Tech medicine of the future
Telemedicine, bioprinting and mobile monitoring were called the main trends of medical services development; a special survey was presented at forum “Open Innovations”. In the near future we will be able to independently monitor vital signs and diagnose using smartphones, and hospitals will print organs and consult patients on Skype.
Development of medicine and pharmacy was one of the key topics of discussion at forum “Open Innovations”. According to one of Forum participants, partner at consulting company Frost & Sullivan Dorman Followill, quality of health care is becoming a global challenge and one shall make every effort to make medical services more available, cheaper and more efficient.
One of the main current trends that will help us achieve this, it is the convergence of medicine and information technology. Availability of health services remains a challenge for most of the world population and increase of longevity and increase of chronic diseases only further increase demand for medical services. This demand cannot be satisfied by traditional ways - by opening of new hospitals and increasing number of doctors because there is not enough money. Possible solution is the spread of telemedicine, when both doctor and patient do have to spend time meeting in real life and all they will need is a computer monitor. On the one hand, this will reduce the cost of services for clients, and on the other - will help facilitate an exchange of experience between experts through webinars.
Another way to save resources in the future is voice recognition technology to help doctors reduce the time expenditures on paperwork (now it takes up to 30 % of the working hours). Also, implementation of new information technologies will solve another important issue - the need to process large amounts of information (currently 80% of electronic information in the field of medicine is not structured). This is crucial, as it will allow improving the quality of research and medical decisions - now share of medical errors in different countries varies from 7% to 30%.
Theoretically, processing and comparison of a huge amount of existing statistical information using supercomputers automatically provides diagnose the patient and offer treatment options. Unified database of personal medical data has big future, as besides other things it will allow doctor to reduce the time he spends on admitting patient, because he will not have to interview patient again and waste time on medical survey that was already conducted before. Access to such database will rise awareness of patients for whom it is becoming increasingly important. So, according to Boris Zingerman, head of IT Department of Hematology Research Center of Russian Academy of Medical Sciences, more than 40 % of patients in the U.S. are ready to change their physician because of lack of access to information about their treatment and other medical information.
In the future, independence of patients will anyway rise because coming to doctor they will already be in possession of survey results. Personal medical mobile devices created thanks to miniaturization and development of sensor technology will be helpful in that. Such devices can monitor vital signs, and this will provide us with opportunity to recognize the symptoms of the disease in its earliest stages and no doctors will be needed to do it. The first trend in development of such gadgets is contactless devices such as video cameras, which are able to determine vital signs on the grounds of redness or microvibrations of body surface. In addition to individual applications such cameras can be installed in public places.
Second promising direction of such technologies development is placement of sensors into human body, in the future it can be done from the very birth. For example, such sensors could transmit data to Google Glass or smartphone screen, which would provide doctor with opportunity to see immediately all the vital signs of the patient and save time and resources. In addition, such sensors could immediately send signals of adverse changes in patient body to patient and doctors. However, accuracy of measurement of some signs is still not high enough. Furthermore, use of this technology is limited by relatively low capacity of batteries for sensors: today they would have to be changed regularly, which is clearly not suitable for implanted devices. The option possible to be implemented today is sensors in the fabric of everyday clothing, or creation of special "smart" patches that can capture data and transmit them to your mobile device.
In the future this kind of continuous body monitoring will allow predicting and preventing possible diseases. If current share of costs for preassessment and disease prevention in the world is 30 % of the total cost of medical expenses, by 2025 it will grow to 49%. Proactive medicine that will prevent disease, using DNA analysis of the patient among other methods, comes to the fore. Now complete genome sequencing costs about $ 3 000, but in the near future the price will decrease to $10 and will become generally available. Using DNA analysis data allows warning the patient about the peculiarities of his body in advance and beginning prevention hypothetical disease in time. In some cases, if the disease cannot be prevented, the affected organ will be partially or completely replaced with implants.
The main types of modern implants are devices that mimic the body's tissues, providing drug doses monitoring vital processes. At the moment one of the main problems in this area is to reduce the risk of immune reactions to implant. One way to avoid immune reaction is development of so-called food electronics. In this case, implant enters the body via the gastro-intestinal tract, as a pill. Here, same as in case of implantable sensors, we still need to find a solution to resupply energy for such devices: perhaps they will be are disposable or will use qualitatively new biomaterials for their work. Demand for this type of medical devices is rather large: it is projected that by 2015 only in Europe sales of implants will reach $ 35 billion. In Russia it will be only 6.5 billion RUB, although in the next three years growth rate of demand will be about 30%. Just as today it is orthopedic implants that will attract the greatest - mostly joint implants, which technically are among simplest ones. However, given that the main cause of death of Russians is cardiovascular disease, share of respective implants (cardio stimulators of various kinds) will continue to grow. For example, in the U.S. the number of people having at least one implant is 11 million people - according to statistics, replacement of knee joint is most common case.
Another option for organ replacement is bioprinting - technology that will "print" stem cells, tissue, and even human organs. The first such bode organ ("printed" kidney) can be created as early as in 2030. By now using 3D- printing, you can create only small vessels, cartilage and skin segments, but we have not been able to learn to "print" vascular tree, and this is the greatest obstacle that does not let us print body organ. Material for such "printing" are special spherical clusters of cells (spheroids) – they are created by are pouring the cell suspension in microwells. Further, using computer reconstruction a drawing for organ needed is created and several types of preformed spheroids are placed in bioprinter. Then they will be applied in layers to the image of organ in 2D; after that the whole structure will be placed into special bioreactor to ripen. Most importantly, these organs can be rejected by patient's body, because organ will be created directly from patient’s stem cells. If this technology will be successfully used and widespread, all modern organ donation (that always implies a risk of being rejected by patient) will no longer be needed. The development of this method is carried out in Russia: the company having the world's first patent for bioprinting is a resident of Skolkovo.
