The Canadian Health Technology Assessment (HTA) agency CADTH released a "Horizon Scan" identifying health tech trends set to significantly impact Canada. These trends aim to leverage data, enhance clinical workflows, and promote accessible healthcare for all. With Canada's spot in the top 20 most innovative countries in the world, we can attempt to extrapolate the trends to what we can eventually expect on a global scale as well. Interestingly, half of these trends were directly related to diagnostics. Let's take a closer look at those.
Point-of-Care (PoC) Testing
Diagnostics anytime, anywhere. CADTH states that Point-of-Care (PoC) integration can relieve pressure on central labs and aid disease control. PoC tests can be done in various settings, even by patients at home, without specialized training. Since the pandemic has dramatically sped up the adoption and popularized PoC testing, there is intense demand for devices and testing workflows that can offer the services of a full molecular biology lab, even in remote and hostile conditions.
Molecular and Genomic Testing
According to CADTH, "The emergence of whole genome sequencing (or more commonly, sequencing of protein-coding regions) will be disruptive and transformative to the Canadian health care landscape." We at ambiom expect with great certainty this will eventually pertain to all other regions of the world. This is owing to sequencing dramatically increasing in speed, precision, and portability whilst significantly decreasing in price. According to CADTH, molecular and genomic testing has the potential to have a major impact on routinizing precision medicine in health care in Canada.
Moreover, in terms of diagnostics, CADTH highlights the importance of AI in medical imaging. The AI radiology tool XrAI, approved for use in Canada, utilizes deep learning to aid clinicians in interpreting chest X-rays. Recently, XrAI was deployed nationwide in Canada to confirm pneumonia and other respiratory symptoms linked to COVID-19.
Artificial Intelligence for Diagnostics and Public Health
CADTH recognizes that artificial intelligence (AI) has the potential to enhance disease surveillance, detection, and mitigation in public health. AI enables global analysis of complex, multi-sourced data, driving significant advancements in the field. Through the utilization of AI in health data collection, researchers can explore innovative approaches to evaluate the efficacy of public health interventions. This, in turn, can inform targeted health promotion initiatives and aid in forecasting disease incidence.
Long gone are the days of one-size-fits-all when it comes to approaching therapy. One of the hallmarks of the ongoing personalization of medicine is the emergence and development of companion diagnostics. CADTH explains that companion diagnostic tests assess predictive biomarkers in individuals, such as genetic variation or protein expression, to determine whether associated therapy is safe and effective to use.
It is important to highlight the growing need for pre-prescription diagnostics in various oncology therapies, including checkpoint inhibitors. This trend is expected to extend beyond oncology and encompass all therapeutic indications. Increasingly, companion diagnostics is based on molecular and genomic testing (see point 2).
Remote Diagnostics, Remote Monitoring, and Remote Care Management
Remote care refers to the delivery of care at a location and time that is convenient for all members within the circle of care. CADTH acknowledges that the widespread adoption of remote care technologies has the potential to revolutionize healthcare access in Canada. These technologies enable the diagnosis, monitoring, and management of patients, offering a transformative shift in how people receive healthcare services. Remote care technologies enhance healthcare access, particularly for rural areas, eliminating the need for extensive travel to access previously inaccessible specialty care.
Emerging tools for assessing "digital biomarkers" enable clinicians to monitor changes and diagnose conditions like Alzheimer's disease or dementia. These tools monitor hand and eye movements, as well as changes in speech. COVID-19 has had a tremendous impact on this trend on all levels. According to McKinsey & Company, telemedicine utilization has stabilized at 38x the pre-COVID-19 baseline. This significant increase has compelled payers to give greater consideration to reimbursing telemedical solutions.
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