From spinal cord regeneration and genome editing to 3D printing of human organs, modern technology could soon allow us to overcome diseases and conditions considered incurable today.
Medical science has shifted from curing the human body in recent decades to strengthening it to a point where in some countries, 100 years old will soon become commonplace.
The McKinsey report Living Longer and Healthier Lives predicts that humanity is standing "at the cusp of a healthcare revolution that will eclipse the achievements of past centuries in its speed and impact".
Scientists have been able to re-engineer immune cells and direct them to help fight cancer – a similar approach could be used to treat a wide range of diseases. Genome editing has the potential for combating and correcting genetic diseases which cost hundreds of thousands of lives each year, the report notes.
Regenerative medicine, 3D printing, advanced sensors, and data analytics are just some of the other areas that can help medical science deliver longer and healthier lives.
“Looking forward, modern technology will soon allow us to overcome diseases and conditions considered incurable today. For example, regenerative medicine holds the potential to recreate a spinal cord to overcome spinal cord injuries or malfunctions. Advances in the understanding of the human genome and gene therapy are enabling and accelerating the treatment of genetic mutations that was inconceivable only a few years ago. Technologies being developed will enable 3D printing (using patient’s cells) of lungs, hearts, and kidneys to overcome organ failure,” the McKinsey report notes.
In addition, chronic diseases that are now difficult to manage will be treated with very different methods. For instance, diabetes could be managed using an electronic skin patch that detects glucose levels in sweat and automatically discharges drugs through micro-needles.
Genetic fingerprinting, possibly at birth, could signal a predisposition for specific disorders or syndromes. Constant monitoring through sensors that record vital statistics and biomarkers could provide an early warning of some impending conditions, such as a heart attack or stroke, and treatment could be delivered before the condition is triggered and permanent damage inflicted.
However, the McKinsey report also points out: "These innovations will also raise new social and moral challenges that will need to be addressed. For one, there are ethical risks from directly intervening in the genome. As Siddhartha Mukherjee argues in his recent book, The Gene: An Intimate History, we cannot be sure that as our ability to correct and coerce our DNA increases, society will show restraint from trying to create superior versions of humans. Second, an older society will have implications on economic productivity and the affordability of western social benefit systems."
Dublin-based medical entrepreneur, interventional radiologist and nuclear physician, Johnny Walker, is at the forefront of the global digital revolution in healthcare. He predicts the personalised and connected health movement will really take off in the next few years, with people becoming far more responsible for the monitoring and management of their own health and wellbeing, and paying far less visits to their GPs.
“Through wearable devices, people can track metrics like pulse rate, blood pressure and blood sugar levels. These measurements are fed into a live dashboard which can be accessed by their asthma or diabetes care team for example on a smartphone.”
Walker, who is involved in the upcoming Future Health Summit in Dublin, also predicts that Artificial Intelligence (AI) will take on a very real role in diagnostics with super computers like IBM’s Watson doing a first read of MRI and CT scans, for example, and coming up with the most likely diagnosis.
“Personal genomics will be huge with tests identifying genetic risk profiles for many diseases in utero. In onco-genomics, a simple blood test can identify tumour oncotypes. It’s very personalised and predictive, and if you can predict, you can prevent.”
Animation and gaming will come into the world of medicine more and more, according to Walker, educating patients prior to procedures and incentivising them to carry out their rehab exercises afterwards.
The use of robots will become more common, Walker believes, not only in performing surgical procedures, but in caring for patients, eg lifting them in and out of chairs, turning them in bed and ensuring they take their meds.
Walker believes Blockchain has the potential to be the “silver bullet” in terms of an international health record that can transcend geographical borders. All of the world’s patient records would be embedded in digital code and stored in transparent, shared databases where they would be protected from deletion, tampering, and revision.
“We need to become less geographical in our thinking and truly global thinking to deal with the huge onslaught of the ageing population coming at us. We need somebody in Government with real courage to say we should be embracing a digital world. Our current acute healthcare system is bent and buckled, but not yet broken, and it’s not in anybody’s interests for it to break. We need to keep the acute services for acute cases and deal with as many non-acute and chronic ailments as we can at home and in the community,” says Walker.
Tanya Mulcahy is manager of Health Innovation Hub Ireland (HIHI), which is involved in developing next generation technologies in Ireland for the global marketplace. She explains that HIHI supports companies with innovative healthcare products by facilitating and managing the trialling and evaluation of these products in clinical settings (primary care, hospitals, pharmacies and community health centres); engaging clinical teams, patients and the extended management teams and, where required, research expertise.
“Successful healthcare innovations address an unmet clinical need. Those best placed to identify those needs and to ideate a solution are those working at the coalface: clinicians, nurses, physiotherapists, orderlies and the extended allied healthcare network – anyone who supports a patient. However, they may not have the time, knowledge or wherewithal to develop their idea or solution and this is where HIHI comes in,” she explains.
The HIHI Consortium includes UCC, CIT, NUIG and TCD, their associated clinical research facilities and their hospital groups (South/South West, Dublin Midlands and Saolta University), with associated primary care centres, community health organisations, pharmacies and HSE support infrastructures.
Here are some of the exciting advances being made in medical science that are already benefiting patients, as well as breakthroughs that are likely in the coming years:
Regenerative medicine promises to be a game-changer for the treatment of a wide range of conditions and diseases – from diabetes and heart disease to spinal cord injury, the McKinsey report predicts. In the next 10-20 years, we may see regenerative medicine therapies for complex degenerative diseases, including Parkinson’s and Alzheimer’s diseases.
In recent years, more than 50 regenerative medicine-related products have been used in the clinic. For example, more than one million patients suffering from cancer and other blood disorders have received bone-marrow transplants, which contain stem cells capable of re-creating the entire human blood system. Skin stem cells are also being used to treat burn victims, expediting the wound-healing process. Additionally, scientists have also developed “spray on” skin approaches (using the patient’s own cells) to treat large wounds and accelerate healing.
Nearly 800 stem cell-based regenerative therapies are in clinical trials today. Cell replacement therapy is the holy grail of regenerative medicine – and science is getting closer according to McKinsey.
Bioelectronics is an emerging area of medicine that uses miniaturised implantable devices to deliver electrical stimulation to control a wide range of bodily functions. Today, implantable devices that electrically affect the inflammatory reflex are being tested as treatments for rheumatoid arthritis and inflammatory bowel disease. The hope is that through these devices, disorders as diverse as inflammatory bowel disease, arthritis, asthma, hypertension and diabetes could be treated.
Advanced immunotherapies to treat cancer
Immunotherapy is a treatment designed to boost the body’s natural defences to fight cancer using substances or cells made by the body or in a laboratory. The use of human T cells to re-engage the immune system has the potential to revolutionise the way cancer is treated. New technologies can genetically engineer a patient’s own T cells to target and kill their specific cancer cells.
The first 3D-printed prescription drug received FDA approval in 2015 and medical devices made from 3D printing now include instruments used for surgery or devices implanted into patients. By 2019, 3D printing is expected to be central in roughly one-third of surgical procedures involving prosthetic and implanted devices. Technologies are being developed that will enable 3D printing (using patient’s cells) of lungs, hearts, and kidneys to overcome organ failure.
Artificial intelligence (AI)
Highly advanced AI systems like IBM’s Watson supercomputer can sift through millions of pages of medical evidence and patient records, covering decades of treatment history to provide a diagnosis and treatment options within seconds. There are numerous start-up companies working on AI applications in healthcare, with the engagement of the major technology companies who have all made major investments in this space.
Genome editing is a way of making specific changes to the DNA of a cell or organism. An enzyme cuts the DNA at a specific sequence, and when this is repaired by the cell, a change or “edit” is made to the sequence. A recently developed technology known as the CRISPR/Cas9 may have the potential to transform medicine by permanently editing disease-associated genes in the human body with a single treatment course. The ability to modify the human genome could allow for the repair of virtually any gene and be a cure for rare genetic disease in particular.
Digital assistive technologies
Assistive technologies include a wide range of devices and equipment that help individuals perform a task or prevent injury and promote independence by compensating for sensory, physical and cognitive impairments.
New advances include:
– Smart walking sticks that alerts carers if the user falls
– Internet connected hearing aid that can be controlled with an iPhone
– Smart glasses for ailing eyesight
– Oedema socks that can detect and notify wearers of swollen feet and oedema
– GPS tracking of dementia patients through handheld devices, smart insoles and barcode nail stickers
– Emergency wearables (pendants and watches) that can detect falls and call for help
– Shoes with vibrating insoles that deter falls
– Healthcare wearables that can measure blood pressure, weight, pulse rate and rhythm, oxygen saturation, physical activity and sleep
– Smart beds can adjust sleepers’ bodies to stop snoring, track sleeping habits and even keep feet warm.
With the latest connected home health platforms, small sensors are placed on objects within the home – such as prescription pill bottles or the fridge – to detect when the resident is taking medications, eating food, or leaving home. The sensors send activity signals to a host website, where family members and caregivers can access the data to monitor.
More extensive monitoring systems are also available, including the use of floor and wall-mounted sensors to detect movement – or a lack of it-as well as video cameras to relay images of older adults at home. Other devices monitor stove use and raise an alarm in the event that somebody forgets to turn it off.
The Future Health Summit, 2017, will take place at CityWest Convention Centre, Dublin, from May 24th-25th. The theme is The Future of Healthcare, the Drive for More Personalised Care in the Digital Age. Further details at futurehealthsummit.com