Technological Change and Disruption in Medicine
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"Change is the end result of true learning."
-Leo Buscaglia
I confess. I don't know what's being taught in residency today.
One thing is for sure - change.
Rapid -unprecedented -exponential
Change and disruption in healthcare are occurring at a brisk clip. Undoubtedly, some of you have already been caught in its wave. I hope that the doctors of tomorrow are being provided with the framework and tools to adapt and thrive.
Here are a few thoughts about change and disruption in medicine.
Practicing with genetic testing will be the norm
The cost of genome sequencing has plummeted from millions of dollars a few years ago to around $100. Testing is widely available to the general public, and online free tools are readily available to convert raw genetic data into actionable clinical information.
Your patients know about this and will expect this to be part of their care. The power of understanding the unique genetic makeup of our patients fosters a personalized approach with a higher likelihood of reaching desired health outcomes. Therapeutic response and patient safety have already been improved with the advent of pharmacogenomic testing.
Advances on the engineering front will allow technologies such as CRISPR, AI-assisted protein folding, and 3D printing to change the way we all practice medicine.
Work on combining AI and mammography is well underway and showing promise in predicting if high-risk breast lesions are present. The implications for global health initiatives are staggering despite the controversy around mammograms.
AI and machine learning are also being applied to pathology, and many specialties must take notice in anticipation of potential career disruption.
Outnumbered
Interest in the microbiome continues to rise among patients and practitioners. Long gone are the simple dietary recommendations dispensed like the cod liver oil of generations past. Companies such as Viome are working to make conflicting food advice obsolete. Founder Naveen Jain hopes to make illness obsolete.
The gut microbiome has vast implications in how an individual processes foods. Center to this discussion is the gut-brain connection and the potential role of leaky gut in dementia, autism, and other disorders.
The combination of nutrigenomics and microbiome data has ushered in a new area of personalized dietary therapies drawing on Hippocrates’s statement of let food be thy medicine.
AI Will Be Part of Life
The interpretation of a continuous data stream is beyond human capability. Rapid consumer adoption of wearable technologies will provide real-time evidence of how clinical interventions are or are not working. AI and machine-learning algorithms can interpret a mountain of data from a single patient to generate actionable clinical data. Today's busy clinician will need to rely on AI to manage the avalanche of information and informed decision-making would rise to a new level.
Materials engineering, AI, and robotics will solve today's problems.
3D printing is more than addition. New technologies combing patient imaging and novel resins will allow bespoke printing of anatomic structures. Researchers have already printed mandibles and more. Joints can be customized to the individual and the off the shelf solutions will become obsolete.
Add in blockchain technology and combine privacy-preserving human data asset management, disease prediction markets, and the power of open, decentralized payment networks to build future healthcare ecosystems. Companies such as Healthcombix are leading the charge in removing the middlemen, increasing transparency, and providing the framework to manage the health of populations effectively.
Think Far Ahead
"Skate to where the puck is going, not where it has been.”
-Wayne Gretzky
This article has barely scratched the surface of the current innovation and inevitable but positive disruption of healthcare.
The race to the bottom is inevitable. This is not gloom and doom but rather an accelerated version of reality. US healthcare leads the world in cost but not outcomes.
Look around your organization:
Have pay structures changed?
Have Mid-levels rapidly grown in numbers?
Is administration lobbying to help you - the doctor?
Has clicking and administrative tasks increased without a parallel compensation?
Technology, AI, data science and a host of other factors have combined make physicians an expensive solution.
Be honest, does it take four years of medical school and 3-5 years of residency to choose Amoxicillin as a treatment for strep throat?
While physicians are vital, much of healthcare can be managed at a lower economic level. Telemedicine has created a low-cost solution to an expensive office or ER visit for many common ailments.
As a consultant to several telemedicine groups, the compensation model for physicians has fallen by 50% or more in the last three years. Asynchronous communication and the commoditization of medicine will push that number lower.
The take home point is this:
You must change or risk permanent disruption. Opportunities are abundant, and the correct mindset will help ensure relevance as exponential technologies and those pioneers pushing the edge and disrupt the healthcare marketplace.
Read more:
http://theconversation.com/what-is-crispr-gene-editing-and-how-does-it-work-84591
https://www.diagnosticimaging.com/di-executive/ai-and-future-radiology
https://www.appliedradiology.com/articles/a-promising-future-for-ai-in-breast-cancer-screening
https://www.ucsf.edu/news/2019/02/413186/mature-insulin-producing-cells-grown-lab
https://www.nytimes.com/2019/01/28/health/microbiome-brain-behavior-dementia.html
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