How to Reform Healthcare

104 Harvard thought leaders outline medicine’s unmet needs.

How can the practice of medicine change to address challenges? | MONTAGE BY NIKO YAITANES AND OLIVIA FARRAR/HARVARD MAGAZINE; BACKGROUND BY ADOBE STOCK; FOREGROUND IMAGE GENERATED BY DALL-E AND MODIFIED BY HARVARD MAGAZINE

Imagine facing an infection that no medicine can cure. Or finally being diagnosed with a disease that explains all your symptoms—but at a stage too late to treat. How can the practice of medicine change to address challenges like these?

More than 100 Harvard faculty and leading practitioners from Mass General Brigham (MGB)—the largest hospital system-based research organization in the U.S.—met in late September to answer a crucial question: What are the most urgent unmet needs in healthcare today? The result? A list of ten pressing priorities that shed light on the future of medicine and the challenges that lie ahead.

“This is a roadmap for the future,” said Jackson professor of clinical medicine José Florez. “It can inform discussions throughout the healthcare and investment ecosystem regarding where we need to go.”

Among the ten priorities: developing a more integrated understanding of human disease and the interconnected nature of chronic illnesses; improving the accuracy of clinical data; and creating better strategies to address and care for underserved or changing populations. These priorities were compiled from interviews with Harvard-MGB clinicians, researchers, and faculty.

Three critical themes emerged: the difficulties in detecting diseases early, the rising threat of antibiotic resistance, and the complex needs of an aging population. Each reflects deeper issues in how healthcare is structured and where it must evolve to meet the challenges of modern medicine.

Breaking silos with systems-level thinking

Medicine as practiced today often divides expertise into specialized fields—cardiology, neurology, oncology—that operate independently. While specialization has led to remarkable progress in treating specific diseases, it limits physicians’ ability to address systemic problems.

“We’re entering a new phase,” said HMS professor of neurology Steven Greenberg, clinical neurologist and neuromuscular specialist at Brigham and Women’s Hospital. “It’s about systems integration—looking at how different parts of the body and different diseases are connected. We can’t just focus on one organ or system anymore.”

To make progress, the experts argue, healthcare needs to be reorganized around the body's interconnected systems. For example, stress affects more than just mental health; it also impacts cardiovascular health and immune function. Solving such complex issues will require more collaboration between specialties that traditionally operate in isolation.

How data and technology are reshaping healthcare

In recent years, advances in data science and artificial intelligence have created new possibilities for understanding and treating diseases. Mass General Brigham, for example, has built a massive biobank that combines clinical data with patients’ genetic information.

But figuring out how to use this vast amount of data to improve care has proven challenging. “We need to leverage AI to segment patient populations,” said Florez, “and identify those most vulnerable or underrepresented.” By analyzing data more effectively, including within electronic health records, healthcare providers can personalize treatments and improve outcomes.

However, AI isn’t a panacea. If not integrated thoughtfully, it could widen existing healthcare disparities. Ensuring that these technologies benefit everyone—not just those with the best access to care—will be key to their success.

Enabling early detection

Despite advances in medical technology, detecting diseases in their early stages remains a major challenge. While certain cancers are now being diagnosed earlier, diseases like Alzheimer’s, pancreatic cancer, and neurodegenerative disorders often go unnoticed until they are too advanced for effective treatment.

“We’ve been looking for more sensitive biomarkers for years,” noted Jean-François Formela, partner at biotech investment firm Atlas Venture and member of the MGB Innovation Advisory Board, “but we’re still not where we need to be.” Late diagnoses lead to fewer treatment options and worse outcomes, which is why early detection remains one of the highest priorities in medical research.

The “silent pandemic” of antibiotic resistance

While the world’s attention has largely been on the COVID-19 pandemic, another “silent pandemic” has been creeping forward: antibiotic resistance. “By 2050, more people will die from antibiotic-resistant infections than from cancer,” warned Nicole Davis, a biomedical communications consultant who formerly worked at the Broad Institute.

The overuse and misuse of antibiotics have accelerated the rise of resistant bacteria, explained Francis professor of medicine Bruce Levy, chief of pulmonary and critical care medicine at Brigham and Women’s Hospital. Without new antibiotics and better diagnostic tools to identify resistant infections, routine surgeries and minor injuries could once again become deadly.

Caring for an aging population

The aging population presents yet another significant challenge for healthcare systems. By 2050, the number of adults over 65 in the U.S. is expected to double, said Levy. This demographic shift will bring with it an increase in age-related diseases including diabetes, heart disease, and dementia—conditions that often require managing multiple health issues simultaneously. After the age of 60, more than 95 percent of individuals live with at least one chronic condition. And 75 percent, said Levy, have at least two.

But the challenges go beyond physical health. Mental health concerns, especially depression and dementia, are growing among older adults, and are often overlooked in healthcare planning. As the population ages, healthcare systems will need to adapt; not only to meet the physical needs of older patients, but also to address their general well-being.

“There is progress to be made in geriatric medicine and pharmaceuticals to think more critically about endpoints and regulatory strategies—and being a little bit more flexible in thinking,” noted John Lepore, M.D., CEO, ProFound Therapeutics and CEO-Partner, Flagship Pioneering.

Towards precision medicine

As healthcare moves toward precision medicine—tailoring treatments to individual genetic profiles and creating more personalized treatment plans, as Lepore, Florez, Formela, and others emphasized—there is growing hope for better outcomes in treating diseases such as cancer and rare genetic disorders.

The goal, according to Formela, would be to build the “Manhattan Project of Data Sharing”: making public, private, genetic, longitudinal, and other pools of data available across interconnected systems of medicine and care. In this way, researchers, practitioners, regulators, and systems could more effectively deliver healthcare in the ten areas Harvard-MGB faculty has identified.

Read more articles by Olivia Farrar

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