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Abraham Lincoln once said, “The most reliable way to predict the future is to create it.”

Every day, clinicians and researchers from Johns Hopkins are creating the future of health care. They are researching the roots of health and applying breakthrough discoveries to promote wellness and provide better treatments. At Johns Hopkins Medicine International, we are helping to share these advances with our affiliates around the world.

It’s an exciting time in international collaborative health, and my colleagues and I have been thinking a lot about what lies ahead. Because the point of this blog is to go on record about what will be next in our industry, we thought we would capture some of our predictions about big trends that will shape 2018.

Here’s my forecast:

Doctors have long believed the power to eliminate cancer and other deadly diseases exists within the immune system. However, the key information needed to turn this promise into reality was locked away inside the DNA of cells.

Researchers and clinicians worldwide, including at Johns Hopkins’ Kimmel Cancer Center, are using science to deliver what may be a universal treatment for diseases such as cancer.

Immune-based therapies reflect a different approach to such treatments. Instead of targeting cancer cells, for example, the new therapies target immune cells in and around cancers. Some treatments increase the number of immune cells sent to the site of a tumor, while others issue the commands that actually put these cells to work against it.

These types of immune therapies have had success alone, but perhaps their greatest power will come in combining them, and through precision medicine, using the biological clues that lie within each patient’s disease profile and genetic code to guide treatment.

Prediction: With more research, we will continue to unlock and realize the immune system’s full potential to fight diseases, particularly cancers.

Precision Medicine

Rising pressures to decrease health care costs globally are forcing a change from a “one-size-fits-all” approach to treatment and medication to personalized, outcome-based therapies.

The conventional method of treating patients has a low response rate and high costs due to the ineffectiveness of some treatments and medications, depending on each individual’s genetic makeup, health status and lifestyle.

This is where precision medicine will offer the promise of doing away with unnecessary treatment, minimizing adverse drug reactions, and ultimately maximizing the efficiency of entire health care systems. Precision medicine will harness Big Data to elevate preventive care for chronic disease management, alongside diagnosis and treatment.

Identifying the most beneficial personalized therapies will transform the patient experience. Eventually, we will make prevention, detection and treatment more precise and affordable.

Prediction: Precision medicine will become more common as we identify new therapies, and this will revolutionize the treatment of diseases such as cancer and boost survival rates.

Outcome Data
My colleague Karen Haller has written about how national and international accreditation gives patients peace of mind as they select a physician or hospital.

Accrediting agencies—as well as government organizations that report on quality—evaluate a variety of health outcomes, including safety of care, mortality, readmission, timeliness of care, and the overall patient experience. Health outcomes measure the link between treatments and results.

Like any product or service, health care is under scrutiny from savvy and cost-conscious consumers and organizations that purchase health services. Patients and payers are arming themselves with outcome data as they compare providers before making decisions about care.

For instance, cost and outcome data can help consumers make decisions on who they want to perform their care, in what setting and which procedures they want to undergo. It also can affect which hospitals or health systems commercial payers select to serve the patients they cover.

Additionally, these data can provide a better view of patients’ total health—allowing for better diagnoses, reduced medical errors, and more opportunities to expand preventive care and improve disease management.

Therefore, there is growing pressure in health care to provide data that demonstrate a hospital or health system provides high-quality, cost-effective care.

Prediction: The continued uncertainty the health care industry will face in 2018 will motivate organizations to demonstrate their value through data that points to positive patient experiences and outcomes following treatment.


Pamela Paulk

As president from 2015 to 2018, Pamela Paulk oversaw Johns Hopkins Medicine International’s enterprises, including developing sustainable international health collaborations with affiliates in nearly 20 countries and providing medical concierge services for thousands of international and out-of-state patients.

2 thoughts on “What Lies Ahead?”

  1. These predictions are all welcome, especially the third which speaks to quality of care. In low- and middle-income countries the latter is closely related to the extent to which frontline health workers are empowered to deliver the care for which they are trained. This includes improving the availability and use of healthcare information to guide decision making, as well as skills, equipment, systems support, medicines, incentives and communication facilities. A health worker *and* people centred approach is needed.

    Also, far more lives could be saved by timely intervention with existing treatments (many of which cost only a few cents) than by any intervention likely to be developed in the coming year, or even decade. I hope for a shift in 2018 towards greater emphasis on meeting the basic needs of frontline health workers.

    1. These are great points. It's a must to give health care staff at all levels the resources and encouragement to do what they do best -- for their own fulfillment, but also for our patients' health and wellbeing. Thank you for sharing, for reading and for adding to the conversation. All the best for 2018.

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