The Future of Healthcare  - A Practitioner and Researcher’s View

This is part 2 of a 2-part series focusing on healthcare consumers, practitioners and researchers.

By Kurt Roemer, Chief Security Strategist at Citrix

Advances in healthcare are advances in life

Our lives are enhanced through the interaction of preventative wellness activities, therapies and the deeply personal health knowledge that the future of healthcare brings. The practice of medicine is rapidly evolving with new insights and technologies announced daily that instantly transform the healthcare landscape – and our quality of life.

If you're reading this as a medical professional, first of all:  Thank you.  As healthcare consumers, we are indebted to your dedication in improving health outcomes.  Our primary goal is to give a futuristic glimpse into trends and technologies that can radically change the practice of medicine from the perspective of practitioners and researchers.

If you’re reading this as a consumer of healthcare, our secondary goal is to give insights into how caregivers, researchers and other medical professionals can streamline the efficiency of care and optimize our health situations. This document expands upon the concepts and predictions presented in The Future of Healthcare – A Consumer View.

Advancing healthcare – from incremental progress to disruptive innovation

There exist many areas in today’s healthcare experience that are suboptimal for the healthcare professional. Workflows that involve too much work, activities that take more time than they should, collaboration that requires constant intervention and, of course, the constant challenge of keeping pace with the ever-advancing practice of medicine.

As healthcare evolves towards personalized medicine, other top-of-mind issues include:

  • Much of your patient interaction will be virtual and complemented by personal telemetry and remote diagnostic tools. Telemedicine will increasingly keep patients from visiting clinics.
  • The notion of “Primary Complaint” will be increasingly combined with patient-specific information from consumer and clinical-grade sensors, as well as eventually their genome.
  • Genomic profiling will specifically target a therapy/drug specific to this genome for personalized therapy, but will also kick the door wide open to invasive privacy concerns.
  • Specialists will be part of a collaborative multi-disciplinary diagnosis team that’s dynamically assembled from a global network with deep expertise in evidence-based medicine.
  • Robotics will increasingly be used for patient interaction, triage and as caregivers.
  • You will be compared to Dr. Google, with personal performance statistics and ratings highlighting your (in)efficiencies published to patients, fellow practitioners and insurance companies.
  • Healthcare education will commence well before you interact with the patient – for good or for bad. Social hypochondria will be an increased burden requiring autonomous management.
  • Research will use patient genomics for predictive analytics and diagnosis of complex and multiple intertwined diseases. Crowdsourcing and social research methods will be prevalent.
  • The business of healthcare will continue to balance response, cost, convenience, efficacy, accuracy and compliance. Consumerization puts these choices in the hands of individuals, allowing them to optimize their own care – but often across compliance boundaries as they work with multiple practitioners and providers.

While incremental improvements are being made, what are some of the big disruptors that would greatly advance healthcare for the medical professional? And how can technology combine with personalized medicine to transform the practice of medicine?

Healthcare can use a boost shot of technology

The following three scenarios are intended to show how technologies could be applied in the future to solve otherwise untenable problems affecting health outcomes:

  • Scenario One: A patient arrives at the emergency room alone, unconscious, undocumented and unable to provide any insights into their condition. Live telemetry from on-route EMS has shown a life-threatening pattern of presenting symptoms – but an inconsistent picture of their etiology.

Future: Using a genomic identification patch the patient is matched against their emergency medical record while a multidisciplinary team of diagnostic robots collaboratively triage the patient using genomics, imaging, heuristics and chip-based instant lab analysis – quickly moving through possible differential diagnoses based on correlation of evidence. Replacement tissues for failed organs are printed using the patient's stem cells and inserted with supercharged immune cells targeted to combat the infection while robots balance body chemistry, monitor vitals and ensure treatment efficacy.

  • Scenario Two: A remote caregiver gets notice from patient telemetry and social media that show a new influenza outbreak in their immediate area. And all indications are that it’s especially aggressive and debilitating. They need to quickly diagnose, isolate the infected patient(s) / area, give assurance and provide detailed therapeutic information to those affected, as well as relay ongoing preventative measures to local residents. All this must be delivered in multiple native languages and dialects.

Future: Sensors capture primary and variant DNA from the virus, doing a live consultation with virologists at the CDC and WHO to authorize a specific new vaccine to be remotely assembled and mass-produced at a local secured facility. Affected patients are screened and then further diagnosed via telemedicine – given the rarity of the new virus, patients are scheduled for automated observation timed to the lifetime of the agent. Preventative measures and treatment instructions are streamed to all local media and personal devices, customized to language and just-in-time personal need for information. Emotional sensing dynamically modifies the message to ensure understanding, compliance and satisfaction of detail for both patients and caregivers. For general population treatment, a preventative vaccine is offered at schools and stores and those infected are instructed to go to specific clinics, or for hospital admission if personal complications are anticipated. Staff at clinics are dynamically balanced and pre-scheduled to meet the next week’s projected patient workload. Surrounding areas are notified of the details and provided a heat map showing “If you live here, here’s how many hours/days before anticipated infection.”

  • Scenario Three:  A patient who was adopted at birth participates in an unrelated genetic research trial and learns of a familial pre-disposition to a very rare debilitating disease. A missense mutation in a single chromosome is the genetic marker, but millions of people live with this same genetic modification with no adverse effects. The patient find that research for this disease is woefully underfunded, decides to crowd source further research and step up the search for a cure.

Future: Social media sites quickly locate hundreds of people ranging from the pre-disposed to the deeply afflicted. The information they’ve provided is anonymously combined with genetic profiles in a search for uniqueness. A medical researcher on the other side of the globe who has been focused on this malady for years finally has details that have been elusive and finds that affected patients have a combination of dietary insufficiency for a particular enzyme along with a local environment that oversupplies a trace nutrient. With slight dietary modifications - and oddly enough eating more avocados – the rare disease never materializes. Guacamole, anyone?

 

From an operational perspective, technology will further highlight issues such as:

  • Who are the most costly physicians and patients?
  • Who recommends most expensive tests, treatments and medicines?
  • How does that compare against patient outcomes?
  • How can we better leverage expertise when and where it’s needed?
  • How do we minimize readmissions?
  • How do we make training and education hyper-dynamic and timed to directly improve treatment outcomes?

Location and need-based resource management predicts the need for staff, information and resources based on social media dynamics, competition for cost and a deep knowledge of workflows. Even something as simple as knowing where the nearest wheelchair is can greatly expedite the patient discharge process, freeing up a room and resources for the next patient. Imagine how vital this is for crash carts and little used emergency tools.

Imagine a future where...

...Healthcare is a model of efficiency and patient satisfaction.

Whether healthcare is being delivered and monitored at home, in a clinical setting or on the go, personalized healthcare is transforming our concept of wellness. And with the consumerization of healthcare, the practice of medicine is likewise being transformed.

While much of the future of healthcare seems to involve technology, robots and automation, people are needed to inspire and manage the workflows, privacy aspects and the dangers of an overreliance on technology. The future of healthcare, even with all the technologies involved, still centers on one key concept: Human experience.

The Future of Healthcare – A Consumer View  directly discusses predictions from a healthcare consumer perspective

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