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Posts tagged ‘Healthcare’

The Ultimate Starter Kit For Looking Into The Future Of Medicine

I receive a lot of questions from patients, physicians, researchers, developers, and policy makers after my talks about where they should start in discovering the future of medicine. Which books, movies, TV series or websites would help them understand and get a clear picture about where medicine and healthcare are heading because of new disruptive innovations.

Here are the top choices in each of these categories.

1) Books

Let me show you two books about the future of medicine. The first is The Patient Will See You Now from Dr. Eric Topol. This is the Number One book in digital health. The second is The Digital Doctor from Dr. Bob Wachter. These two books will give you an absolutely clear picture about where we are heading.

Here are nine more books about the future of medicine.

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2) Movies

Regarding movies, Gattaca shows you the non-desired future of genomics. Big Hero 6 talks about how we could measure health parameters at home. And Elysium is discussing the future of radiology and how financial differences will harm society if it comes to health.

Read more in the Top 10 Science Fiction Movies About the Future of Medicine.

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3) Television series

Regarding TV series, The Knick gives a great picture about the first years of modern surgery and how medicine develops over time. And I like Humans which depicts a future with robot companions and what problems on the level of society we will have with them. I also like Star Trek that shows you what people thought about the future of medicine decades ago.

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4) Websites

These are the ones I check on a daily basis.

5) Social Media channels

Regarding social media channels, there are great communities on Google+ (see the image below) and I regularly check the futurology sub-Reddit on Reddit.com.

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What are your choices?

Why Predicting The Future Of Medicine Is Hard – Video

Science fiction movies sometimes show us a great future, but in medicine, they almost always make a huge mistake. There are 3 major reasons why predicting the future in medicine & healthcare is hard, if not impossible.

Please do share what you think.

5 Healthcare Startups Among The 30 Innovative Companies Changing The World

CNN came up with the Upstart30 list that features 30 innovative companies that are changing the world. The only good thing about such lists is that you can come across startups you have never heard of before. Here are 5 healthcare startups from the list:

  • uBiome: genetic sequencing of your microbiome, the microbes living in your digestive system.
  • Ovuline: data on menstrual cycles and physical and emotional symptoms to predict when a woman is most fertile.
  • Honor: In elderly care, they screen and assign caretakers to seniors based on skills.
  • Eko Devices: Using Bluetooth technology, the Core sends digital recordings of heartbeats to Eko’s app and web portal. Doctors can chart the heartbeat or send the recording to a specialist for further review.
  • BioBots‘ first product is a revolutionary 3D printer for building cells, tissues and organs. The printer uses a chemical that works with visible blue light technology, which doesn’t harm the cells.

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The Future of Clinical Trials: Video

An excerpt from The Guide to the Future of Medicine:

Today, new pharmaceuticals are approved by a process that culminates in human clinical trials. The clinical trial is a rigorous process from development of the active molecule to animal trials before the human ones, costing billions of dollars and requiring many years. Patients participating in the trial are exposed to side effects, not all of which will have been predicted by animal testing. If the drug is successful in trial, it may receive approval, but the time and expense are present regardless of the trial outcome.

But what if there were another, safer, faster, and less expensive route to approval? Instead of requiring years of “ex vivo” and animal studies before human testing, what if it were possible to test thousands of new molecules on billions of virtual patients in just a few minutes? What would be required to demonstrate such a capability? At the very least, the virtual patients must mimic the physiology of the target patients, with all of the variation that actual patients show. The model should encompass circulatory, neural, endocrine, and metabolic systems, and each of these must demonstrate valid mechanism–based responses to physiological and pharmacological stimuli. The model must also be cost efficient, simulating weeks in a span of seconds.

Such simulations are called computational cognitive architectures, although the current ones actually lack a comprehensive representation of human physiology. A truly comprehensive system would make it possible to model conditions, symptoms, and even drug effects. To order reach this brave goal, every tiny detail of the human body needs to be included in the simulation from the way our body reacts to temperature changes to the circadian rhythms of hormone action.

HumMod is a simulation system that provides a top–down model of human physiology from organs to hormones. It now contains over 1,500 linear and non–linear equations and over 6,500 state variables such as body fluids, circulation, electrolytes, hormones, metabolism, and skin temperature. HumMod was based on original work by Drs. Arthur Guyton and Thomas Coleman in the early 1970’s.

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HumMod is not the only effort in this area. The Avicenna project, partially funded by the European Commission, aims to construct a roadmap for future “in silico” clinical trials, which would make it possible to conduct them without actually experimenting on people. Other projects use real models instead of computational ones. A liver human organ construct, a physical object that responds to toxic chemical exposure the way a real liver does, was designed at the Gordon A. Cain University. The goal of the five–year, $19 million multi­institutional project is to develop interconnected human organ constructs that are based on a miniaturized platform nicknamed ATHENA (Advanced Tissue–engineered Human Ectypal Network Analyzer) that looks like a CPR mannequin.

It would then be possible to test molecules without risking the toxic effects on humans, and to monitor fluctuations in the thousands of different molecules that living cells produce and consume. The beauty of this project is its plan to connect their working liver device to a heart device developed by Harvard University. If successful, they hope to add a lung construct in 2015 that is being developed at Los Alamos, and a kidney designed by the UCSF/Vanderbilt collaboration by 2016, thus building the first physiological model of a human being piece by piece.

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What Comes After The #Wearable Health Revolution?

The wearable health trackers’ revolution has been going on producing devices that let us measure vital signs and health parameters at home. It is changing the whole status quo of healthcare as medical information and now tracking health are available outside the ivory tower of medicine.

A 2014 report showed that 71% of 16-24-year-olds want wearable technology. Predictions for 2018 include a market value of $12 billion; a shipment of 112 million wearables and that one third of Americans will own at least a pedometer.

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Now a growing population is using devices to measure a health parameter and while this market is expected to continue growing, devices are expected to shrink, get cheaper and more comfortable. At this point, nobody can be blaimed for over-tracking their health as we got a chance for that for the first time in history. Eventually, by the time the technology behind them gets better, we should get to the stage of meaningful use as well.

Let’s see what I can measure today at home:

  • Daily activities (number of steps, calories burnt, distance covered)
  • Sleep quality + smart alarm
  • Blood pressure
  • Blood oxygen levels
  • Blood glucose levels
  • Cardiac fitness
  • Stress
  • Pulse
  • Body temperature
  • Eating habits
  • ECG
  • Cognitive skills
  • Brain activities
  • Productivity
  • I also had genetic tests and microbiome tests ordered from home.

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What else exists or yet to come? Baby and fetal monitors; blood alcohol content; asthma and the I could go on with this list for hours.

The next obvious step is designing smaller gadgets that can still provide a lot of useful data. Smartclothes are meant to fill this gap. Examples include Hexoskin and MC10. Both companies are working on different clothes and sensors that can be included in clothes. Imagine the fashion industry grabbing this opportunity and getting health tracking closer to their audiences.

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Then there might be “insideables“, devices implanted into our body or just under the skin. There are people already having such RFID implants with which they can open up a laptop, a smartphone or even the garage door.

Also, “digestables“, pills or tiny gadgets that can be swallowed could track digestion and the absorption of drugs. Colonoscopy could become an important diagnostic procedure that most people are not afraid of. A little pill cam could be swallowed and the recordings become available in hours.

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Whatever direction this technology is heading, believe me, I don’t want to use all my gadgets to live a healthy life. I would love to wear a tiny digital tattoo that can be replaced easily and measures all my vital signs and health parameters. It could notify me through my smartphone if there is something I should take care of. If there is something I should get checked with a physician.

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But what matters is finally I can become the pilot of my own health.

Right now patients are sitting in the cockpit of their planes and are waiting for the physicians to arrive.

Insurance companies such as Oscar Health have touched upon this movement and offer incentives and rewards (e.g. Amazon gift card) if the patient agrees to share their data obtained from health trackers. This way motivating the patient towards a healthier life.

There is one remaning step then, the era of the medical tricorder. Gadgets such as Scanadu that can detect diseases and microbes by scanning the patient or touching the skin. The Nokia Sensing XChallenge will produce 10 of such devices by this June which will have to test their ideas on thousands of patients before the end of 2015.

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I very much looking forward to seeing the results. Until then, read more about health sensors and the future of portable diagnostics devices in my new book, The Guide to the Future of Medicine.

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Virtual Reality Will Change The Healthcare Experience

Virtual Reality or VR is a computer-simulated environment in which we can have the feeling as being in a digital, virtual world experiencing smell, sound, taste, and visuals. VR has been mentioned in many sci-fi masterpieces such as the Necromancer by Gibson, but technology behind that only came to a point where it can become reality now. Therefore I decided to describe some medical implications of virtual reality in the newest video of The Medical Futurist Youtube Channel.

I recently started discovering the options of virtual reality with the Google Cardboard. Putting my own smartphone with the right application into a cardboard can give the feeling of being in a virtual world. My favorite apps so far are Roller Coaster VRCmoar Roller Coaster VR, and Solar System VR. I should start filming the first reaction of people who give it a try.

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Cardboard is just the very first step. Devices such as Oculus Rift acquired by Facebook, Sony’s Morpheus or Magic Leap will make the difference in the coming years. Check how Magic Leap could change the world around ourselves. Let’s see how virtual reality could change the healthcare experience with ever-improving technologies.

  • Imagine that we could use virtual reality for training surgeons. They could be inside the human body based on the patient’s radiology images discovering all the options before opening up the patient during an operation.
  • We could use virtual reality for patients to experience the hospital feeling even before going to the hospital. They could see how a procedure takes place, how much time it takes, what’s going to happen to them by getting a treatment or procedure.
  • We could use that for psychology treatments, for people with addictions to show them different kinds of worlds. One with being addicted to something, and one with not being addicted any more showing them the real differences in life and how it could change if they found a solution for that addiction. The same is used in PTSD or fighting phobias.
  • Imagine that we could use it for stress relief letting people travel to countries around the world and experiencing the real world through virtual reality.
  • We could train people for emergency and disaster situations without risking anybody’s life.
  • Virtual rehabilitation performed at the patient’s home for anxieties, attention deficits or amnesia. The list of conditions in which VR could be helpful is incredibly long.
  • 360 immersive Virtual Reality arrived to the Cathlab chaning Medical Education.
  • If there is no available real cadaver to practice surgery on, VR can help.
  • A new way for motivating people for doing exercises could be merging VR with video games. See this video:

When for the first time I showed Google Cardboard to my 7 years old niece and she checked that out, she asked me, why would people want real-life experience any more when they can have this. So we will face really serious ethical questions in the coming years, but again virtual reality with the devices coming to the market very soon has the potentials to change the whole healthcare experience.

Read more about the future of virtual reality in my new book, The Guide to the Future of Medicine!

The Guide to the Future of Medicine ebook cover

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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