Singh Yadav
Tamil Nadu, India

Double doors swing open as paramedics rush a burn victim into the hospital’s Emergency Department. A nurse checks the patient’s pulse and vitals, while another takes a blood sample and deposits it to a nearby machine. A scanning device determines the wound size and depth and guides an attached 3D printer to build, layer-by-layer, the correct type of skin tissue to cover the wound. Bio-ink has been formulated with an organic signature from the blood sample to enable optimal grafting. This may sound like a scene from a science fiction movie, but could be a reality in the not-so-distant future. Institutions such as the Wake Forest School of Medicine have embarked on the second phase of test-printing skin cells directly on burn wounds sustained by soldiers¹ and a team of researchers in Canada have unveiled a prototype bio-printer that uses cells from burn patients to replicate skin.²

We are currently in what the World Economic Forum calls the Fourth Industrial Revolution, an era characterized by new technologies that are connecting the physical, digital, and biological realms. This revolution is having an impact on all disciplines, economies, and industries, including healthcare.³ The technological innovations at the forefront of this era—the Internet of Things, artificial intelligence, and robotics—are integrating with consumer and scientific trends to open new horizons for the industry.

Technological forces of change

With more than 3.9 billion users worldwide,⁴ the internet is one of the most prominent features of this generation. The web is a powerful tool that has the potential to educate and empower consumers by providing information on health and healthcare services, and supports self-help and patient choice. Surveys show that 60–80% of internet users obtain health-related information online.⁵ Websites like “Patients Like Me” allow users to share diagnosis and treatment details, information about specific symptoms and medications, and also function as a support group.⁶ Doctors and medical students are using a more diverse range of resources as educational tools as well. Knowledge sharing apps connect doctors to one another, enable crowdsourcing of diagnoses for cases, and provide peer updates on rare diseases, new medical procedures, or interesting new medicine applications. Finally, “smart” wearable technology from Fitbit, Apple, and Xiaomi encourages consumers to know more about their health, take control over their own lives, and reach goals for fitness, weight, and stress management. Ubiquitous connectivity, big data, analytics, and the cloud have thus combined to become the “Internet of Things” as humans, devices, and machines communicate continuously and in ever-greater numbers.

The second technological force, artificial intelligence, includes programs and algorithms that have been developed and applied to practices ranging from drug development to patient monitoring and care. In 2015, Atomwise launched a virtual search for safe, existing medicines that could be redesigned to treat the Ebola virus.⁷ As a result, they found two potential drugs in less than a day, showing the potential of how efficient drug creation could become. Tech giants such as Google and IBM have also launched various data-harvesting and machine learning projects.⁸ IBM’s Watson for Oncology application, developed in partnership with the Memorial Sloan Kettering Cancer Center, allows physicians to quickly identify key information in a patient’s medical record, surface relevant articles, and explore treatment options.⁹ In an experiment with the University of North Carolina School of Medicine, Watson processed medical records of 1,000 cancer patients and recommended the same treatment plans as human oncologists in 99% of the cases. Supplied with all the latest cancer research information, Watson provided additional options that were missed by human physicians in 30% of cases.¹⁰

Moving one step further, robotics is one of the most exciting and fast-growing fields in healthcare. With developments ranging from exoskeletons to nanodevices, companies like SuitX and ReWalk Robotics are building suits that enable paralyzed people to walk and aid in the rehabilitation of stroke or spinal cord injury patients.¹¹ Exoskeleton makers are driving costs down far enough to compete with motorized wheelchairs. Nanoparticles and nanodevices are promising more precise drug delivery systems, cancer treatment, and surgical tools. Researchers at the Max Planck Institute have been experimenting with robots smaller than a millimeter in size, able to swim through blood and plasma, and could be used to deliver drugs or other chemicals in a highly targeted way.¹²

Finally, 3D-printing is making its way to nearly every corner of the world. In the most unlikely of places, Not Impossible Labs is printing low-cost prosthetic arms for people who have lost their limbs in the war-torn country of Sudan. The prosthetic arms are inexpensive (costing around USD 100 to produce) and can be printed in a short period of time (about six hours). Residents have received training on operating the machinery, creating customized limbs, and fit the new prosthetics.¹³

A vision of the future

The future of healthcare will likely include a more consumer-driven market, a holistic approach to health, and more personalized treatment. New channels such as the internet and social media are transforming how consumers select and purchase healthcare products and services. Consumers are no longer passively receiving medical attention from healthcare providers. Rather, they are increasingly doing their own research, comparing the costs and benefits of different treatments or insurance plans, and seeking second opinions or alternative treatments. Healthcare offerings will continue to evolve due to these technological forces. With increasing computing power, thousands of potential drug variations may some day be tested on millions of virtual patients in minutes. In addition to healthcare treatment, research and technological applications may encompass a more holistic focus to preserve the health of aging populations.

Treatments will also become increasingly customized to the needs of the individual patient. Breakthroughs in genomics, big data analytics, and “smart” systems may render the one-size-fits-all approach obsolete. Sensors, probes, and biometrics may some day be combined with smart phones to detect abnormalities, alert patients, and inform physicians.

Perhaps some day when we fall ill, we will not need to go—feverish and in pain—to our doctors’ offices to wait in line with other patients whose diseases we may catch. Tele-doctors would come to us instead, using the internet, two-way video, email, and smartphone technology.¹⁴ Our body sensors could even provide tele-doctors with more precise medical and diagnostic data than they obtain today.

These technological forces and emerging themes are merely the tip of the iceberg, as there are many more breakthroughs occurring daily. In the future, regulators, decision makers, healthcare professionals, and patients will need to handle the developments in this rapidly changing environment very carefully. Nevertheless, these technologies provide a glimpse into a fascinating new world that could become a reality in our lifetime.

End notes

1. Scott, C. “Wake Forest Institute for Regenerative Medicine Progresses with 3D Printed Skin Technology.” 3DPrint, January 19, 2017. https://3dprint.com/162193/wfirm-3d-printed-skin-burn-care/.
2. McCullough, M. “The 3D-printed organ is coming, and Canadian firms are leading the way.” Canadian Business, December 8, 2014. http://canadianbusiness.com/innovation/the-3d-printed-organ-is-coming-and-canadian-firms-are-leading-the-way/.
3. Schwab, K. The Fourth Industrial Revolution. New York: Crown Business, 2017.
4. Miniwatts Marketing Group. “Usage and Population Statistics.” Internet World Stats, June 30, 2017. http://internetworldstats.com/stats.htm.
5. Powell, J.A., Darvell, M., & Gray, J.M. “The doctor, the patient and the world-wide web: how the internet is changing healthcare.” Journal of the Royal Society of Medicine 96, no. 2 (2003), 74-76.
6. PatientsLikeMe. “About Us.” 2017. https://patientslikeme.com/about.
7. Atomwise Inc. “Atomwise finds first evidence towards new Ebola treatments.” March 24, 2015. http://atomwise.com/atomwise-finds-first-evidence-towards-new-ebola-treatments/.
8. Hern, A. “‘Partnership on AI’ formed by Google, Facebook, Amazon, IBM and Microsoft.” The Guardian, September 28, 2016. https://theguardian.com/technology/2016/sep/28/google-facebook-amazon-ibm-microsoft-partnership-on-ai-tech-firms.
9. Memorial Sloan Kettering Cancer Center. “Innovative Collaborations: Watson Oncology.” 2017. https://mskcc.org/about/innovative-collaborations/watson-oncology.
10. Lohr, S. “IBM Is Counting on Its Bet on Watson, and Paying Big Money for It.” The New York Times, October 17, 2016. https://nytimes.com/2016/10/17/technology/ibm-is-counting-on-its-bet-on-watson-and-paying-big-money-for-it.html.
11. Brewster, S. “This $40,000 Robotic Exoskeleton Lets the Paralyzed Walk.” MIT Technology Review, Feburary 1, 2016. https://technologyreview.com/s/546276/this-40000-robotic-exoskeleton-lets-the-paralyzed-walk/.
12. Max Planck Gesellschaft. “Tiny vehicles for medical applications.” November 7, 2014. https://mpg.de/8741521/micro-robots-medical-application.
13. Bort, J. “How A $100 3D-Printed Arm Is Saving The Children Of Sudan.” Business Insider, January 7, 2014. http://businessinsider.com/how-a-100-3d-printed-arm-is-saving-the-children-of-sudan-2014-1/?IR=T.
14. Beck, M. “How Telemedicine Is Transforming Health Care.” The Wall Street Journal, June 26, 2016. https://wsj.com/articles/how-telemedicine-is-transforming-health-care-1466993402.