Trends in Healthcare for 2024

Healthcare in the United States in 2024 will see many dramatic innovations driven by information technology and microelectronics, by the brilliance of neurological and biomolecular research, and by robust responses to the economic and demographic crisis plaguing hospitals.

Information Technology

The massive amount of investment in marketing of artificial intelligence (AI) products will begin to pay off in 2024. The Medtech Digital Innovation survey expects application of generative AI to automation of back-office functions, restructuring and streamlining of supply chains, and better compliance with the draconian regulatory regime that unfortunately is forecast to become even more burdensome.

Harnessing AI is predicted to speed up and improve interpretation of laboratory results, as well as automatically write out personalized recommendations for patient treatment (which, of course, will be reviewed and signed off on by a physician). Some see more use of synthetic data to train medical AI, instead of risking privacy problems with real patients.

AI will be further harnessed to interpret giant data sets and possibly help in early detection of diseases. This should lead to better accuracy in diagnostics and faster decision-making for doctors.

The Internet-of-Things (IoT) refers to the interconnection of devices and sensors to feed real-time data into complex networks and applications. In healthcare, we will see the Internet of Medical Things (IoMT) proliferate in the form of wearable devices and trackers hosted on both providers and patients. These will allow monitoring of a patient’s physical activity, continual gathering of real-time health data, improvement of a patient’s awareness of their own condition, and widespread application of continuous health assessment. IoMT in a sense will allow the commoditization of intensive-care patient monitoring.

Augmented and virtual reality also will continue to improve as crucial tools for treatment. Augmented reality allows surgeons to have useful images and crucial information superimposed on what they are seeing as they do their work. Virtual reality will allow for realistic simulations of surgical procedures, conversations and other interactions with patients, and run-throughs of complex medical scenarios.

These technologies originally were developed in the military. Virtual reality continues to be useful for treatment of mental health problems, including those associated with severe injuries, such as loss of limbs or mobility. The science-fiction movie Avatar featured advances of real treatments of paraplegics and other severely injured persons using virtual reality. New technologies such as the forthcoming Apple VR headset will further merge virtual reality with the real world.

We also may expect breakthroughs in bioprinting of organs. This is an extension of three-dimensional printing, except that instead of depositing ink or metallic-plastic compounds, the printer nozzle will spray out cellular structures that can host stem cells. This will make possible further advances in the ability to print livers, skin, or even hearts. Compared to organ transplants, if it can be made to work, this technology will use a patient’s own stem cells, so there will be no problem with organ rejection – a major challenge with today’s implants, which are harvested from recently deceased (and in some cases, living) humans.

For cybersecurity, the prediction for 2024 is easy: continue to expect constant attacks by hackers for purposes of sabotage, nation-state driven war-fighting, extortion, compromise of privacy, and identity theft.

In healthcare data centers, continue to expect constant (although incremental) improvements in data interoperability.

Neuroscience

According to some forecasts, the market for neuroscience in 2024 will be $35 billion. Part of that will be the proliferation of brain implants, which should be a $7.4 billion market in 2024, with a CAGR of 11 percent.

One important area of work is deep brain stimulation. Here the implants are microchips that feed little electrodes attached to a nerve system to deliver small surges of current. This technology will become more accepted as a treatment for symptoms of dystonia or involuntary muscle contraction, epilepsy, Parkinson’s or essential tremor.

Chronic pain is another important application. Spinal cord stimulation is another. Finally, Vegas nerve stimulation, which is aimed at the parasympathetic nervous system, can have a calming effect and influence body functions such as digestion, heart rate, and the immune system.

There also are prospects for these technologies to help with depression.

A more exciting area in neuroscience is the placing of microelectronic implants to interface directly between AI and the brain. In 2024 it is expected that AI implants that capture the electromagnetic signals of a paralyzed stroke patient will actually translate these signals into normal speech of 150 words per minute, and also control a digital avatar that will enhance this synthetic speech with facial expressions.

This would liberate patients with amyotrophic lateral sclerosis (ALS) or spinal-cord injury. Researchers look ultimately to augmentation of human intelligence.

Bio-molecular Oncology

Cancer will remain one of the most dreaded and lethal diseases, but in 2024, the Food and Drug Administration (FDA) is expected to approve use of adoptive T-Cell therapy to cure melanoma. Here, a person’s own immune system is trained to kill the cancer. Genetic engineering can be used to re-make Chimeric Antigen Receptor (CAR) T-cells that can eradicate human epidermal growth factor receptor 2 (HER2)-positive cancer cells. “Chimeric” means a synthetically engineered life form. HER2 is a marker for at least 30 percent of breast cancer events.

The protein that fits this chimeric T-cell is encoded on the human chromosome address of 17q12. There also are CAR-Macrophages and CAR-Neutrophils being aimed at cancer and autoimmune disease.

Other aspects of cancer treatment will see improvements. Women will be aided by techniques for creating more realistic nipple tattoos and better surgical techniques involving the latissimus dorsi flap. A single shot has been developed that reduces the time to administer the chemotherapies of Herceptin and Perjeta from 2.5 hours to 5 minutes.

Additional breakthroughs will be announced using personalized mRNA vaccines in cancer, wider use of universal donor-induced pluripotent stem cells, and more efficient genetic therapies produced by exploitation of clustered regularly interspaced short palindromic repeats (CRISPR) technology used to modify DNA in living organisms. This is exciting also because it potentially can stop the inheritance of defective genes. Also in 2024, expect better biopsies of blood, urine or sputum to non-invasively detect disease biomarkers. 

Government Imposed Price Controls

In 2024, you can expect even higher drug prices. GSK will cut prices for asthma, herpes, and anti-epileptic drugs, but it is the exception. According to 46Brooklyn and 3 Axis Advisors, Pfizer, Sanofi, Takeda, and others are raising prices on more than 500 drug doses and formulations. More than 140 medicine brands will see their prices increase. Sanofi is increasing vaccine prices by 9 percent for typhoid fever, rabies, and yellow fever. The current U.S. policy is to implement price controls, a popular approach internationally. It has identified 48 Medicare Part B drugs that have prices rising faster than the rate of inflation. By changing coinsurance, these additional prices will be transferred to the taxpayer, which gives the appearance of lowering prices, but actually, the pharmaceutical company keeps the price rise in place.

The stunningly profligate 2022 Inflation Reduction Act that allows Medicare to negotiate drug prices has triggered a flurry of lawsuits from Merck, Johnson & Johnson, Bristol Myers Squibb, AstraZeneca, Novo Nordisk, Novartis, and Boehringer Ingelheim. The lobbyist organizations PhRMA and the U.S. Chamber of Commerce have argued that mandatory negotiation of drug prices are unconstitutional because the negotiations would force them to sell their medicines at huge discounts, below market rates, which they claim violates the Fifth Amendment requiring that government pay reasonable compensation for private property taken for public use.

The new prices should take effect in 2026 and involve drugs for blood clotting, diabetes, heart failure, rheumatoid arthritis, and blood cancers.

A Permanent Pandemic

This is the fifth year of the COVID-19 pandemic. 2024 is expected to see the second-largest surge ever recorded. In 2024, expect a number of new COVID vaccines. The number of COVID variants, such as BA.2.86 and FL.1.5.1, will continue to grow.

There should be better understanding on how to treat “long COVID.” Expect the announcement of a combination flu-COVID shot, given that as of December 2023, a total of 42 percent of adults had taken the flu shot, but only 18 percent the COVID shot. The good news is that according to the World Health Organization (WHO), deaths from COVID-19 in leading countries has dropped from 110 per million to 2 or less per million.

A Deferred Action for Childhood Arrivals (DACA) Executive Order has been used to declare that undocumented individuals have a “lawful presence” and are thus eligible for Medicaid benefits. California has given such benefits to 700,000 individuals, ages 26 to 49. This will inject $11 billion in taxpayer money into California to help pay for it. Although California allocated $4 billion to Medi-Cal, it has a $68 billion deficit. In 2024, particularly since this is an election year, expect this debate to heat up because of the significant implications it is having for the costs of healthcare in the United States.

Hospitals Develop New Strategies

More than half of hospitals are losing money. This trend will be exacerbated in 2024, forcing development of new strategies for delivering services and managing operations. According to Becker’s Hospital Review, hospitals will tighten their focus on retaining patients and improving payer mix.

As we discussed before, the government pays hospitals less than the cost of delivering its services. The difference is made up by over-charging private insurers. This is a hidden and substantial additional tax on consumers. Expect hospitals to keep searching for specific services that promise to increase patient volume and revenue. Hospitals will work to improve the patient experience, and to do so, will beef up digital outreach and AI-based solutions.

The shortage of healthcare workers will continue in 2024. The result will be more reliance on contract staffing firms, which already has led to a 258-percent increase in hospital labor expenses from 2019 to 2022. Thirty percent of nurses are looking for new jobs. The significant shortage of primary care pay physicians is expected to continue in 2024. This will lead to a rethinking of some credentialing, which will make it easier to obtain “certified” employees.

Hospitals will be forced to work harder at standing out. This will lead to more focus on quality rankings, management of online reputation, publication of transparent pricing, and hard work at getting more engagement with patients, all aimed at increasing their satisfaction.

Expect more use of information technology to engage patients with more virtual consultations, and setting up of remote monitoring, proliferation of outpatient locations, with major retail chains rolling out co-branded urgent and primary care to neighborhood drug or grocery stores. Although challenging, work will intensify on understanding the entire patient experience, and learning how to make improvements. In sum, 2024 will be a very exciting year for healthcare, but it will require a lot of work by a lot of people to make the difference that is required.