Future of Healthcare

Abstract

Future medicine will focus on preventing new diseases and monitoring a person’s pre-nosological state, which is perfectly evidenced by the current situation with the coronavirus epidemic. The medicine of the future is not about treating the sick, but making sure that you do not get sick in principle. The boom of innovations, gadgets, and technological solutions cannot but affect medicine. The traditional healthcare system is a highly fragmented structure. Technology can offer an interconnected solution to the individual. Sensory wearable technologies will likely become the basis for future disease prevention, diagnosis, and treatment. The new generation of doctors is interested in innovation and making better decisions rather than in traditions and centuries-long working SOPs.

FormalPara Interviewees

• Gina Badenoch

• Eli Beer

• Chris Behrenbruch

• Thomas Crampton

• Özlem Denizmen

• Facundo Gareton

• Soulaima Gourani

• Christoph Holz

• Robert Krotzer

• Tristan Lecomte

• Elisha London

• Bob Macmahon

• Martin Müller

• Tolullah Oni

• Bjarte Reve

• Caroline Schober

• Ivan Vatchkov

“The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition.”—Thomas Edison

To guide us through our world’s unpredictability, we have relied on focused sets of experts until now, whether in healthcare, education, or any other field. However, it is even more complex to predict the future of healthcare, as medicine and healthcare are very diverse and complex initially. Events like the Covid-19 pandemic shook even the foundations of the future of healthcare built on expert plans (Image 1).

Image 1

Future of healthcare. Original Photo: LKH-Univ. Klinikum Graz, Austria. Illustrated by: Astghik Kyurumyan, used with permission

I am happy for this opportunity to write about the future of healthcare, not only as a medical doctor and researcher but also because I was not sure of my own future several years ago. I started to have hemiparesis during migraine attacks in 2018. What it exactly meant was that the left part of my body began to hang like a dead flash and was not reacting to my brain’s orders. Do you know what a human (especially a doctor) does in this situation?—Panic! But to my fortune, I got one of the best neurosurgeons in the world, who spent a very long time explaining the exact procedure to me—a doctor. If I had been born half of a century earlier—I would not be alive or would be disabled, but now, although I run through a months-lasting short-time memory loss period, which was horrible at that time, funny—if I look back to that. I have the same brain capacity—thinking and logic—and I am extremely happy about it. This type of surgery is available only in the developed world. Today, I am one of the lucky humans with the availability of an incredibly secure but innovative and research-prone health system, like the one in Austria. Being a doctor, researcher, research manager, and patient, I see the future of medicine and healthcare in an integrative approach.

What do we expect from the medicine of the future: prevention, gadgets, technologies… . Suppose the twentieth century mainly directed the scientific interest of man outward and continued to push for discoveries related to space and the depths of the sea. In that case, the twenty-first century can be safely called the era of searching within ourselves. Humanity has discovered high technologies for itself. Of course, the boom of innovations, gadgets, and technological solutions cannot but affect medicine, turning the idea of what will underlie it in the future by 180°.

The traditional healthcare system is a highly fragmented structure, while technology can offer an interconnected solution to the individual. Suppose now the collision of a person with medicine occurs when the disease has manifested itself, then in the future. In that case, treatment will become an ongoing process of preventive healthcare and will move from treating conditions to preventing them. The central concept of the transformation of future medicine is the 4Ps: predictive, personalized, participatory, and preventive.

The medicine of the future is not about “treating the sick” but making sure that you do not get sick in principle.

Considering a person’s pre-nosological state, monitoring and finding this stage is the main task of future medicine, which is perfectly evidenced by the current situation with the coronavirus epidemic. Right now, we see that all public health efforts aim to assess risks and prevent new diseases.

Do you want to live in harmony with your body and not feel like an owl in the world of larks? That future will come soon.

Personalized medicine: Even 30–40 years ago, scientists could not even imagine that one day they would be able to decipher the genetic code—this was considered impossible. DNA makes it possible to determine a person’s predisposition to breast cancer, type 2 diabetes, intestinal inflammation, and heart disease nowadays. Furthermore, although this is only the beginning of the journey—scientists have a long search for links between specific parts of the genome and diseases—in a few years, an individual fully sequenced DNA profile will likely become an indispensable part of every patient’s medical record.

“Precision” or “personalized” medicine is already a genuine field of modern health science. The essence of this approach is to find the best treatments for a particular person based on his own unique biochemical characteristics. Thus, by reading the DNA of a patient’s cancer cells, one can identify specific mutations and see which of hundreds of drugs and millions of combinations of treatments will be most productive, or to determine which of the patient’s own lymphocytes are capable of attacking cancer cells. After growing “good” cells in the laboratory, they are introduced into the patient’s body, where the restored immune system begins a targeted fight against a cancerous tumor. There have already been successful precedents for curing cancer in this way, but these are only the first rays of hope—it is too early to talk about mass healing.

Or, for example, tissue analogs of the affected organs are already being grown from the cells of patients, thereby creating “living” models for testing. Subsequently, they are used to analyze how the organ of this particular patient will behave if one or another drug, including an experimental one, is applied to it. This approach allows them not to waste time and not aggravate the patient’s condition with non-working therapy but with his desire to ensure the monitoring of everything in the world. Now, smart fitness bracelets, which have long become a familiar attribute of everyday life, can count many indicators of health and physical condition or activity: number of steps per day, HRV, pressure, quality of sleep and training, calories consumed, frequency of meals and meal times, weight, body composition, etc.

Sensory wearable technologies will likely become the basis for future disease prevention, diagnosis, and treatment.

1 What Other Critical Medical Technologies, Gadgets, and Devices Are Already in Place, and What Can We Look Forward to in the Future?

Bionic eye: Even though movie characters have been flaunting functional bionic eyes almost since the late 1980s, creating such a functional prosthesis is a challenging task, and it is unlikely that it will be solved quickly. Nevertheless, scientists are already taking the first steps in this direction and, for example, have already learned how to print working light receptors. So far, their structure is too rigid, the receptors themselves are bulky, and photoids convert sunlight into electricity with an efficiency of 25%.

Smart lenses: As mentioned above, various sensory health monitoring systems will become the primary tool for monitoring health. Already, scientists are working on a smart contact lens that can read glucose levels in tears. These lenses can eventually become a great alternative to regular blood collection and make life easier for people with diabetes.

Pressure sensor: Another mobile body monitoring device is an elastic touch “patch” that, using ultrasonic waves sent into the body, reads blood pressure and transmits data directly to the doctor’s monitor. The device is smaller than a postage stamp, and the patient does not feel its impact.

Surgeon robots: The boom of talk about nano-robots has long passed, but the idea itself has not gone away. True, so far, scientists are testing the technology on larger counterparts of nanorobots. The first tests are already being carried out by a robot placed in a capsule, which unfolds in the intestine like a clamshell and can remove a foreign body from it or help restore damaged tissues.

Three-dimensional (3D) prostheses: Over the past ten years, 3D printing as a technology has finally moved into the field of mass consumption. Anyone can now buy a 3D printer, which means that objects produced using 3D printing are gradually becoming more affordable. Yes, the production of a 3D prosthesis is still a costly process, and yet this field of medicine has been multiplying in recent years. A person with an ergonomic prosthesis made on a printer is no longer a rarity.

AI diagnostics: Over time, artificial intelligence will likely make most of the primary diagnoses, while the work of doctors will expand to the most complex and ambiguous cases. Most recently, using the principles of machine learning, Google experts analyzed more than 250,000 images of the retina. The AI’s task was to identify patterns in the images that correlate with high blood pressure, the risk of cardiovascular disease, and strokes. Furthermore, although full-fledged robot diagnostics is still far away, in some cases, AI determines the presence of the disease more accurately than doctors.

Virtual reality (VR) for education: Of course, we cannot ignore digital technologies for training a new generation of doctors. You will not surprise anyone with online education, but there is not only one way to connect. Using virtual and augmented reality technologies, it will be possible, for example, to “take a tour” of a person’s internal organs or look at an accurate operation through the eyes of a famous surgeon.

The main task of the medicine of the future, all this gene analysis, cellular programming, and tissue engineering, is to give a person control over their own health, which was simply unthinkable before. Very soon, the refrigerator will monitor our diet and advise us to eat a particular product at a specific moment or throw away an extra package of ice cream. The phone will determine the degree of depression, and toothbrushes will analyze saliva composition daily to notice the first deviations from the norm.

The future changes will be in two different areas—acting healthcare and forming healthcare.

The acting triad includes the following:

• 1. Healthcare workers—doctors, nurses, therapists, etc. The question is, who will devote their lives to this very challenging profession? Just some numbers. In the USA, between 300 and 400 doctors commit suicide annually—it is a doctor a day on average. Here are some more statistics for the plasticity of the message: in developed countries—for every hour spent with patients, doctors spend one and even 1.5 hours with paperwork (mainly for the insurance companies). On the other hand, the new generation of doctors is interested in innovation and making better decisions rather than in traditions and centuries-long working SOPs. Parallel to researching doctors, we will also have business-trained doctors (medical doctor [MD], master of business administration [MBA]), and politics-trained doctors to make the right laws and fitting models for healthcare and medicine.

• 2. Future diseases and new challenges. The future conditions and hotspots will be affected first by an aging society: sedentary lifestyle-related diseases—obesity and co and psychiatric states—due to an overload of information and sharper life competition. Second, it will be affected by new infectious diseases and agents that are consequences of “not recycling”—which is not only about infections but also about heavy metal drainage in drinking water, soil corrosion, and other effects that we do not know yet. We research to explore which diseases are most likely to cause the next global pandemic, racing to keep that from happening. Still, more resistant bacteria, viruses, or prions may cause another pandemic that we cannot even imagine today.

• 3. Future diagnostic and therapeutic technology is developing with enormous speed. There is no doubt that our society is developing much faster than before. This also applies to medical technology, which has reached an incredible level today. However, what is ahead of us? We mention some technologies, like:

  • Portable health monitoring tools or indicators—like my e-Watch

  • Mobile applications providing medical support

  • Artificial intelligence in medicine, which becomes precisely accurate, especially in picture-based diagnostics

  • Genome editing technology—which may once be the trend for xenotransplantation

  • Biohacking—against expectations, the main goal of biohacking is noble: to bring the human body to a new qualitative level, improving well-being and refining vital processes

The forming triad of future healthcare and medicine is about:

• 1. Healthcare trends—In 2004, we spoke about personalized medicine, and several years ago, the term precision medicine came out and started to, even more, tend healthcare to a single person. The preventive enhancing approach, digital healthcare, integrated (into daily life) medicine, etc. will become usual. The future is not about how we treat diseases but how we prevent them from occurring.

• 2. Health system challenges—We must fight the idea of seeing a hospital as a business. We need to enhance affordability. In the future, we will overcome the problem of payability and affordability. The system will change in favor of health accessibility, system and best quality sustainability, integrative health patient experience, and simply better health.

• 3. The enablers like regulatory enhancements, researching and curing medicine symbiosis, new integrative organizational and business models, and healthcare platforms (technological) will make future medicine more accessible if politics keep the speed of technological and curative development.

In the future, we will be able to heal wounds in minutes; grow full-fledged organs, bones, and cells; create human-powered equipment; repair damaged brains; and much more.

Integrative healthcare infused with a human approach, holistic well-being, and comfort supported by high-end diagnostic and therapeutic technology will become a reality. In the future, not the virus or any other infective agent will be contagious, but the health itself.¹

I want to finish with the words of Antoine de Saint-Exupery.

“It is only with the heart that one can see rightly; what is essential is invisible to the eye.”

2 Input from Interviewees

Gina Badenoch

Social entrepreneur and photographer; founder, Ojos que Sienten AC and Capaxia, UK

In medicine world acceleration will increase due to technology, impacting directly blind people and paralyzed ones, significantly changing their lives.

Eli Beer

Social innovator and first responder; founder, United Hatzalah of Israel

The medical world is my world… In New York City if you want a taxi, you put out your hand and you get a taxi. In 50 years from now people will continue dying from the same things, choking, car accidents, terrorism, etc.… but when people call for help, it will be there immediately, because so many people will be well trained, within less than 1 minute, medical response will arrive.

Even in Africa where today no response is available, through education (via new technology), they will learn how to save someone.

Everyone who is able to respond will be connected through a digital network like Facebook and organize themselves to respond to accidents. My company is trying to reduce response time to 90 minutes across the world. In 50 years if someone would die from heart attack on the street, it will be in the news next day, will not be considered normal. Israel puts a lot of money into research and medicine.

Even enemy countries will come to Israel and learn about healthcare.

The real invention will be how to prevent death—protect people from dying suddenly, not from deceases because they always renew themselves, but biggest cause of death is cardiac rest or stroke/but in future all this will be taken care of, which will save so many people.

People’s life could be saved from their phone, for example (giving an electric shock).

I don’t know about flying cars, and other technology, but I am talking about life.

In future less people will die; hence, less people will be able be donors for others; hence, artificial heart will be probably invented/you will be able to buy yourself a heart in the future.

Technology should also be invented that protects people by monitoring their body functions.

Chris Behrenbruch

Biomedical engineer; co-founder and CEO of Telix Pharmaceuticals

Humans will lose their natural biological identity—we will move to homo nano-technus. There will be a price/performance/risk equation applied to healthcare and medicine, which will become deregulated because it has no choice. If we don’t remove the regulatory barriers for medicine and the almost arbitrary nature of drug development as mandated by our government authorities, the gulf in care between rich and poor will be too great. The quality of medicine will depend on what you can afford, as will the lifetime of replacement organs.

Within 50 years we will see bio-replacement strategies that are started from birth.

Thomas Crampton

SVP and head of Corporate Affairs at GreenLight Biosciences

I look forward to the eradication of illnesses and ailments that plagued previous generations as well as treatments that serve populations formerly unable to access the best that medical advancement offers.

Özlem Denizmen

Opinion leader in women empowerment; founder, Para Durum

There is going to be the recreation of the human body, cloning ourselves, replacing body parts, look younger; in other words there will be a biological revolution, I feel.

The whole Botox and so on will be much more advanced. We could be looking just the way we would want to be looking at any given time and at any age.

I believe that because of this there is going to be a bit too much emphasis on the physical part of things; people will possibly lose their souls, leading to an increasing gap between body and soul.

Different types of illnesses will come about of psychological nature.

Chip under our ears, no phones, no credit cards.

As a body, we will almost be as numbers, and taking, receiving, handling; we will be like a transaction point.

Healthcare will revolutionize. Even today we can care a woman in India through a cell phone from the USA.

Facundo Gareton

Serial entrepreneur, CEO of Terraflos, chairman of Blueberries Medical Corp.

It is difficult to predict with certainty what the future of plant medicine will be in 2050 and beyond, as it will depend on many factors such as advances in technology, changes in societal attitudes, and the discovery of new plant species. But I’m convinced that the future is in nature, my thesis is that we are on a new revolution that will transform prevailing production methods for food, medicine, and materials based on nature, built on foundational advancements in biochemistry, computing, AI, ecology, synthetic biology, cellular agriculture. I see three core “ecobiotechnologies” (biotechnologies designed to promote environmental goals and circular systems) emerging that could lead to radical socio-economic shifts.

These core “ecobiotechnologies” are:

• Cellular agriculture—production of biomolecules (like proteins) and whole cells (animal and microbial) through fermentation and cell-culture processes

• Biofabrication—manufacturing of materials with biodesign principles (like biomimicry) and leveraging self-assembling qualities of living organisms (like fungal mycelium)

• Bioagronomics—applications of biotechnology (like genetic engineering) and systems-based approaches (like soil microbiome) to agriculture, includes crop optimization for novel applications and plant molecular farming

The result of this revolution will be (1) no longer using animals to produce food, materials, and medicines, (2) decoupling economic growth from carbon emissions, and (3) commercial models built on principles of industrial ecology. In this context, the use of AI can help speed up the development in different areas related to the drug development process and reduce the costs associated with identifying and developing new plant-based drugs.

There are several ways that AI can assist in the development of plant-based drugs:

Data analysis: AI can be used to analyze large datasets of plant chemical compositions and biological activities, which can help identify potential plant-based drugs and predict their effects on the human body.

Lead compound identification: AI can be used to identify the most promising plant-derived compounds for further development as drugs, based on their chemical structure and biological activity.

Drug development: AI can be used to optimize the chemical structure of plant-derived compounds to improve their effectiveness and reduce their toxicity.

Clinical trial design: AI can be used to identify the most appropriate patient populations and dosage regimens for clinical trials of plant-based drugs.

In this context, it is possible that plant medicine will continue to play a significant role in healthcare, particularly in the areas of traditional and complementary medicine. Many plant-derived substances have been used for medicinal purposes for centuries and continue to be researched for their potential health benefits.

It is also likely that advances in technology and research will lead to the development of new plant-derived medications and treatments. Overall, the intersection of technology and nature is really promissory.

Soulaima Gourani

Entrepreneur, author, and keynote speaker; CEO and co-founder of Happioh

I believe it to be a certainty that people in Western countries will live much longer in the next 50 years. In the last 50 years, we have already been able to significantly prolong life as well as cure many life-threatening diseases. We will have found a cure for cancer (but dangerous new diseases will have developed).

In Western countries, we put a lot of focus on public expenditures on healthcare, and therefore, we will invest a lot of resources on the development of products and services that will allow people to check their own health.

In the next 50 years, your home will be able to check your health. Fever scanners will be installed in the front door, and every time you go to the lavatory, your excrement will be scanned for diseases—this way, you will be alerted of any sudden development before your doctor. Also, your toilet will warn you to be careful not to consume too much unhealthy food because you are at risk of developing diabetes.

Some researchers claim that in 2025–2030 life expectancy will increase faster than we age. This is primarily because biotechnology can significantly slow down the aging process, deactivate harmful genes, and activate positive ones.

Christoph Holz

Keynote speaker, Digitalization

Can you imagine a most dangerous place in the western world than a hospital? The concept was invented by Florence Nightingale in the middle of the nineteenth century as a surveillance system, decades before the concept of privacy was even conceived. In 2050, the stern eye of a nurse is no longer responsible for surveillance, but dozens of sensors on and in the body.

Mobile operating rooms on trucks have long been reality in war zones. In a few years, they will be deployed in rural areas by successors like Toyota’s autonomous e-Palette vehicles. After all, cities will hardly exist anymore. These vehicles have enough space for a small version of the Da Vinci surgical robot, which has long since learned to perform operations itself. It parks at the family doctor’s, who observes my prostate surgery, and then sends me home with a nursing robot. Aging in dignity is inconceivable without care robots anyway. In 2050 research will have moved on to quantum computers. The old centralized health factories of the industrial age will not only be too expensive to sustain, but also ethically questionable.

Robert Krotzer

City councilor of Graz, Austria, for Health and Care

Health and care facilities are public and free for everybody.

Tristan Lecomte

Chief executive officer, Pur Projet

More and more we will use natural remedies by using science to observe nature. We will be using more natural plants to cure diseases, instead of chemical drugs.

We will also go back to nature in health, education, energy, etc. If not as a species we will destroy ourselves by destroying our ecosystem. It is just the law of nature.

We have started to see this (environmental degradation, pollution, etc.), and if in 50 years from now no change happens, our life on Earth as humans will not be viable anymore.

We need to use technology to understand this and make a change in all the sectors or otherwise we will not be there. Game-changing future innovations in health will include toilettes analyzing what we ate and advising us on our health, telling us to go back to eating natural products.

Elisha London

Founder, United for Global Mental Health, and founder and CEO, Prospira Global

We know that money can be a key source of stress for many people and that people living with unreasonable debt are more likely to be depressed, anxious, or consider suicide. By 2050 I see we have two options. One path is that our world does not deliver upon commitments to improve inequality and financial inclusion in line with the Sustainable Development Goals. Without this progress, these social determinants of mental health and well-being will continue to put pressure on the global mental health crisis. Alternatively, if progress is made to reduce poverty and inequality and improve financial inclusion, this will make a positive contribution to the mental health of our world.

Bob Macmahon

International affairs journalist; managing editor, Foreign Affairs Magazine, Council on Foreign Relations

I would expect skin transformation to keep young or a pill allowing us to live longer.

Martin Müller

Executive director, Academic Forum, GEneva Science and Diplomacy Anticipator (GESDA)

Personalization of everything is the most amazing trend. The personalization of your digital experience, your health, your food. With technological advancements everything will be tailored, like the medicine you take, your therapies, food you need to eat. Think of healthcare as a Netflix subscription, where on a monthly basis you pay your premium and receive your therapies to keep you in good health and prevent diseases.

Tolullah Oni

Public health physician scientist, urban epidemiologist, University of Cambridge

The future of healthcare is health beyond healthcare. We have long known that the majority of factors that influence health lie outside healthcare. So I see a future where a wide range of sectors such as transport and urban planning work purposefully to create and preserve health, working closely with the healthcare sector to optimize population health for all. Accordingly, the definition of health professionals would be widened to include diverse actors from city mayors and urban planners to architects and farmers. Critically these health-centric endeavors would seek to reduce health inequities by ensuring healthy infrastructure benefits those most in need.

Bjarte Reve

Partner Considium Consulting Group AS; CEO, Nansen Neuroscience Network

From 2050 and beyond we have an equitable healthcare system where personalized treatment, shared decision-making, and good communication between clinician and patient is the norm.

Caroline Schober

Vice rector of Research and International Affairs at Med Uni Graz

Sensors checking vital and blood parameters on and inside our body and in our environment will double up with genetic information and past medical history to monitor and predict our health status 24/7. We will be nudged (or more than that) to lead a healthier lifestyle, be sent personalized medication automatically, or will be called in for an appointment with the appropriate physician. This will all feel natural to us. But we will still be human beings—more than just our biology translated into parameters and bits. We can only feel healthy if we are seen and treated as individuals with a psyche, a soul, and social needs.

Ivan Vatchkov

Founder and CEO of Kalibra.ai

The future of health will depend on how we change the user experience towards personalization, continuous preventive care, and seamless 24/7 diagnostics with ambient technology.