Medicine’s bright future
By Vivek Wadhwa,
The Internet and social media are capturing the public’s attention, but some of the most significant advances today are happening in medicine. Technology and medicine are converging in new ways to make possible the types of innovations that could be seen on “Star Trek.” Consider this: We spend the majority of our health-care dollars on treating chronic diseases. Technological advances will enable us to shift those investments into improving our health and preventing disease.
My colleague Daniel Kraft is a physician who chairs the medicine track and heads the FutureMed Program for Singularity University. The Silicon Valley-based university teaches business executives, technologists and government leaders about “exponential technologies.” These are inventions in fields that experience faster growth than average — such as robotics, nanotechnology and artificial intelligence. Singularity University’s founders believe that these technologies, when combined in new ways, could solve some of the world’s major problems, such as poverty, hunger, energy shortages and disease.
Here are the three major trends Kraft sees in health and medicine:
Medicine goes mobile and goes home.
Many aspects of health care and disease management will become cheaper and more effective as our mobile phones and other, similar technology platforms become smaller, Web-enabled and interconnected. In essence, these smartphones will become health platforms. They already contain a wide array of sensors, including an accelerometer that can serve as a pedometer, a camera that can photograph external ailments and transmit them for analysis, and a global positioning system (GPS) that can track our locations.
Developers are also looking beyond the smartphone when it comes to developing these new technologies. For example, Fitbit is a clip-on, Web-integrated device that helps track how many calories you burn during the day; Zeo is a wireless headband that helps you track the quality and duration of your sleep. Other devices, such as the Basis monitor, which is still in development, can keep track of heart rates and movement. Meanwhile, an array of devices, including scales, blood pressure monitors and blood glucose monitors, are becoming Wi-Fi-enabled. These technologies, when they are connected to electronic and personal health records and to social networks, can create powerful feedback loops with friends, and provide clinicians with better information for helping their patients.
Expect to see products that keep track of your health by connecting to global health-care systems similar to the in-car assistance program OnStar. These will incorporate ubiquitous sensors embedded in toothbrushes and clothes, for example. They may even analyze our bathroom visits and food intake. They will likely use artificial-intelligence to constantly monitor our health data, predict disease and summon help in the event we fall ill.
Personalization: From genomics to proteomics
We learned how to sequence the genome a decade ago, and doing it cost billions of dollars. Companies like 23andMe are now offering partial DNA genotyping for as low as $99 (with a one-year subscription to their information service). Expect prices to continue to rapidly decline to that of a regular blood test.
This means that it is now becoming more affordable to compare one person’s DNA with another’s, learn what diseases those with similar genetics have had and discover how effective different medications or other interventions were in treating them. Imagine doing a Google search on specific genes to find others like you and learn their abilities, allergies, likes and dislikes and what diseases they are predisposed to. That future is closer than you may think.
This opens up an era of crowd-sourced, data-driven, participatory, genomics-based medicine. Today, medicines are prescribed on a “one size fits all” basis. When a particular medication causes a significant negative reaction with a small part of the population, it is prevented from being available to anyone. In the future, expect to see doctors prescribing and selecting the most patient-appropriate medicines based on a person’s DNA (the field of “pharmacogenomics”).
Physicians have been conducting adult stem-cell therapy for more than 40 years in the field of bone-marrow transplantation, which involves transplanting stem cells that become red blood cells. Adult stem cells are now being applied in a variety of arenas, from orthopedics to cardiovascular therapy. The first trials using cells derived from embryonic stem cells were for acute spinal cord injury and started within the last year. But embryonic stem cells have raised ethical and moral controversy even though the research remains critical for future progress.
The good news is a new type of cell, induced pluripotent stem cells, which will enable the generation of personalized stem cell lines for use in diagnostics, prognosis or potentially for therapy in the same patient. IPS cells can replace embryonic stem cells for some applications and are, for example, being used to develop neurons from patients with ALS/Lou Gehrig’s disease in order to better understand the disease and develop new therapies.
Tissue engineering and 3-D printing technologies are also beginning to merge. The combination of the two technologies could lead to an era of personalized organ generation. Indeed, earlier this month, surgeons in Sweden carried out the world’s first synthetic organ transplant— a synthetic trachea/windpipe structure created and seeded with the patient’s own progenitor cells.
These developments are just the beginning. There will undoubtedly be regulatory, reimbursement and other challenges. And there will be heated debates about ethics and morals. But it won’t be long before we are using devices similar to the “Star Trek” tricorder and synthesizing our medications.