Improving the delivery of healthcare is arguably the greatest challenge facing the United States and the global community particularly with regards to aging populations. Next generation healthcare services also represent one of the largest growth sectors for applied information and communication technologies that improve access and quality while reducing costs for patients and healthcare institution.
Is Healthcare 2.0 preparing for prime time?
This notion of applying advanced technology systems is not new, but widespread applications might be much closer to mainstream adoption than is currently reported.
This notion of next generation healthcare services has been explored by a number of forward looking physicians such as Dr. S. Vincent Grasso who organized a recent symposium at the Stevens Institute of Technology in Hoboken, New Jersey titled: ‘Enhancing the Delivery of Healthcare Services to an Aging U.S. Population.
Among the many topics explored by experts were: forecasts of diseases common to aging populations, and solution platforms based on low cost video conferencing to connect Doctors, patients and families, commercialization of easy to use imaging and sensing systems for remotely based diagnosis equipment, standards for patient records, and healthcare facilities management.
Over the next 12 years, biotech and stem cell research could
enable doctors to replace aging skin, bone, and organs on demand,
thus restoring many ‘boomers and seniors alive today to a healthy,
more youthful state.
Already successful in replacing damaged heart tissue, stem cells
might also tip the scales in the war against cancer. Scientists
recently discovered that these proliferating wonders are the source
of most cancers. At the heart of every tumor lie a handful of
aberrant stem cells that feed malignant tissues.
Whitehead Institute’s Robert Weinberg believes this explains why
tumors often reappear after chemotherapy and radiation seemingly
destroyed them. It also suggests new strategy for developing
anti-cancer drugs: focus more on attacking cancer stem cells and
not, as at present, killing just any cells to shrink tumors.
On another front, Indiana University’s Dr. Michael Murphy uses
stem cells to treat a debilitating cardiovascular condition called
peripheral arterial disease, which causes poor blood circulation in
the legs, resulting in sores, ulcers; even amputations.
He and his colleagues use adult stem cells to create healthy
cells in the lining of blood vessels. They extract cells from bone
marrow, then process and inject them into patients’ legs. Every
patient in the tests experienced positive benefits. (cont.)
As our “miracle” 21st century begins to unfold, a statement,
which has been an eternal truth for most of human history, is now
being seriously challenged: Humans will always be battling
sicknesses. Many scientists believe this statement could be
overturned within the next three decades, and most of the credit
for this feat would lie in our ability to increase computer power.
Today, medical researchers, in efforts to cure heart disease,
cancer, obesity, Alzheimer’s disease, and many other human ills,
perform trial and error experiments in labs, and conduct human
clinical trials that yield excruciatingly slow results. Cancer
deaths are predicted to not end for another seven years, and cures
for other diseases are projected to be even more elusive.
But researchers say we could speed medical research progress by
first using Clinical Trial Simulations (CTS). If we preceded actual
human trials with high-speed computer simulations, the end results
would be reached much faster. Ronald Gieschke, of Hoffmann-La Roche
in Switzerland, claims CTS will have a
significant impact on the way in which drugs are developed in the
future. “Human clinical trials will still be necessary,” Gieschke
says, “but CTS will make them faster and
more accurate”.
In addressing the need for increased computer power,
IBM’s new “Roadrunner,” built for the US
Department of Energy’s Los Alamos National Laboratory has achieved
performance of 1.026 petaflops (more than one quadrillion floating
point operations per second) and is now rated as the fastest
supercomputer in the world.
The DOE announced that this computer
will link its facilities to other government labs and major
research centers around the world. Scientists will find easy access
to this new supercomputer later this year, according to a
LANL spokesman. The new machine will
enable breakthrough discoveries in biology that will fundamentally
change medical science and its impact across society. (cont.)
We often think nostalgically of our past as the “good old days,”
but projected scientific and technological breakthroughs suggest
the greatest and most exciting times are yet to come. Today,
breakthroughs in healthcare rush at us with amazing speeds, but the
golden ages of biotech, 2010-2020, and molecular nanotech,
2020-2030, promise even greater advances in human health.
Legendary biologist Leroy Hood predicts that in the next decade,
we will understand genetic predispositions for most sicknesses and
develop tools for preventing them. “We’ll move from a mode that’s
largely reactive to one that’s predictive and preventive,” he
says.
Between 2010 and 2020, research labs will place strong focus on
regenerative medicine with its amazing prospect for re-growing
organs and tissues from inside the body. According to a recent
government report, this new technology promises to radically
improve health, restore a more youthful appearance to aging seniors
and ‘boomers, and eliminate most deaths from cancer, heart disease,
obesity, and many other illnesses.
Last fall, I had the opportunity to give the keynote
presentation at the Wisconsin Hospital Association’s annual
meeting. The title of my talk was “The Future of Health Care.” At
the behest of the conference organizer, I provided an advance copy
of my presentation so that they could make copies for the
participants. The only problem was that the organizers asked for my
presentation a few weeks in advance and the pace of technological
change – especially as it relates to the health care industry – is
so rapid that I was compelled to update a number of slides prior to
my talk.
As proof of the accelerating pace of technological change, I’d
like to just walk you through a few weeks of technological and
scientific advancement in the health care industry. In October,
researchers at Chonnam National University in Korea announced that
they had created a microscopic
robot small enough to travel through blood vessels. The robot
is so capable that once it is inside a blocked artery it is able to
release drugs to dissolve blood clots. According to this 2007 study, deaths from severe heart attacks
after hospital admission have already been halved in the past six
years. As a result of advances such as this microscopic robot, it
is reasonable to believe that we will continue to make even more
progress.
In early November, researchers at the Institute for Advanced
Bioscience in Tusuroka, Japan successfully demonstrated that they
had used inkjet printers to “print” human
stem cells. The significance of this advance is that society is
now one step closer to creating implantable organs. (cont.)
In the past we have consumed certain drugs because they keep us
awake or make us feel good, even if they had dangerous side
effects; but soon we will come across powerful drugs and techniques
to boost our cognitive capabilities.
As an example, a recently developed drug has caught some
attention. In the healthy human being, Provigil
fatigue and suppresses sleep. That sounds great when you walk into
your office exhausted and you can’t imagine going through the rest
of the day without it; but it was originally used in the treatment
of narcolepsy. (The off-label use of this drug resulted in a $425
million penalty for Cephalon), the
producer.) Provigil is known to boost working memory, executive
function and attention and has attracted a variety of fans ranging
from athletes to the French military.
In comparison, tobacco was promoted in 1560 for their medicinal
uses, and as early as the Stone Age humans chewed plants containing
caffeine to stimulate awareness, ease fatigue, and elevate mood.
We’ve seen how both the caffeine and nicotine industries have
shaped today. Provigil, our contemporary counterpart, is newer to
the game but its effects are stronger and safety is still debated.
Might they be even safer than caffeine and nicotine? How will
Provigil and other developing enhancers shape the future?
From an ethical dimension, humans have been taking drugs for a
while, including the aforementioned, and in a way we have
co-evolved together with them. They were useful to us, and so we
helped them to reproduce and scale. We might try to imagine how the
world would be without coffee and cigarettes – might that lead to
lower productivity or other negatives? It’s certainly difficult to
quantify. Jumping forward, what if we increased productivity by 10%
by using new drugs such as Provigil? How would/will this transform
our economy? How intrusive are we willing to get?
Although camera pills have been around since 2001, Philips recently unveiled the next generation of swallowable gadgets. Called the iPill, it is able to deliver medicine to specific areas of the intestinal tract as well as measure the acidity levels of its environment. “In the form of an 11×26 mm capsule, the iPill incorporates a microprocessor, battery, pH sensor, temperature sensor, RF wireless transceiver, fluid pump and drug reservoir.” It’s also small enough to pass through your intestinal tract without causing any issues.
Although it determines its location by measuring PH levels (which is accurate enough already), Philips expects iPills to get more accurate when combined with medical imaging devices such as MRIs or CT scans. The iPill could come in especially handy when Crohn’s disease or colitis is involved — typical medicine for sufferers involve lots of steroids and has many adverse side-effects. The direct delivery of medicine with the iPill means medicine levels can be lower, reducing unpleasant side-effects.
One chapter of The End of the American Century focuses on the relatively poor levels of health care in the U.S., and how badly it fares in comparison to other wealthy countries. As I point out there, this is surprising in many ways “because the United States indeed does have available the best medical care in the world and spends more on health care than any other country.” But “because there are so many poor people in the United States and so many people without access to health care, the average level of health and medical care in the United States is among the worst in the developed world.” In the late 1990s, the World Health Organization ranked the U.S. at 37th in the world in the overall performance of the health system. This was the lowest ranking of any country in the OECD. “
New data reported in the New York Times confirms these disturbing trends. The United States now ranks 29th in the world on infant mortality rates which, as the Times points out, is “one of the most important indicators of the health of a nation and the quality of its medical system.” The U.S. ranking has declined sharply since 1960, when its ranking was 12th in the world.
This international gap has widened even though the U.S. spends far more on health care than most other wealthy countries, on both a per capita basis and as a percentage of GDP. In 2006, according to the Times, “Americans spent $6714 per capita on health—more than twice the average of other industrialized countries.”
Grace Marie Turner, president of the Galen Institute, a conservative research organization, told the Times “infant mortality and our comparison with the rest of the world continue to be an embarrassment to the United States.”
Once nanotechnology, stem cell research, and genetic engineering were able to converge upon the same laboratories it became clear that a wide variety of deadly and debilitative diseases share their origin: damaged or failing tissues, organs and bodily systems. Some are chronic due to aging, others are more acute, but they have correlated pathologies after all. The interrelationships between the biggest 20th century killers of humankind became astonishingly clear, as did the road to the regenerative medicine to cure nearly all of them.
Although it determines its location by measuring PH levels (which is accurate enough already), Philips expects iPills to get more accurate when combined with medical imaging devices such as MRIs or CT scans. The iPill could come in especially handy when Crohn’s disease or colitis is involved — typical medicine for sufferers involve lots of steroids and has many adverse side-effects. The direct delivery of medicine with the iPill means medicine levels can be lower, reducing unpleasant side-effects.
