impact of breakthroughs in medical science and digital technology in just the last few years bodes well for the future. The pattern and pace of innovation show no signs of slowing down. As better wearable sensors are invented and more people strap them on to take control of their own health; as treatment options for major disorders increase; as data-driven decision-making becomes standard practice in clinical care; and as new genetic diagnostic tests and therapies are tested and approved, the world will become a healthier place and the global economic burden of disease will be reduced. And patients will remain at the center of it all. “These changes are really putting the power of management into the patients’ hands,” said Dr. Anne Beal, Sanofi’s chief patient officer. “And they need that power in order to achieve the best outcomes.”
IQVIA Institute for Human Data Science
Centers for Disease Control and Prevention
US National Library of Medicine
National Institutes of Health