Today is a momentous occasion. At 7.30GMT, the retired maintenance manager Brian Pinker, 82, became the first patient to receive the Oxford-AstraZeneca vaccine. The first vaccine that doesn’t require super-cold storage. The ‘2020 BC epoch’, as I like to call it (Before-COVID), showed how predictions are often wildly inaccurate, and subject to different realities yet to be imagined. But, in a 2021 AC era (After-COVID), with vaccines being rolled out across the UK, I feel confident enough to make a few predictions about what the rest of 2021 has install for us.

My only disclaimer is these are my thoughts, and I reserve the right to change them. But, perhaps, just perhaps, you might be bold enough to wager a few Bitcoins that I might indeed be right. Bitcoin is currently trading at a record high of $33,562 so my first prediction is it will only go down. Sorry about that. But with that disclaimer out of the way, here are my top ideas for 2021 AC.

Prediction 1 - Telemedicine & remote care will be rehabilitated.

I’m currently receiving physiotherapy on a strained hip flexor muscle. Treatment before 2020 BC would have required me to book time off work, drive to the clinic, find a parking spot, sit in the waiting room, attend my session, drive home… you get the picture. But, in a 2021 AC era, I have a 20-minute call at my convenience with the physio. She talk’s me through the exercises whilst I roam around the lounge stretching and panting through a headset. My wife (now working from home) looks at me quizzically. I open the Physio App I’m subscribed to and watch the short videos elegantly demonstrating how the exercise is actually supposed to look. It’s not pretty. A moment later, I tick-off the exercise and it gets logged in my medical record that I am a good, compliant patient. The following morning, I receive an 8am reminder on my phone to repeat the exercises which I dutifully do. Up until 2020, I would have felt short-changed with this kind of affair. I’m sure University students feel the same about remote learning, but that’s a whole different topic.

The prediction is that remote care will finally feel normal and will start to gain traction in the health service, and these services will become more specialised. The app I use for physiotherapy is wonderful for MSK issues, but it wouldn’t work for Diabetes, or other treatment paths. For as long as I can remember, remote care seemed weird, impersonal, pointless even, but remote care will be rehabilitated in 2021. Services and software vendors that support remote care will boom in 2021, as patients accept it as normal, perhaps even more convenient.

Care providers have been eager to move to remote care because of the proven benefits like quality and safety, together with cost reduction.

Companies I predict to boom include device manufacturers such as Honeywell, Medtronic, Abbot Labs, Baxtor International, treatment platforms such as Virta Health and DrChrono, and personal data aggregators such as Validic and Envision2bWell.

Prediction 2 – Cloud giants will expand their Healthcare ecosystems.

2020 saw the big cloud providers take a giant leap with their Healthcare platforms. In November, Google unveiled its Healthcare Interoperability Readiness Programme. In December AWS launched it’s ‘FHIR Works on AWS’ offering and sprang the Amazon HealthLake. Earlier in the year Redmond showcased Microsoft Cloud for Healthcare and introduced the world to Azure IoT Connector, Azure API for FHIR and a slew of other interoperability tools. Early April saw a shake-up at IBM with Arvind Krishna taking the top job, and in December IBM joined up with Salesforce to integrate IBM’s Digital Health Pass with Salesforce for COVID-19 screening. Salesforce continued the march and launched for Vaccines, and added new tools to its Healthcloud including Destinations, its no-code healthcare interoperability solution.

With Cloud infrastructure spend in Q3 2020 growing by 33% to US$36.5B, coupled with the ongoing COVID-19 pandemic, I think it’s safe to predict that the big cloud providers will continue to invest heavily in healthcare. It also gives them access to a treasure-trove of valuable data ripe for exploitation through the democratization of machine leaning.

Prediction 3 – There will be an expansion of mental health initiatives to combat a global pandemic.

During 2020, SAP launched its Mental Health initiative, and Accenture found that 81 percent of people who talked about their mental health at work reported reduced stress levels and increased productivity. DXC joined forces with the UK NHS Service and revolutionized mental health services with its Open Health Connect platform. In December the Lancet stated “People with depressive, anxiety, or obsessive-compulsive disorders are experiencing a detrimental impact on their mental health from the COVID-19 pandemic, which requires close monitoring in clinical practice”.

With the UK government announcing a third lockdown today, I think it’s safe to predict an increasing demand for mental health services during 2021. The BMA found in September the mental health workforce has grown little over the past 10 years, and that the five-year forward view for a mental health workforce is not on track. The workforce challenges aren’t going to be fixed overnight, and I hope technology can help readdress the balance with new solutions to address loneliness, social isolation and build communities. Perhaps technologies like virtual reality will be reborn allowing us to travel beyond our homes.

Prediction 4 – We will have a National Health Defense System for Insights Integration.

Like so many, I have become an armchair expert in analysing government datasets. I’ve noticed it takes a woefully long time to see data aggregated from across the nations. Even today, COVID statistics are skewed on Mondays and Tuesdays – Monday is often lower because of data lag over the weekend, Tuesdays is often higher because it’s playing catchup. That means data is not accurate for at least two days a week. Back in March 2020 the UK was plunged into lockdown because the hospitals were reaching capacity. Now, in January 2021, we’re told that hospital admissions are 40% higher than in March. Does that mean, capacity is now at 140%? I think I need to phone a friend for that one. In September, the UK Government pointed the finger at Microsoft Excel for misplacing 16,000 COVID test results.

Everyone is doing their very best in a difficult time, and it highlights to me a growing need for a ‘national health defense system’ akin to a military surveillance system.

We need data that is accurate and timely at a national level so it can be acted upon at a local level.

The insights gleaned from real-time surveillance will help better care planning and take a step towards a national alert system. Alerts will be used to avoid national lockdowns and return to some level of normality.

And this leads me onto my final prediction.

Prediction 5 - AI for Care Logistics.

My final prediction is a little unorthodox. It’s hard to escape the ongoing impact of the global pandemic, and the detrimental impact it is having on the smooth operation of hospital networks. The BMJ announced in September that waiting times in England have reached record highs with an 81-fold increase in patients waiting more than a year. In 2021 AC there will be a new class of AI and machine learning focussing on care logistics. We will learn to more accurately predict the length of stay, forecast extended stays, avoid capacity problems, optimise staff rosters, implement skills matching and smart resource allocation. Perhaps we will even build ‘marketplaces’ where patients can be matched to spare capacity across extended hospital networks. Analysis by the Health Foundation showed there were 4.7 million fewer referrals for routine hospital care for things like hip, knee and cataract surgery during 2020. It will take time to work through this enormous backlog, and perhaps AI and machine learning can help with the burdensome task of care planning and logistics.