MEDTECH: What worked during the last 10 years and the new technologies that will shape us for the next decade, by Dr Jason Arora
“I’m a health systems guy and these lists are about health technologies that have moved health systems forward, rather than deep or niche technologies.
“When I left medical school in 2011, the best tech was highly concentrated in the hospital. We lagged behind other industries in processing power, elegance, simplicity, and consumer focus. We still do. Now, we’re seeing tech utilization across the full continuum of healthcare. In fact, advancements in healthcare have been increasingly grounded in tech over the past 10 years, and will continue to be so at an exponential rate.
“A lot of what we’ve seen has naturally been reliant on the evolution of tech more broadly. But, as we know, healthcare tends to lag behind. That is beginning to change because of the growing role that tech is playing in healthcare, across the continuum. Whilst we’ve had amazing science and tech in healthcare for ages, we’re now really trying to move healthcare from art to science as a whole.”
Many of these will continue to become more widespread and evolve further over the next 10 years, but have already begun to transform healthcare.
Digital health records
Patient information is the currency through which health systems process, exchange, and interpret information. Most patient data was (and much still is) contained within written notes. Whilst the earliest electronic medical records (EMRs) were created over 40 years ago, we’ve only seen the mass shift in health information go from analogue to digital in the past 10 years. And still, the trend continues today. This has been the foundation for some of the other major shifts we’ve seen.
You can now search for health information online, simply by typing in your symptoms. Whilst the results can often be misleading for patients, this unprecedented access to health information has been a major driver of the shift in patient power. No longer is the doctor the keeper of all knowledge and information about the patient.
Beyond health information, you can now book your appointments online, order prescriptions, message your doctor, and so on. Taking healthcare online has created a new medium for information exchange between patient and health system, and between health system players themselves. Whilst health systems still remain heavily siloed and lack connectivity, a health system without internet connectivity, at the very least, is now unthinkable.
Smartphones have given patients access to a plethora of tools that are extremely useful for capturing and transmitting useful health information: internal sensors, a camera, the ability to create custom apps, etc.
We now have mobile apps for healthcare that cover all sorts of things: medical records - with the patient now having access to their own records and being able to take these with them, wherever they go; diagnostics - for instance, taking photos of lumps and bumps or using the camera to examine the eye in the absence of specialised equipment; prescriptions can now come to your phone; we have wellness trackers for steps taken, hours slept, calories consumed, etc; we can use apps to help coordinate patient care away from the hospital, and doctors and trainees can message other doctors for advice.
This is playing a huge role in making healthcare more personalised, more real-time, and on empowering both the patient and the doctor further.
With the increase in access to health information, the need to track health behaviours away from the hospital, and the Instagram generation getting obsessed with looking fit and healthy, we’ve seen a huge rise in the use of wearable devices for fitness. Fitbit - one of the best known - was founded in 2007 and starting selling fitness trackers pretty soon after, but we didn’t really start to see these being uses by the masses until a few years later.
Not too long ago, most surgeries were performed by making large incisions in patients - so called ‘open’ procedures. These are associated with more complications and longer recovery times. We then saw more surgeries performed using ‘minimally invasive’ techniques - cutting small holes and inserting cameras to guide instruments inside the body. These tend to lead to fewer complications and quicker recovery times. One of the latest methods is robotic surgery, which - whilst being approved for use around 20 years ago - has been widely adopted by hospitals over the past 10 years. These ‘robots’ are actually robotic systems/machines, controlled by a doctor, which allows them to perform procedures with better accuracy and control.
Whilst we still have a long way to go to understanding the human body, nothing better represents the ‘final frontier’ than the brain. We are still trying to understand how the brain really works, but in the last 10 years, we’ve managed to link thoughts to the control of implants and prosthetics, which is a pretty amazing feat. As human and machine become more integrated in the years to come, we’ll see more of this, and it’ll go a long way to helping us better understand just how this amazing organ works.
You’ve heard of a lot of these technologies, but how will they affect our healthcare?
Artificial intelligence (AI)
AI is when computer systems are able to perform tasks that normally require human intelligence, but really it is when we input data into a system with an algorithm, that works it out for us - faster and with more data points than a human would be able to do in the same amount of time. Indeed, there is nothing artificial about this intelligence, so AI is a bit of a misnomer. And - you’ve probably been using AI since you were in school - just think of your calculator!
In healthcare, we’re using AI to help doctors work through patient data quickly, so that they can make well-informed decisions. One of the first examples we’ll see be employed widely is in AI-supported imaging diagnostics - that is, using AI to diagnosis something on a scan (e.g. an x-ray or MRI), based on pattern recognition. The computer will have seen thousands of similar scans before (just like a doctor, but even more pattern recognition), and will be able to make a diagnosis accordingly. The likelihood is that this will be more accurate than what a human or doctor can do. However, we have to be careful, as data can be interpreted dangerously without adequate context.
Data and personalised medicine
When your doctor sees you, they’re seeing a human being. But, what they also see is a collection of data/information, which they need to use to make a diagnosis, pair you with the best treatment, and then monitor your recovery. With the rise in the availability and specificity of healthcare information - from data on your day-to-day activities right down to your genes - we should start to create highly specific data profiles for patients, such that we can target the right technology, to the right patient, at the right time, in order to optimise the outcome for the patient.
We’ve seen the release of VR glasses and platforms for gaming and movies, we’ll also see VR deployed widely in healthcare. Two of the earlier focus areas will be mental health (simulated reality to help people deal with addiction, phobias, post-traumatic stress, etc) and medical training (e.g. simulated surgery, just like the old popular flight simulator video games!)
Telephone consultations with doctors have been around for a while. The problem is that the doctor can’t see you, and you can’t see the doctor. As we know from our personal lives, video calls are better than telephone calls, which are better than text messaging, for cutting through all the nuances of remote human communication. What we’re starting to see now are platforms for secure video consultations between doctors and patients, particularly in general practice - where a good conversation may suffice. Anything more than that, and the doctor can call you in for a physical examination and any other investigations that might be needed. This will help make things more convenient, reduce no-shows, and lower costs for the health system, without (if deployed correctly) adversely affecting patient outcomes.
Just like other tech, medtech needs to be produced in a factory. And just like other tech, we’re always looking for faster and cheaper ways to make tech. 3D printing - where we use a machine to construct a physical object from a 3D digital model by laying down several thin layers of material in succession - is poised to transform the medtech industry. We’ll be able to develop prosthetics, devices, anatomical models for surgery planning, and maybe even replacement organs in the future. All at lower cost, with greater ease, and with better customization.
Many of you will have seen drones for photography, and you’ll have heard about them being used for military surveillance and to deliver your Amazon packages. But drones will also being used to transport medical supplies, drugs, transplant organs and blood units, birth control, etc to remote areas, to beat the ambulance to an emergency,. Getting stuff from A to B over relatively short distances will always be needed, and where ground transportation fails, we’ll certainly be using the air.