Thanks to the advances of modern science and innovations in medicine, we are living in a time of great hope and improved outcomes for patients. When I compare the medical treatments and therapies that are available today with those described in textbooks from my university days, I am amazed by the amount of progress that has been achieved in such a short time.

The ENVI Committee spoke to the accelerated rate at which medicine is progressing in a report the organization delivered to the EU on improving access to medicines. As a result of advances in pharmaceutical drug development during the last decade or two, the mortality rate of those diagnosed with HIV/AIDS has decreased by 80 percent, fewer people are dying from cancer, and hepatitis C is curable. It wasn’t all that long ago that receiving such a diagnosis was considered a death sentence.

When I consider how healthcare has progressed in leaps and bounds, it does make me wonder: in the future, where will medical breakthrough originate from? Which development will have the biggest impact when it comes to improving patient outcomes? Will it stem from new therapeutic options like the progress described above, or will it come from an improved adherence to these therapeutic options – will the way the new therapeutic options will be implemented have the strongest impact on improved patient outcomes especially in cases of chronic disease. Perhaps most progress will be achieved by implementing lifestyle changes, in patients and healthy persons alike. Knowing how many health and adherence enabling tools – many of which digitally enabled – have become available recently, it only seems logical that usage of these will significantly impact the health status of many patients.   

Wherever the source of progress comes from, patient engagement will  play a key role. Truly engaged patients, supported by digital technologies that can lead to a more integrated, efficient and patient-centered approach to healthcare will be key to better health outcomes. And that is easier said than done.

For patients to be so engaged and capable of taking control over their health, they need to fully understand their own role in their healthcare. They need to understand how they can take advantage of healthcare options that are available to them. With so many digital tools available to manage our own health, the discrepancy in patient outcomes between highly engaged and health literate patients and those who are less risk to become magnified.

There are patients who take ownership over their own health. These patients pro-actively use digital support tools to collect data on themselves, they research what this data means, and often take action and make lifestyle changes accordingly. When these engaged, well informed and prepared patients visit their doctor, their doctor will be able to give optimal advice to improve their health status based on the data these patients present to their doctor. Lucien van Engelen refers to this phenomenon as the “democratisation of patients.” The doctor is able to initiate an open dialogue, following the patient’s lead. Outcomes in this situation are likely to be optimal. Engaged patients are more likely than their less engaged peers to receive a diagnosis earlier and to receive treatment in the earlier stages of their illness. They are more likely to have higher rates of compliance, and to enjoy better psychological health. It’s empowering to know that your health, to a certain extent, is in your own control.

Not all patients will be able to take the lead of their own health care in such a strong way. The enabling effect of all supportive tools currently available does therefore not have the same potential for all patients. Less health literate patients can still benefit from many of the benefits offered by these enablers by following their doctor’s advice to use more digital medical technologies like telemedicine. As doctors start to appreciate the value of these technologies more and more they will receive information about patient status, symptoms, and adherence to treatment, which will allow them to tailor their advice and the course of treatment they recommend according to the needs of each patient, even when their patients do not fully comprehend the data collected. This personalization of treatment will also improve outcomes in those patients, albeit to a lesser extent than the improvement seen in highly engaged and literate patients.  

The patients who pose the biggest challenge for healthcare professionals are those who aren’t health nor digitally literate. Generally speaking, these patients feel as if they lack control over illness–that disease is happening to them–and struggle both to understand and to follow the medical advice that doctors give to them. Patients who aren’t health literate are less aware how lifestyle and nutrition affect one’s health, and they don’t know how to take charge themselves. These patients are challenging for healthcare professionals to treat; they experience poorer outcomes due to late diagnosis, uncontrolled risk factors, and leading a less healthy lifestyle. The more digital support tools available to patients and doctors alike will become standard of care, the larger the differences in outcomes between the different types of patients risk to become.

In light of research that demonstrates health literacy and its marked ability to influence patient outcomes, healthcare providers will not only need to adapt the way they deliver information to different patients but also need to differentiate between the support tools becoming available for their patients to try to make the divide in outcomes for different patient types as small as possible.

So, when I look back to the textbooks from my university days, and reflect on potential progress for the future I realise that the answer will not come from updated books. The combination of new therapeutic options becoming available and optimal usage of different enablers helping to optimise the effect of these therapeutic options with increased patient empowerment and involvement cannot be captured in a simple way and will be challenging to implement. The promise for progress it holds is so strong however that I can only look forward to the next time I will pause and reflect. I am very sure that that combination will lead to improvements I cannot even imagine now!