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Posts from the ‘Technology’ Category

Shall We Sequence Genomes At Homes? – The Future of Genomics

As a geneticist, talking with George Church or the President of the Personalized Medicine Coalition was a fascinating experience while writing my recently published book, The Guide to the Future of Medicine. This is still one of the most promising fields of medicine but without getting it closer to the general public, genomics will never play a pivotal role in practicing medicine.

Let’s start from the beginning. From the years of 2005, 2006 and 2007, patients have been able to order genetic tests online with 23andme, Navigenics or Pathway Genomics. In 2013, 23andme received a letter from FDA about ceasing marketing of the screening service. Since then, the market has been transforming into something new that could also meet the regulations of the FDA. At least, hopefully.

My Gentle Labs package.

My Gentle Labs package.

I’ve had 3 genomic tests with Navigenics, Pathway Genomics and My Gentle Labs with 3 different results and experience. I thought the direct-to-consumer (DTC) market is just not ready for prime time. I also analyzed my own raw data with Promethease and got to very interesting conclusions about the future of my life. I loved the possibility to get insights about my genome as well, not just measuring my vital signs. Here is my overall experience with genetic testing:

Similarly to how the wearable revolution is transforming into a world of smart clothes, disease prevention and insideables (swallowed sensors), the field of DTC genomics has been changing too. Here are some reasons why.

  • While the cost of sequencing one person’s genome was about $3 billion in 2003, now it’s possible for under $1-3000 (see figure below). The $1000 genome is still not here, but the trends are clear and soon the shipping cost of the sample will be higher than actually sequencing that genome.
  • The number of sequenced genomes is skyrocketing. Illumina said that 228,000 Human Genomes would be sequenced only in 2014 and the predictions for this year are even bigger. Soon we will all have access to our own genomes.
  • It is known that fetal DNA is circulating in the mother’s blood,and it can be separated from her blood to allow analysis of the fetus’s genetic makeup. Imagine the possibilities.
  • Large US hospitals are about to begin sequencing the genomes of healthy newborn babies as part of a government-funded research program called BabySeq. Major diseases could be pointed out and precautions could be made about others far in time.
  • Oxford Nanopore developed the MinION™ portable device for molecular analyses of DNA, RNA and proteins that is driven by nanopore technology. It might be the first step towards sequencing genes at home, despite early criticisms.
  • There are more and more targeted cancer therapies available. As certain tumors have specific genetic mutations such as BRCA in breast cancer or EGFR in lung cancer, among others, they might be sensitive to targeted drugs. Sequencing a tumor’s own genome is becoming a routine step in designing the therapy for cancer patients, although the costs are exceptionally high.
Cost of genome sequencing.

Cost of genome sequencing.

As you can see, examples underscore the notion that genomics could play a very important role in everyday medicine, but numerous steps and elements are needed for that.

  1. Comprehensive and thorough regulation from organizations such as the FDA or EMA about what DTC companies can offer and actually do. Can patients order tests online or only their caregivers?
  2. Innovative companies connecting patients to medical professionals through the genomic knowledge behind cancer and other diseases.
  3. Reliable algorithms that could help use the huge amount of data genome sequencing leads to in analyzing health outcomes. A great example is how Joel Dudley at Mount Sinai Medical Center is working on implementing big data in medical decision making. IBM Watson is also analyzing genomic data to find treatments in brain cancer.
  4. With the widespread of genetic testing and the decline in the cost, it should be a common thing to analyze my genome or get a detailed analysis. Moreover, caregivers should be trained to be able to use that data in patients’ health or disease management.
  5. A better understanding of what genomics can and cannot offer by the general public. Professor Church pointed out to me that without educating people about the pros and cons of the genomic revolution, we cannot make the right steps forward.

It has become clear, seeing the trends, that the technology letting us sequence genomes at home is coming. Although it’s still hard to make good, evidence-based decisions purely based on genetic background; to get reimbursed if genetics-based personalized treatments are cost-effective on the long term (but expensive on the short term); and to interpret the huge amount of data. Cognitive computers are meant to help us with that, but I’m sure ever-improving technologies will provide all of us with our own genomes far before we could do anything with that information.

Read more about the future of genomics in my book, The Guide to the Future of Medicine.

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Channelling the future in medical education: Infographic!

I launched two courses at Semmelweis Medical School in order to prepare students for the digital world. One is focusing on the medical use of social media, and the other is dedicated to disruptive technologies and how to find the human touch in the digital jungle. Therefore I was very excited when Ashfield, an international healthcare services organization, asked me to be the moderator of a global discussion on the future of education.

I had a chance to work with key opinion leaders of medical education and to engage in amazing discussions about the future needs of medical professionals.

Medical education must ­finally step up to meet the expectations of empowered patients, the needs of busy physicians, and the use of disruptive technologies. This forum was designed to facilitate this process.

See the detailed article about the results on Pharmaphorum, the announcement by Ashfield and the whole infographic. Here is my favorite part and an excerpt from the article of Ruth Herman:

The digital revolution has already led to major changes in channel preferences as mobile technologies, online networks and other innovations provide better ways for healthcare professionals to learn and obtain new information. These changes are likely to continue as the digital skills and sophistication of both patient and physician populations continue to grow. So how can the providers of this information stay ahead?

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The Future of Diabetes Management: 8 Reasons Why We Face Extraordinary Times!

Around 400 million patients have diabetes worldwide according to estimations. And over the last few years, diabetes management has been improving but due to the new technologies and devices coming to the market very soon, the whole management of diabetes will significantly change in the coming years. Let me show you some examples how.

Digital Contact Lenses

Google has an augmented reality glass called the Google Glass which they just stopped developing, but they also patented a digital contact lens through which we can get more information from the digital world plus it can measure blood glucose levels from tears as an added benefit. Google launched a partnership with the pharmaceutical company Novartis to develop these smart contact lenses that can track diabetes and fix farsightedness as well.

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Gamification

There are amazing applications for smartphones that can help you manage diabetes efficiently. MySugr, an Austrian company, released several applications that can add a little bit of gamification to the traditional diabetes management apps. The company also developed the mySugr Junior App designed for kids to learn how to manage diabetes properly. It also enables parents to keep control over the therapy when they are not around the kid. The app looks like a game in which the children get points for every entry and the goal is to score a particular amount of points every single day.

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Patient empowerment with big data

Databetes helps patients better manage their diabetes by providing a good way for logging and measuring data, as well as a revolutionary concept to analyze the big data behind one person’s disease. Patients can support each other through social media channels and become coaches for each other. Look at sixuntilme.com for best practice examples.

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Bionic pancreas

There is artificial pancreas which means that it’s a closed-loop insulin delivery system. The device can measure blood glucose levels constantly and decide upon the insulin delivery itself. Engineers from Boston University have developed a bionic pancreas system that uses continuous glucose monitoring along with subcutaneous delivery of both rapid-acting insulin and glucagon as directed by a computer algorithm.

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Food scanners

TellSpec, a Canadian company is coming up with a food scanner this year which by scanning your food can tell you how many and what kind of ingredients, how many allergens, toxins, how many carbohydrates you actually have in the food you are about to eat.

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Pocket-sized gadgets

When you live with diabetes, you get used to carting around with plenty of things such as meters, test strips, lancing devices, and so on therefore a pocket-sized gadget can change this called Dario that also comes with a diabetes management system.

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Wireless monitors

The medical company Abbott just released a FreeStyle Libre system which makes it possible to constantly measure blood glucose levels in a wireless way.

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Digital tattoos

Here is a digital tattoo that can measure glucose levels by using electric current to attract glucose to the surface of the skin. The proof-of-concept study was just published and it’s time to bring the era of wireless diabetes management to patients.

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So there are more and more technologies that can help people manage diabetes properly besides potentially future therapies such as new drugs or islet cell transplantation but it’s really time to manage diabetes in a gamified and comfortable way and I believe that the best gadgets and the best technological solutions are just yet to come.

Please share your experience and thoughts on this!

Further reading:

Running Tips For Geeks: Wearable Devices and Smartphone Apps

It’s really hard to find motivation to go out for a run or to do exercises every single day. I struggle with that, just like you. I only go out for a run if I can measure data, I’m a geek. Here are the wearable devices and smartphone apps that help me find the motivation I need.

What Should Hospitals Look Like In The Future?

How do you start when the goal is to design the hospital of the future? When I was writing this chapter for my new book, The Guide to the Future of Medicine, I contacted talented architects, as well as organizations such as NXT Health focusing on this sensitive topic and shared my own views as well.

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Here are a few things from the top of my mind as excerpts from the book:

  • No waiting time will harden the lives of patients as cognitive computers will organize all the details of the healthcare system. It will direct people when and where to go by analyzing their records, and automatically responding to doctors’ notes and prescriptions.
  • Extrapolating from today’s trends, it is clear sophisticaed surgical robots will rule the scenes of operating rooms (ORs), although not all ORs will include surgical robots as there will still be operations that could not be performed using only robots.
  • Devices and equipment of radiology, surgery and many other specialties from CT scans to endoscopic technologies will be so small they would all fit in the OR.
  • Cameras will record every movement in the OR as robots will be controlled from a different, sometimes distant locations. Examples are already available, e.g. in the Radboud Medical Centre.
  • Using radiology images such as CT or MRI scans ot patients, surgeons will be able to look into the body and even organs of patients before the operation for better surgical planning and during the operation for more precise movements. Augmented reality in action.
  • It will only include materials that cannot be infected; flexible touchscreens featuring important health data will be around the bed which will be controlled by the patient.
  • The walls might include virtual reality to make sure the patient feels literally at home by showing them images and pictures from their home which they can upload to the system while lying in a hospital bed.
  • Waiting rooms will feature charging sets for wearable devices where data could also be exported before the visit.

Here is how NXT Health thinks about the future of patient rooms:

A canopy above the bed houses electrical, technical, and gas components, even a noise–blocking system. A Halo light box can be programmed for mood and light therapy, and also serving as screen to display clouds or the sky. The head panel contains equipment that can measure almost any health parameter unobtrusively while continually logging results. The footwall features a screen for entertainment, video consultations, and accessing whatever information the patient needs. Floors are made of low–porosity rubber that does not need chemical sealers and does not trap bacteria and other substances. In case of a fall it reduces impact.

To reduce potential infections all surfaces are made of solid materials that are often used in kitchen countertops. A light at the entrance reminds staff to wash their hands before entering the room. Information and data can be added to patient records here as well as at a control panel.

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Although not all advantages will be the consequences of ever improving technologies but a different kind of training for the staff:

The Walnut Hill Medical Center in Dallas has been referred to as the Apple experience hospital due to its design and innovative nature. Potential employees must take a psychological exam, and the application process is exceptionally tough. Patient greeting begin in the parking lot with complementary valet service. Inside, the staff follows the Ritz Carlton “15–5” rule meaning that a hospital employee must smile at the patient from 15 feet and greet them with a warm hello at 5 feet. All employees are trained to communicate properly with patients and their families. Patient rooms feature large windows that provide natural light and pleasuring views.

Read more about the hospital of the future and what examplary hospitals operate today in The Guide to the Future of Medicine.

And as a bonus, here is how people in the 1950s saw the future of hospitals:

What Question Does Excite You the Most About the Future of Medicine?

I have amazing conversations on social media with people from around the world about where technology leads us in medicine and healthcare in the coming years. As I give around 90 talks per year, I also receive fantastic questions from the audience from time to time and I started listing these.

Now I would love to hear what question excites you the most about the future of medicine! Will we print organs or will robots replace doctors? Anything else? Please leave a comment here or submit your question on medicalfuturist.com.

The questions will be used anonymously for an upcoming and very exciting project which I will share more details about soon. Thank you!

Medical Doctor holding a world globe in her hands as medical network concept

Will Robots Replace Doctors?

It is quite obvious, based on my previous posts, that I think cognitive computing will play a major role in the future of diagnostics. See these examples:

Now MobileHealthGlobal.com asked me to share my views on this:

In fact, these machines, which are also called cognitive computers, have the advantage of allowing the doctor to focus all of his or her attention on the patient, instead of having to concentrate on finding information. Thus, to combine human and artificial intelligence is key. Meskó defends that “the best potential pair is a human with technology.”

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