A lot has happened to change the landscape of medicine over the past 100 years, but we still have a long way to go. To wrap up Elsevier’s year-long celebration of the 100th anniversary of the Medical Clinics series, we asked several healthcare leaders what they foresee as the top innovations in medicine in the years ahead. Although their expectations of medicine’s future differed, there were four common paths. In the words of Dr. Geeta Nayyar, Chief Healthcare & Innovation Officer at Femwell Group Health, they will make medicine “look much better but also a world away from where we are today.”
1. Genomics and personalized medicine
Genomics, the study a person’s genes and their interactions with other genes and the person’s environment, is a relatively new approach to understanding complex diseases, from heart disease to cancer, and its application in biomedical research is expected to accelerate over the next century. In the next century, advancements in genomics research will allow patients and doctors to be more proactive, says Fred Bazzoli, Editor of Health Data Management: “Patients are going to be more knowledgeable about so many factors — about their genomes and their risk factors — and we are going to be able to prevent them before they even start.”
Dr. Nayyar adds that we will “know the DNA composition of patients — their genetic makeup and their families’ genetic makeup, and we will precisely be able to (administer) treatment regimens that we know are going to be effective and personalized to that individual.”
Personalized medicine, which the Personalized Medicine Coalition defines as “an evolving field in which physicians use diagnostic tests to determine which medical treatments will work best for each patient,” is becoming more and more an integral part of patient care. Pharmaceutical and diagnostics industries are increasingly investing in this field.
Dr. Peter Edelstein, Chief Medical Officer of Elsevier Clinical Solutions, projects that personalized healthcare will be at the forefront of medicine into the next century. He foresees patients and doctors being able to identify disease risk and manage disease and treatments in a “truly individual, DNA-based way.”
2. Value-conscious patients and consumer/patient-centered care
Bazzoli predicts that in 100 years’ time, “patients are going to be at the center of care.” According to Victoria Tiase, MSN, RN-BC, Director of Information Strategy at New York-Presbyterian Hospital, the shift to patient-centered and patient-directed care will increase as “the general public and patients will be very well educated and they will be able to address illness issues before they happen.” She also hopes “we will see innovations that allow a person to understand their state of wellness at all times … (including) daily body scans to truly understand what’s going on in their bodies.”
Bazzoli sums up this trend by stating: “I have a lot of hope that we’re going to see a real renaissance of what healthcare can be, and it’s going to revolve around what the patient can do for himself.”
3. Health information technology to gather patient data and allow patient self-management
If patients are going to be more, or perhaps completely, in charge of their own medical care in 100 years, then technology is going to be the means to get there. “Medicine is going to become commoditized in many ways,” says Dr. Jonathan Teich, former Chief Medical Informatics Officer at Elsevier Clinical Solutions. He explained:
I think technology is going to make it possible for consumers to regulate and control a lot of their stuff — start picking up their own medications, start deciding on things for themselves because they’ll have the tools to do so. Just like we have Quicken, now where I can make my own financial decisions, we will be able to have “Sicken,” where we’ll be able to make our own medical decisions.
Dr. Edelstein says people will be able to access their own genome data on their cellphone/smartphone, while John Lynn, Founder of HealthcareScene.com, thinks in 100 years everyone will have their own “personal health robot that follows them around and tracks what’s happening in their environment and tracks what’s happening in their bodies via sensors” and asks, “Are we going to weave an IP mesh on your organs?”
Meanwhile, Dr. Carol Steltenkamp, Chief Medical Information Officer at the University of Kentucky Healthcare and Vice President of HIMSS, wonders if “wearables” will be the way doctors provide better and more compassionate care in the future.
4. The evolution of healthcare practitioner training and development through technology
As patients become more enabled to control of their health, the educational and resource needs of healthcare practitioners will also undergo significant advances. According to Michelle Troseth, MSN, RN, Chief Professional Practice Officer at Elsevier, “we are no longer going to be educated in individual silos; we are going to be educated together as a collaborative team, and we're going to be practicing in the actual clinical settings in that way, and to do that we're going to be able to leverage technology: virtual learning labs, virtual experience and (providing) telehealth for patients. So really our whole experience as clinicians is going to flip, and it’s not going to be done in traditional ways. We are really going to honor the education and the practice, the technology and the practice, and being together with our patients together in person as well as in a whole new virtual experience. It’s going to look totally different.”
Dr. Nayyar adds, “we’ll also see cognitive thinking and artificial intelligence play a role in clinical decision support, and doctors and nurses will know precisely how to evidenced-based medicine in real-time.”
To see the full predictions from these thought leaders and others — and to see how far we have come over the past 100 years — visit medicalclinics100.com, a website dedicated to the 100th anniversary of Medical Clinics. Found on ScienceDirect, ClinicalKey and Journals Consult, Medical Clinics provides the latest clinical reviews on the issues healthcare professionals face every day.
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