People talk a lot about disruptive technologies but so often the ideas we hear are either mundane or so wacky that we can only be thankful that they’ll never see the light of day.
In December I visited the New Media Medicine Laboratories at the Massachusetts Institute of Technology in Boston to see what some of the best thinkers in the world are planning for our future. MIT is a remarkable place, seemingly run by unbelievably bright and engaging teenagers (do I sound old?) unbound by conventional norms.
For most of us, life can be rather predictable. We carefully plan objectives and then we try to deliver them. The youngsters at MIT turn life upside down. They wake up in the morning with apparently no idea what they are going to do or create. They just design things and then ask people out in the real world whether the inventions might be useful.
I was introduced to a rather beautiful cuddly teddy bear, about 45cm high, whose soft fur hid the most remarkable robotics and artificial intelligence system that enable the creature to respond to external stimuli in the most convincingly human way. The design team had found a paediatric diabetologist who was struggling to help children to inject themselves with insulin. The children were terrified of grown-ups armed with needles, but loved being taught by the skilled and empathetic programmed teddy.
The best idea that I saw was less high tech but potentially far more disruptive. The idea gets to the heart of healthcare: the interaction between patients and health professionals. If the work reaches fruition, and I can see no reason why it shouldn’t, it has the potential to radically transform the dynamic between doctors and patients.
The current dominant model of care delivery requires patients and doctors to meet face to face, for a short period of time, with hardly any preparation and only marginally more follow up. This model has barely changed for centuries and really meets the needs of those providing the service more than those receiving it. It is an inefficient and ineffective use of a precious resource – the personal interaction between two people – and a massive inconvenience to patients. In the future the consultation could look very different: most significantly it will be more dependent on technology and more asynchronous in nature (ie patients and doctors won't need to be in the same place at the same time for a consultation to take place).
Let me give an example. John Smith has COPD and wants advice because he thinks he’s developing a chest infection. He uses his smart phone to access Dr Hitech, a medical avatar who goes through a computerised protocol to take a history and asks John to direct the phone’s camera to take a close up of his throat and a video of him breathing. John then utilises mobile diagnostic and monitoring apps to record his pulse, blood pressure, peak flow and chest sounds and to assess the viscosity and content of a sputum sample.
All of this information is transmitted to his GP who assesses it and sends a video message back to John perhaps advising him to increase the frequency of his inhalers, or start antibiotics or take a course of steroids. John picks up this message between meetings at work and takes appropriate action. If he decides that he wants to see his GP face to face then that is arranged online and the information that has been provided optimises the precious time available for the meeting, since both parties will be well prepared. After the consultation, the GP sends a message to John reinforcing the advice and providing general encouragement. John picks this message up that evening between frames at the local snooker club.
All of a sudden, the patient is in the driving seat and the doctor is using his or her skills appropriately. Technology doesn’t replace the human side of medicine, it redefines and potentiates it. The technology to facilitate all of these processes already exists and is neither sophisticated nor expensive. The future is nearly now, if we want it to be.
Martin is Clinical Director and Director of Research and Development at the Health Foundation.