We know that global trends are changing clinical and preventive health care, research and development, workforce development and education.

I encourage those of us in international collaborative health to discuss some of the unintended side effects we’ll encounter as our field grows more connected and complex. Here are some thoughts to get the conversation going:

Aging Populations
Aging is a triumph of development and globalization. People are living longer, thanks to better health care, nutrition, sanitation, education and economic stability. As a result, the number of people older than 65 has increased to more than 656 million, or 11.5 percent of the total global population. By 2020, there will be more elderly people than children worldwide, according to the U.S. National Institute on Aging. Given the unprecedented growth of older populations, there will be an increased challenge to create affordable, in-home care options for the elderly in both developed and developing countries.

Cybersecurity and Privacy
Organizations are collecting more and more data and information across the health care ecosystem. This raises questions about the reliability of these data, issues of ownership and responsibility for the confidentiality of this information. There will be huge concerns to ensure data stays safe, accurate and reliable.

Credentialing
There is no standardized worldwide system for credentialing, licensing and education in health care. Within the United States and other countries, requirements vary between states and territories for acquiring and maintaining licenses. This lack of standardization already complicates our industry in terms of in-person practice, but we will continue to see credentialing challenges as telemedicine and remote second opinions become more integrated into diagnosis and treatment. Is the person on the other side of the screen qualified to give medical advice? And by what standards is he or she qualified?

Clinical and Leadership Shortages
Already there are severe worldwide shortages across a number of clinical and leadership areas in health care. The shortages are intensified by political and economic instability and individuals who choose to emigrate for more professional opportunities or greater personal freedoms. People everywhere deserve access to excellent medical treatments close to home. It becomes difficult, however, to deliver quality care in communities that lack skilled health leaders and professionals.

Investment Costs
Global health care spending is projected to reach $8.7 trillion by 2020, which will be 10.5 percent of the global economy. Of all U.S. academic medical centers, Johns Hopkins is fortunate to receive the most funding from the National Institutes of Health, the largest biomedical research agency in the world. We are also No. 1 in the amount of government research and development funding we receive—$2.46 billion—not to mention private philanthropy.

There is great promise behind the research our institution and many others are doing to advance immunotherapy, precision medicine and telehealth. But these innovations won’t make it through the research phase and into our everyday lives unless we continue to invest.

What challenges do you foresee in the future of international collaborative health?

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