THE FUTURE OF MEDICINE
From the desk of MD
THIS ARTICLE focuses upon the timely impacts of “Telemedicine” and the notion that medicine might become increasingly digitised in the future. Whilst remaining two separate and clinically mutually exclusive variables, the overlap might be obvious, given the future integration of IT into medicine and how information, in particular, might be shared.
Telemedicine is a rapidly developing area and application of clinical medicine where medical information and data is transferred via telephone, through the Internet or other networks for the purpose of consulting. It has been used, too, for the purposes of remote medical procedures and examinations, an area which is likely to be developed in the future. As far as the NHS is concerned, where applications of Telemedicine is being used or intended to be tested, telecommunications equipment being used is deemed safe and secure through the use of secure digital equipment and through the ISDN carrier, tele-cables that offer greater protection as opposed to standard telephone lines.
Some people may already be an early adopter of telemedicine and telehealth, such as those who are family caregivers and already have an online subscription to portals such as MeAndMyCaregivers.com.
Telehealth is an expansion of telemedicine. It primarily encompasses preventative and curative aspects, through the delivery of health-related services and information via telecommunications technologies. Centrally, it stresses a myriad of technological solutions. For example, a subscription to MeAndMyCaregivers.com allows members of the Care Team – caregivers, doctors, pharmacists, lawyers – to view daily records of the care-receiver. Another instance is physicians using e-mail to communicate with patients, order drug prescriptions and provide other health services.
There are a number of excellent idiosyncratic benefits associated with telehealth, applying to individual care-receivers, caregivers, family members, and healthcare providers. The benefits may also extend to community organisations, healthcare facilities, and governments.
But, more importantly, the number one benefit of telehealth is that it undoubtedly improves the way patients and their family’s access information, while at the same time improving overall healthcare. It has improved, in many instances, the way healthcare providers deliver care and by making information more widely accessible. Significantly, too, it is helping to lower the costs of healthcare.
DIGITISATION
On the 16 April, 2009, the Economist produced a special report on the effects of health care and technology. It says the convergence of biology and engineering is turning health care into an “information industry”. Whilst being hugely beneficial to patients, the interim period, meantime, of digitisation is likely to be highly disruptive.
Formatively, innovation and medicine are complementary parallels. The Romans who initially developed medical tools such as forceps and surgical needles have been largely eloped and transformed by scientific waves of discovery that have brought marvels to humankind including the advancement of antibiotics, vaccinations and heart stents. The ancient practices of the Egyptians who are thought to have performed surgery as far back as 2750 BC have clearly been surpassed by scientific discovery and advancement.
Yet, surprisingly, given its history of innovation, the health-care sector has been reluctant to embrace the benefits and economies afforded to Information Technology. Almost every other sector has been revolutionised since the 1980s; computerisation largely appears the norm: doctors in most parts of the world, though, still work mainly with pen and paper.
But now, after a lengthy period of procrastination, medicine sees the benefits in catching up. At the centre of health care digitisation lies the introduction of electronic health records that can be turned into searchable medical databases, providing a “smart grid framework” for medicine that will not only aid and improve clinical practice but also help to revive drugs research.
As the special report published by the Economist highlights many developing countries are already utilising mobile phone technology for doctors to be more accessible for their patients. Devices and diagnostics are also going digital, advancing long-heralded ideas that have been in the wings for a while such as telemedicine, personal medical devices for the home and smart pills.
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INTERESTINGLY, the first technological revolution in modern biology started 50-years ago when James Watson and Francis Crick described and analysed the structure of DNA. That work established the fields of molecular and cell biology, the basis of which, then, founded the biotechnological industry. The sequencing of the human genome, discovered nearly a decade ago, set into motion a second revolution which has started to help scientists’ illuminate the origins of diseases.
CONVERGENCE
It seems certain that a third revolution will come about after the convergence of biology with engineering and technology. That revolution is certainly underway.
Citing a report from the Massachusetts Institute of Technology (MIT) the Economist is precise when it says that the physical sciences have already been transformed by their adoption of information technology, the use of imaging, nanotechnology and sophisticated modelling and simulation. Such tools are likely to bear greater significance on biology in the future. In my own experience, having served with several NHS committees for some time now, Magnetic Resonance Imaging (MRI), for instance, is 3-D digital imaging that is already being perceived to offer unorthodox benefits such as gauging the probability of brain activity: a highly sophisticated area in the making combining traditional biology with technology and engineering.
… Like chemistry before it, biology is moving from a world of alchemy and ignorance to becoming a predictable, repeatable science.
[Menno Prins of Philips, a Dutch multinational with a big medical-technology division].
The Economist’s special report also cites Robert Langer, a biochemist at MIT who holds over 500 patents in biotechnology, thinks innovation in medical technologies is about to take off.
Others, such as IBM, an IT giant, argue in a similar vain:
… It’s the transformation of biology into an information science from a discovery science.
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CRITICALLY, the special report focuses on how much of this grand vision is likely to become reality.
The optimism being held-out by the industry is, at least in part, well-founded. As the rich world gets older and the poor world gets wealthier, for instance, the markets for medical innovations of all kinds are bound to grow. Advanced and clever technologies can help solve two major problems in health care: overspending in the rich world and under provisioning of resources in the poorer and developing world.
By anybody’s reckoning the chances are that this transformation will take time. Whether the entire overhaul will be deemed a revolution, or more of a reformation, will depend, largely, on how the hidebound health-care systems of the rich world might resists the use of new technologies even as poorer countries surge ahead. For example, there is already a backlash against genomics, which has been oversold to consumers as a deterministic science. Given soaring health-care costs, insurers and health care systems may not want to adopt new technological ideas unless investors can show conclusively that they will produce productive outcomes and offer better value for money.
Arguably, though, if these obstacles can be overcome, then the biggest winner will be the patient. Historically, medicine has taken a paternalistic stance (i.e. advising what is best), with the physician dispensing wisdom from on high. This position is becoming increasing untenable particularly as digitisation pledges to connect doctors not only to everything they need to know about their patients but also to other clinicians who have treated similar disorders.
The convergence of biology and engineering is an industry waiting to explode and offers high prospects of information being transferred at a touch of a button. While some aspects of health information are already being disseminated via digital means, information technologies will continue to lie behind further reforms of health services. Ultimately, it may well mean the digitisation of medical records and the establishment of an intelligent network for sharing those records. On that premise alone, will enable many other big technological changes to be introduced.
Of equal importance, perhaps more so, is that information will be more readily available to the patients, empowering them to play a bigger part in managing their own health affairs. This is controversial, and with good reason. Many doctors, and some patients, reckon they lack the knowledge to make informed decisions. Yet, patients actually know a great deal about many diseases, especially chronic one’s like diabetes and heart conditions with which they often live for many years. The best way in dealing with such illnesses is for individuals to take more responsibility for their own health in an attempt to prevent problems that might otherwise have required costly hospital visits. This means putting electronic health records directly into the hands of patients.
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© Mark Dowe 2009: all rights protected
Outstanding political and current affairs coverage
Filed under: Medicine, NHS, Science, Technology, information technology | Tagged: biotechnology, databases, developing countries, digitising medicine, DNA, drugs research, electronic health records, francis crick, genomics, health care, health care systems, human genome project, IBM, individual responsibility, information sharing, information technology, innovation, intelligent network, james watson, medical innovations, medical records, medical research, Medicine, MIT, mri, NHS, nhs computer systems, patient empowerment, smart grid, telehealth, telemedicine
I have to make it public. It’s suppose to be secret, however most people in Austin, Tx knows about it. The police department has machine that can read your mind. A machine that can read someone’s mind will be used to violate EVERYONE’S CONSTITUTIONAL RIGHTS!!! It can also change the way you feel. Sexual impulses, anger, and paranoia are all feelings they can induce to you at their fingertips. This means it can cause a girl or boy to feel sexual, and get raped thinking they wanted to. Its like a drug. This is just one of the many crimes they commit with this machine RIGHT NOW!!!! They are using it right now to spy on their citizens RIGHT NOW!!! People will be spied on in there homes, without a warrant. (this means someone will be able to watch you during sex without your knowledge.) There are a lot of people all over the United States knowing about this machine. The police department is able to use it to spy on people in their own home. During interrogation they keep a person dazed, confused and not sound of mind to cohersed them into making certain statements. This is a violation of these people’s constitutional rights. Start thinking about how the government has given the police department a weapon to commit not only one of the biggest civil and constitutional rights violations of all time, but to commit war crimes such as rape, brainwashing, and toturing people without the victim’s knowledge. I know it is hard to believe, however if you happen to know someone in the police department who cares for you enough, just ask if they have a machine that can read and control people’s mind. After that, I would also like people to think about how we are able to get the government to stop letting the police department violate the people’s civil and constitutional rights, and committing war crimes against there own citizens. Major media companies have knowledge of this, but are not willing to broadcast it. People need to find out and talk about this issue.
Interesting article. I think readers might also be interested in this telemedicine/humanitarian program that I have heard about- iCons in Medicine (www.iconsinmed.org). This program uses telemedicine to connect healthcare providers in remote or medically underserved areas, with specialty physicians, who provide expertise, encouragement, and advice on difficult cases. It is a free service and it also is a very good social networking site for those in the healthcare industry.
Hi Maggie,
Yes, there is also the interconnectedness between the Citizen Advisory Service and those people wishing to receive legal support through the use of a similar system. In Scotland, where many outlying regions are off the mainland, digital networks (similar to telehealth) are being used where consultations have become effective.
Personally, I believe that this area is on the tip of a much larger iceberg waiting to break. It does, of course, have many benefits non-more-so than saving on travel costs which would otherwise have taken place. People are being consulted via secure means, as they will through digi-medicine in due course, from their own homes.