The Future of Healthcare

‘’ Omar, I think you are pretty confident person’’ said one of my British mentors which means in plain English ‘’you are arrogant’’ in which I replied calmly ‘’ I pay my dues to be the best in my industry’’ his reply ‘’then you should be expert in medical technology as it will disrupt everything!’’

I asked ‘’where I should start learning about it?’’ his answer was from a totally different industry, he was right!

Let me start by making these points clear:

1- My Principle: Patient first. Even though a lot of the technology I will mention have brand names but I did not personally use it or know someone who did so I will keep its names vague.

2- My second principle: Healthcare professionals second, it’s strange to me that most healthcare business does not care about that at all.

3- The definition of a futurist is someone who is not wrong today, so take everything with a grain of salt, even though I maintain my intellectual properties, I think its moral obligation to give back to society in every possible means.

4- Most of these technologies are not available in Middle East & even though I am willing to reallocate to gain the experience necessary I think recruitment today depends on the colour of your passport than your competencies, so my knowledge is mainly based on books & online courses.

With that lets start,

"It is difficult to think of a major industry that AI will not transform. This includes healthcare, education, transportation, retail, communications, and agriculture. There are surprisingly clear paths for AI to make a big difference in all of these industries."

-?Andrew Ng, Computer Scientist and Global Leader in AI

Six Technologies That Will Reshape healthcare in the Next Decade:

1- Artificial Intelligence

2- Sensors and the Internet of Things (IoT)

3- Autonomous Machines—Robots, Cobots, Drones, and Self-Driving ambulances

4- Distributed Ledgers and Blockchains

5- Virtual, Augmented, and Mixed Reality

6- Connecting Everything and Everyone: 5G Networks and Satellite Constellations

"I imagine a world in which AI is going to make us work more productively, live longer, and have cleaner energy."

-Fei-Fei Li, Professor of Computer Science at Stanford University

The Challenge: Meeting the Needs of an Aging Population:

The global population is aging. Americans over the age of 65 will outnumber children by 2035 (Source: U.S. Census Bureau). By 2060, almost one quarter of the American population will be seniors, up from about 15% today.

In China, population aging is acute. Despite the repeal of the government's one-child policy, birth rates in China are still dropping and the fertility trend looks bleak. China has more people over the age of 65 than the entire population of Russia. By 2050, almost 40% of the population will be over the age of 60 (Source: ChinaPower).

If you want to glimpse the future of the United States, China, and Western Europe, you need look no further than Japan, where the number of people over the age of 65 has quadrupled in the last 40 years. They account for more than a quarter of the population and sales of adult diapers now outnumber the sales of diapers for babies (Source: Wikipedia). By 2050 there will be 20 million fewer Japanese people than there are today.

How technology might help?

"Machine learning allows us to build software solutions that exceed human understanding and shows us how AI can innervate every industry."

-Steve Jurvetson, Board Member of SpaceX and Tesla

Technology will transform the delivery of healthcare, a revolution that is already well under way, here are some examples:

1- Super sensors boosted by sophisticated AI, will enable clinicians to “see” their patients in a way that they have never seen them before. AI will augment the diagnostic capabilities of doctors, offering them a second pair of eyes and a valued second opinion. Ultimately, AI may take on lower-level diagnosis and care, allowing doctors to focus on the more challenging cases and spend more quality time with the patients that need it most. Remote sensing, using a combination of wearables and in-home sensing, will maintain a constant connection between patients and clinicians, transforming the nature of their relationship and turning the current healthcare model upside down.

2- Artificial Intelligence Discovers Drugs and Designs Prosthetics

"The development of exponential technologies like new biotech and AI hint at a larger trend - one in which humanity can shift from a world of constraints to one in which we think with a long-term purpose where sustainable food production, housing, and fresh water is available for all."

-Arvind Gupta, Indian Toy Inventor

Pharmaceutical companies use AI to suggest chemical compounds that might be candidates for therapeutic drugs. Technology companies like X train their AIs with data about the molecular structure and efficacy of known drugs. With exposure to enough data, the AI can establish complex relationships between the molecular structure of a compound and its associated impact on the body. Some correlations are entirely coincidental and not causative. Other correlations may illustrate the potential for a breakthrough drug that interrupts a disease path. AIs like X's can be given a set of desired characteristics as an input and will output the molecular structure of compounds that may have those characteristics. Pharmaceutical companies use to build a short list of drug candidates. This narrowed list of candidates informs first-pass exploration and saves pharmaceutical companies many millions of dollars. Future AIs might also make intelligent suggestions on the most effective and efficient ways to synthesize new compounds, too.

3- Artificial Intelligence “Sees” Patients in New Ways with Super-Sensing:

"What all of us have to do is to make sure we are using AI in a way that is for the benefit of humanity, not to the detriment of humanity."

-Tim Cook, CEO of Apple

An Israeli start-up is building an AI to screen voices for a particular set of biomarkers. These vocal biomarkers may indicate specific healthcare conditions or changes in a patient's emotional state. it claims early success with their effort, specifically to indicate COPD, sleep apnea, and congestive heart failure (CHF). They also claim to be able to predict the need for hospitalization and the likelihood of mortality for CHF patients. Through joint research with the Mayo Clinic, it has also demonstrated that their AI can detect coronary artery disease (CAD) just by listening to a patient's voice. Further, they are working to find significant correlations between voice and a range of other health conditions, including hypertension, diabetes, and cancer. The hope is that future tools will constantly monitor a person's voice and raise flags when vocal biomarkers are detected.

Another Israeli start-up has developed an AI-enhanced smart stethoscope. AI analyzes audible body sounds and infrasounds—sounds that are beyond a human's audible range—to diagnose health conditions. It claims their product can avoid the use of expensive CT and x-ray scans.

4- Healthcare Gets Personal with Precision Medicine:

For the entire history of modern medicine, healthcare services have been designed to serve the broad population as a whole. By and large, treatment plans are rarely individualized. A typical experience at the doctor's office goes something like this: The doctor examines you, figures out what's wrong with you, and then prescribes some kind of pharmaceutical medication. Often, the doctor will say something like, “Let's try you on ABC medication and if that doesn't work, or if you experience XYZ side effects, we will try something else.” The reason the conversation goes like that is that doctors have no idea if a particular medication will actually work for you, or if you will experience any side effects. Treatments assume we are all like the general population. Only, we aren't all alike. Our genetic makeup is different, and thus the interaction of pharmaceuticals on our bodies, and on disease paths in our bodies, is different. When a doctor prescribes a medication, they might know the percentage chance it'll work on you, based on how trials went on the general population. But they don't know how it'll work on you. They play a statistical game, trying the medication with the best efficacy on the general population and the lowest known number of side effects.

Precision medicine could change all that. With access to your genomic data, a physician will use a powerful computer to choose the best medication for you. Artificial intelligence is really good at finding correlations hidden inside massive data sets. An AI will review the genomes of all previous patients who have been prescribed medications for your condition. Based on your specific genetic makeup, it will then recommend the medication likely to have the highest efficacy and the fewest side effects. For you.

Precision medicine will also improve cancer treatment. To treat cancer effectively, doctors must identify molecularly distinct cancer subtypes and potential drug combinations for targets. This requires a high-quality analysis of vast amounts of data. By ingesting electronic medical records and molecular diagnostics, an AI can filter through the data and recommend the best personalized cancer treatment for a specific patient.

5- Drones can Save Lives:

A robotics company based in California, builds drone networks that deliver urgently needed medical supplies to remote locations. Their first trial focused on the country of Rwanda, where challenging terrain, heavy rains, and poor infrastructure make it impossible to access some locations by road for several months of the year.

The drones sail over mountain ridges and washed-out roads to reach remote rural communities with urgently needed blood supplies, vaccines, and medicine. A fixed-wing design lets drones travel greater distances than quadcopters (Z claims up to 10 times farther) and fly in challenging weather conditions. Drones cruise at about 70 miles per hour (110 kilometers an hour), carry up to 3.3 pounds (1.5 kilos) of cargo, and have a round-trip range of 100 miles (160 kilometers).

6- The Remote-Monitored Patient: Sensors and Wearables Flip the Model:

Think about today's healthcare model. You don't feel well so you call the doctor's office to make an appointment. Unless your symptoms indicate an emergency, you'll be offered a 10- to 20-minute time slot in the schedule of a doctor, likely sometime in the next week or so. When you arrive at the doctor's office, you may or may not still be exhibiting the symptoms that you were experiencing when you first called. Perhaps you had a crazy headache, felt light-headed, or had pain somewhere. But now, you feel fine. The doctor examines you and asks you to describe how you felt the previous week. You do your best to remember and describe how you felt. This is not a very effective use of anyone's time. A more worrying scenario is that you continue to get sicker while you wait for your appointment, perhaps infecting others with your ailment, and ultimately need emergency treatment and a more expensive intervention…. Wearable biosensors will change all of that for good.

7- Blockchain-Based Medical Records Reward Healthy Behavior and Take Us beyond Accidental Wellness:

Data from wearable devices, digital scales, and other home health devices can be gathered and stored in private healthcare records stored on a Blockchain. When secure data from doctor and hospital visits are added, a complete, private picture of a person's health can be built.

Longitudinal health records, built over decades, will give doctors better insight into what keeps us healthy. Today, we are “accidentally well.” That's a term coined by Dr. Brigitte Piniewski, who is both a medical doctor and a leading mind on the healthcare application of Blockchain technology. The healthcare community has some understanding of the behaviors and choices that keep us healthy, but as demonstrated by ever shifting dietary advice regarding the amount of coffee, red wine, or butter we should or shouldn't consume, there isn't deep knowledge on what actually keeps people well. To truly understand wellness, we need to review longitudinal behavioral data on the population that's gathered over the course of their lives. Blockchains provide the foundation of trust that enables data to be gathered, stored, and shared while honoring individual privacy. Compare this to the current model where data brokers sell five-year chunks of health system data to pharma companies. Piniewski's view is that we must stop treating old people as cost centers and instead look at them as national treasures. She contends that our biology is unable to keep up with the rapid environmental changes wrought by the modern world. Today's elderly people are our last opportunity to benchmark the health of people who lived in pretechnological times. As more sensors are deployed in homes, in wearables, and ultimately inside our bodies, digital technology will be used to help us all understand more about our own health, and to prescribe the steps we should take to remain well.

8- Augmented Reality and 5G Transform Telesurgery and Telemedicine:

High-speed internet connections, robotics, and virtual or augmented reality will enable clinical and surgical talent to reach across huge distances. Autonomous robot surgeons are still decades away. To maximize the reach of human surgeons, particularly into far-flung rural communities, we will need to use telesurgery.

Robot-assisted surgeries have been conducted since the mid-1980s, and telerobotics, where the surgeon operates at a distance from the robot and patient, was introduced in the late 1990s. Telerobots are used to perform routine laparoscopic abdominal, spine, heart, and urological surgeries. Typically, the robot, physician assistant, and other support staff are scrubbed in and positioned at the operating table while the surgeon controls the robot from the other side of the room. The robot enables the surgeon to make fine-grain movements and doesn't even require them to scrub in. For patients, these keyhole surgeries are minimally invasive, heal faster, and result in less trauma, less blood loss, and less pain.

The first true remote surgery was performed in September 2001. A surgeon in New York City performed an operation on a patient located in Strasbourg, France. The connection was made over dedicated fiber optic cables laid beneath the Atlantic Ocean. While such remote surgeries are possible, they are not optimal. Even with dedicated and reliable data connections, the time lag involved makes it hard for surgeons to perform delicate manipulations and defeats haptic feedback systems that help the remote surgeon to “feel” what they are doing. Low-latency, high-reliability 5G networks and satellite constellations will make it possible for more remote surgeries to be performed, making specialist surgical talent available to far wider areas.?

9- Augmented reality (AR) is changing surgery:

"Some people call this artificial intelligence, but the reality is this technology will enhance us. So instead of artificial intelligence, I think we'll augment our intelligence."

-Ginni Rometty, CEO of IBM

?Patient vital signs can be displayed in the surgeon's field of view, making them easily accessible at all times. Presurgical scan data can be overlaid on the surgeon's view of the patient, allowing them to see x-rays, CT scans, and other imaging projected onto the patient in three dimensions. This essentially gives the surgeon “x-ray vision” so they can better plan surgeries and avoid major blood vessels and nerves. Augmedics’ xvision system is an early example of research in this area. Without AR, many surgeons have to continually look away from their patients to review images and charts. By bringing this imagery to the patient, the surgeon's eyes are kept in one place. This improves the speed, accuracy, and safety of procedures, which leads to better outcomes.

Here are six ways that the technologies described can be used to improve patient's lives:

1. Honor every patient as a Unique Individual.

2. Value Everybody's Time by Creating Friction-less Experiences.

3. Understand Ultimate Intent: better healthcare!

4. Design Highly Responsive healthcare Business Operations That Coordinate Healthcare professional and Machine Intelligence.

5. Create Innovative Products, Services, Experiences, and Transformations That Solve diseases for Patients.

6. Elevate Healthcare professionals Work.

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''Mark my words: A combination of airplane and motor car is coming.''

—Henry Ford, 1940

In the end, I come across this quote by a visionary at his time; do you think he was right? May be I am also… No Patient Left behind!

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