What does the future of medicine look like?
How important will technological developments – especially artificial intelligence (AI) and robotics – be to medicine in the future? What does it look like, for example, in an intensive care unit? Can having various specialists in one location streamline patient care? And will these future medical innovations further widen the gap between those who can access them and those who cannot?
These are some of the fascinating questions discussed at last night’s UNSW Sydney Future Medicine event, hosted by ABC reporter Tegan Taylor with medical experts Professor Louisa Jorm, director of the Foundation of the Center for Big Data Research in Health at UNSW; cardiologist and Scientia professor of medicine at UNSW Anushka Patel; Professor Anand Deva, Head of the Plastic and Reconstructive Surgery Program at the Faculty of Health Sciences and Medicine, Macquarie University; and Associate Professor Joseph Powell, a leading biomedical researcher and statistical geneticist.
An underlying theme of conversations with the panel of experts was personalized healthcare, improving patient care and outcomes as technology in the medical field evolved.
So what does the future of medicine look like?
Artificial intelligence in healthcare
Health care facilities are full of data. How do you sift through the data, protect the patients, and train the people in the system to make the most of the power of AI when all this technology is developing so rapidly?
Professor Louisa Jorm, who is an international leader in big data health research, explained how data could be harnessed in an intensive care unit (ICU).
“Critical care is one of the biggest producers of data within a hospital, with current technology producing continuous streams of data on physiological parameters such as heart rate, breathing rate, blood pressure and blood pressure. blood sugar. This was primarily used on site to monitor an individual patient. What we can now do is pull together the data generated by the ICUs of multiple patients – potentially thousands of patients – and then apply these AI or machine learning techniques to produce more personalized approaches to patients. intensive care.
Although this technology is still in its infancy, Professor Jorm said there are some great examples emerging from the research arena related to automated blood control and automated mechanical ventilation control. However, in intensive care units there is a big implementation gap between what is possible – using data and technology – and what works in the clinical setting of a hospital.
“As you can imagine, there are so many human factors involved and in particular there is the current generation of physicians and other clinicians who are not necessarily familiar or comfortable with all of these technologies. Rightly so, they worry about who makes the decisions and are they good decisions? Are there possible ethical and legal implications if decision making is done in an automated way? So I think the big challenge is how to implement AI-assisted decision making or machine learning, but with the clinician still feeling in control and able to engage patients and caregivers in the process. some of these decisions. It’s not always the machine that makes the best decision.
Imagine if you could figure out cancers that were undiagnosed before they were seen or detect cancer clones in advance that were going to be resistant to treatment. Cellular genomics is the basis of this future.
“Cellular genomics is basically a type of technology that allows us to generate sequencing data – information about our genomes – but at the level of individual cells,” said associate professor Joseph Powell, who heads the Garvan-Weizmann Center for Cellular Genomics.
“The reason it was so revolutionary is that genomics and the generation of sequencing data has been around for a while… this is where you would take a cancer sample from a patient, and you would sequence the contents of millions and millions of cells, which is fantastic. It can be used for very important results, but it doesn’t give us any information about the difference between a cancer cell and another cancer cell, for example.
“However, cell genomics gives us this information and it allows us to understand the differences between cells in cancer, for example, or why these genetic differences between them impact the response to treatment or why we respond to an infection. or even why we develop the disease in the first place, ”explained A / Prof. Joseph Powell.
Integrated models of care
Being diagnosed with skin cancer is a troubling feeling, in addition to having to schedule medical appointments and appointments with specialists in various locations. What is the solution to this problem?
Professor Anand Deva is an architect of integrated care models. He is the director of the nonprofit Integrated Specialist Education and Research Foundation, which is dedicated to improving Australians’ access to quality health care.
“What we’re trying to do is simplify the system for patients. So for example with the diagnosis of something like skin cancer that can certainly be quite frightening, if you add the confusion, costs, wait times and inefficiencies of going from doctor to doctor. , in its simplest form, an integrated model of care around skin cancer would put all the pieces that would be needed to treat that patient in one place, at the same time. And that’s exactly what we did, ”explained Professor Deva.
However, when implementing such a model, Professor Deva stressed the importance of a collaborative mindset in a naturally fragmented system.
“The biggest change, of course, came when Medicare was introduced. I firmly believe in universal access to health care, but the problem is that since then we have had the private sector against the public sector. We had specialists versus generalists. We have had health insurance funds against doctors. We had the industry versus private hospitals. Each of these components doesn’t necessarily like working together, so to begin with, I think you have to find people who are open to collaboration and it’s not easy.
Prof Deva said for the integrated care model to work successfully, you need to choose a cause. “At the end of the day, if you have a patient sitting in front of you with a problem, there is nothing like coming together as a system to help that particular patient.”
Equitable access to health care
With all of these medical advances, the future looks bright. But what must we do to ensure a bright future for everyone? How can we ensure that these advances in health are distributed fairly?
Professor Anushka Patel is Senior Vice Director and Chief Scientist at the George Institute for Global Health and is dedicated to making healthcare both affordable and effective.
“I think we have a healthcare system in Australia that we can be really proud of. But the health system we have today was developed and established for problems of the past and most of the health inequalities we see today are problems of the present and the future, ”said Professor Patel.
Professor Patel suggested that Australia’s healthcare system is not equipped to deal with an aging population and the growing problem of multimorbidity. She said it needs to be transformed in the future and that this could be achieved using three principles that can help ensure greater fairness.
“It’s a concept that is gaining credibility around prevention that is sometimes called the“ three Ps ”. These are innovations or changes in medicine or health care that not only prevent disease, but at the same time help promote fairness and protect the planet. It is about transforming the health system towards patient-centered health care with more emphasis on prevention than on cure.
“What I mean by patient-centered care is you know that for each person, we provide the right care, at the right time, in the right place, with a real focus on shared decision-making. . It is fundamentally personalized care. It is a collaboration between providers and patients and it is coordinated between providers, especially in the context of multimorbidity, ”said Professor Patel.
She explained that it’s also about meeting the needs of the patient, not the convenience of the systems and processes currently used in traditional brick-and-mortar healthcare systems.
“These aren’t new concepts, but they happen very gradually, when they need to be transformative. For this transformation to patient-centered care to occur, I think it will take major changes in vision values, leadership drivers for quality improvement that include funding models but also new ones. workforce strategies.
“But I have no doubt that some of the other innovations we’ve talked about today around data and technology will be critical catalysts for any transformation, especially the transformation that will promote fairness.”
About the medicine of the future: This event was presented by the UNSW Center For Ideas and the Faculty of Medicine and Health. This is part of a program of digital events organized by UNSW and supported by Inspiring Australia for National Science Week.