Looking Back At Today’s Healthcare In 2060

I receive many questions after my talks and on my online channels about the not-yet-visible future. People want to know what healthcare will be like in the next decades. But throwing around predictions will not help us design better healthcare. However, showing a utopian future for healthcare might do so.

On a chilly October afternoon in 2060,

after having watched the leaves falling off the trees in our garden for too long to get bored, my beautiful and overtly curious grandchild, Nina, came to me and started asking me questions.

She pointed at one of the many sensors in the living room - small, simply designed cubes measuring air quality, temperature, humidity, noise, light, air pressure, that optimize our home environment based on our personal information. Nina asked whether I had ever lived in a house without sensor cubes. When I said yes, she looked at me with wide, marveling eyes and asked me to tell her how I had lived when I was young. She liked to ask about the past. I told her about the unbearable heat in third-floor apartments during hot summer nights without proper air-conditioning and the inconvenience it caused when you could not set the right amount of light for working.

Nina was satisfied with my responses, but I had the impression she still had something on her mind. I asked her about it. She told me that she heard a word from her fellow first-graders and she did not know what that was, but one of her friends, Lyanna, told her it was from the age when people did not use smart cubes at home, so she wanted to ask me and make sure I can answer the question.

So, I asked her, what that mysterious word was, and she said, hospital.

I laughed out loud. Hospital. I have a grandchild who does not know what a hospital is. Isn’t she the sweetest (and for that matter the luckiest) girl in the universe?

And isn’t it amazing that she doesn't know what a hospital is?

So, I told this charming little lady to come over and listen to her old, wrinkle-faced grandpa who will tell her the story of hospitals, doctors, nurses, pills – and pretty much how healthcare used to look like in the 2020s, in the barbaric, pre-technological era of medicine. Here is what I said:

"More than 40 years ago, patients had to go to huge and unfriendly buildings called hospitals to receive any kind of care and to measure vital signs or health parameters, for example how hearts and brains work. So when people fell sick, they had to go to that specific building instead of just getting care at home or wherever. And there, at the doctor’s office, you could not just go and see the physician. Sometimes you had to wait in line for hours while other people got checked.

Do you remember, Nina, how mommy called up the doctor, she appeared on the screen and mommy showed her your ear when you said it hurt? And she also told her whether you had a fever, and what the device put into your ear for checking it properly, showed? And everything happened in your room, and also your friend, Gregor, the little salamander could be there? I wish it was so easy back in the day.

And by the way, back then, all doctors were actually humans

I know that sounds very funny now, but back in those days, all doctors, and nurses I talked about were actually humans. There were no health robots, like Docco, in homes, no Dr. A.I. at your service 24/7. When you needed a blood test, you had to go to a specific building, where a specific human took a lot of your blood with syringes. No, not just a few drops how Docco does it. A full vial!

Mommy told you that this method of how you speak with a doctor through the screen is called telemedicine, right? You know, back in the day it was just a shiny new thing which not many believed in. People had to travel from their homes to a different place to receive care. And as doctors were not as widely available as nowadays, sometimes people had to travel a lot. Sometimes by real ambulance cars with real drivers – no driverless cars and no drones delivering medical equipment were available.

No robo surgeons, either

And there were no robo-surgeons either, those were all real people, with no help from artificial intelligence or robots. I know it sounds scary, but they managed somehow. People obviously did not live that long, but even then they could cure a lot of diseases. Considering how these human doctors had to remember everything themselves, without the A.I. analysing all the patient data real-time, they actually did quite well.

You know, Nina, nowadays computers can send each other every health data that you have within a blink of an eye. In the 2020s not every device could communicate with each other, so sometimes physicians did not know about the patients and they had to ask for all the data and information that the other doctors and nurses already had. Again and again.

And records on paper!

Moreover, they had to write down all the information, they used keyboards to type down information, not even looking at the patient or talking to them. And I think you are not going to believe this but some medical records were on paper. Yes, people wrote by hand on paper, like you draw those butterflies with the lilac pencil, and those were not even stored or analyzed later on.

Nina, look at grandpa’s digital tattoo on his arm!

Can you imagine that instead of this tiny and shiny metal lamina, doctors used as huge and expensive equipment as this living room? Measuring the electrical activity of your heart (ECG) or measuring blood pressure took time and effort – even for physicians. Medical devices were huge and scary like computers a century ago and patients had to travel to the machines to have very complex examinations, such as the so-called CT scan, by which various photos are taken from the otherwise not visible parts of your body or the MRI which examines parts of the body with the help of a magnetic field. There was also the problem called radiation, which means that invisible but harmful energy waves reached the body of the patients.

Printing organs was just an idea for the future

And back then doctors could not even print an organ if you needed one. A malfunctioning heart or kidney was considered a life-threatening condition, and new organs could only come from other human beings. So, please don’t get scared, but people had to use the hearts and livers and lungs and kidneys of others who just died. And as these organs were not specifically printed for you, sometimes they did not even work properly. The scientists had been thinking about printing tissues but had a hard time figuring out how to do it.

And some people could even go blind. Forever

Do you remember when Mr. Simmith had all that trouble with his eyes last year? And he had to have his neurons checked, and the lab has grown him a bionic chip with his neurons populating it, and he had it implanted. And now his eyes are working as well as before, and he can read everything easily. This was not like that when I was young. Some people could actually have so much trouble with their vision that they went completely blind. Oh, that means that they don’t see anything at all. Nothing. It was because in the 2020s, they could not just easily connect the biochips with your neurons. Some scientists have been dreaming about it, but nobody could do it.

No supercomputers analysing all the data in seconds

You know, Nina that you can ask things from your little tablet, and it will eventually find you an answer? Right, I told you already that there is a technology called artificial intelligence through which devices learn a lot about you – like you do about the letters in first grade – and they eventually will give you the solution to problems that might arise. It takes just seconds to find those answers. Now, can you imagine that doctors back in the day had to do searches in huge databases (like Pubmed) to find the information somewhere in hidden studies? They had to mine the database themselves and artificial intelligence could not help them? That it would last days or even weeks to read through the irrelevant data to find the right answer?

And the same pill for everyone, without it being personalised to your genome

Also, do you remember that the other day mommy and I went to the pharmacy with you and you observed how the 3D printer machine printed the pills prescribed by your doctor? Now, listen. In the 2020s, medicine was produced by pharma companies who had made the same drugs for decades and made the same dosage for millions. Everyone received the same pills – there was no personalized medicine. So, you and Gregor would have got the same, even if you had some kind of allergy and Gregor wouldn’t. Back then researchers believed in 3D-printed drugs, but most everyday folks have never heard of them.

I think I also told you some stories about the tiniest bits of our body, the DNA and how with the technique of genome sequencing as they call it, you can get to know more about hidden weaknesses in your organism and use that “secret” data in healing you. Right, Nina? But there was no chance of knowing so much medical information about the person in the 2020s, thus grandpa could have received a drug in a dosage that would have led to serious side effects if he were too sensitive to the particular treatment.

New drugs were tested on animals and humans

I remember how the invention and innovation of new treatments and healthcare methods took forever and the authorization of regulatory agencies even more – some patients literally died while waiting for a new cure. Back in the day, clinical trials were long and unbelievably expensive. Moreover, drugs were tested on patients – not on algorithms and physiological models, but on real people.

And hospitals were run by humans, not supercomputers

You not only had to stay in hospitals but infections were commonly acquired while being hospitalized. As there was no algorithm to supervise the process of care, people made mistakes repeatedly. In the 2020s, medical errors were the third most common cause of death.

Hospitals were run by managers, not supercomputers. Every decision was subjective and not backed by huge amounts of data. Also, physicians worked in an unquantifiable way. Actually, nobody knew whether they were successful or not.

I recall that epidemiology studies were slow and it took a lot of time to deal with a new infection and develop vaccines in case of epidemics.

Cancer was considered dramatic

Cancer was considered a dramatic life event and not a chronic disease for decades. There was no effective cure or treatment for a long-long time. And even if there were some personalised treatments, people had to pay for them, and only rich people could get them.

Health insurance companies mostly lacked any kind of quantified data. They only knew the age and gender of their insured patients and that’s how they made business decisions. And one of the most important factors: patients were not equal partners of physicians, as they prescribed treatments without asking them.

Nina? Are you listening?"

How come she always falls asleep when I talk about the past? I think these stories are better for her than fairy tales. As I was looking at her face with her eyes shut, breathing smoothly in and out, I thought maybe it is for the best that she fell asleep, I have some information about the 2020s which I could not share with this sweet child anyway.

Well, that’s how I imagine

it will be when my future self talks to my grandchild about healthcare and medicine in 'the barbaric era' of the 2020s. Okay, sometimes she won't fall asleep but asks me to bring her some ice cream.

The point is that I’m optimistic that when I will talk about healthcare in the early 21st century to my grandchildren, they will find many of my stories amusing because they are so unrealistically remote from their experiences.

Today, patients are still not equal partners with their caregivers; innovative treatments are not affordable in many places worldwide; and prevention is not even in the top 3 priorities. People do not use cheap sensors to get to know their own health better. Physicians still have to dive into dozens of publications to stay up-to-date when there are millions.

To sum it up, all the technological progress I see as The Medical Futurist makes me say we still live in a barbaric era of healthcare and we have a lot of work to do – such as embracing disruptive technologies, and empowering patients, digitizing healthcare information or shifting focus from treatment to prevention - to fulfill at least some of the fantasies above so that the conversation with my granddaughter decades from now might have a similar tone.