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دوشنبه 18 آذر 1398 :: نویسنده : عبدالواحد خالدی
We cover a lot of news and announcements about digital health technologies to provide context for you. Even within The Medical Futurist team, there are favorite technologies and trends. And we thought it would be time to share the technologies we’re excited about! With advancements in exoskeleton technology, A.I.’s ever-increasing importance in healthcare and technologies like 5G and quantum computing soon going mainstream, there’s much to be excited about. Without further ado, let’s jump in!

1. Quantum Computing: faster, cheaper and safer

Late last month, Google claimed “quantum supremacy” and made the cover of Nature. With all that buzz around qubits, quantum circuits and Sycamore when it comes to Google’s breakthrough and quantum computing, will this technology impact the healthcare sector? Heck yes! We even published an article shortly after the news and are still very much excited about developments in this field. 
The applications of quantum computing to healthcare are manifold, ranging from (much) faster drug design to quicker and cheaper DNA sequencing and analysis to reinforced security over personal medical data. While the technology does hold such promises, we still have to be patient before such practical solutions can be implemented in medicine. However, with continued progress in this area, it is worth keeping an eye on.

2. Exoskeletons: from paralysis to super-strength

We’ve had our fair share of highlights this year when it comes to exoskeletons. What with the news of a tetraplegic man being able to control an exoskeleton with his brain that wowed readers all over the world and Europe’s first exoskeleton-aided surgery, we have high expectations for these sci-fi-esque wearables.
While exoskeletons like HAL are already helping in the therapy of people with debilitating conditions like Friedreich's ataxia and multiple sclerosis, such devices need to be made accessible to more, if not all, physically disabled patients. “Only 15% of people with disabilities had a wheelchair or other assistive devices,” says Prof Tom Shakespeare, from the London School of Hygiene and Tropical Medicine, to the BBC. "A danger of hype always exists in this field. Cost constraints mean that hi-tech options are never going to be available to most people in the world with spinal cord injury."

Nevertheless, the global exoskeleton market is expected to reach almost $1.9bn by 2025, but some hurdles need to be overcome by the industry. For one, the mind-controlled exoskeleton from Grenoble University Hospital is still in its early stages and confined to the hospital itself. Before more physically disabled people can control such devices with their brain waves, these devices need to be made more affordable and lighter for more practical use outside of the hospital setting. We are on the lookout for progress along those lines.

3. Voice-to-text solutions: talk more, save more

Traditional paper-based medical records have been shown not to be reliable, ripe with missing and/or incomplete data crucial to a patient’s file. But if you thought that electronic health records (EHR) would be better, then you thought wrong. 70% of physicians aren’t satisfied with the systems they use, physicians spend on average half of their workdays just to input data into EHRs while spending only 27% with their patients and EHR is even perceived as the number one challenge by 37% American physicians. The solution that we think will lift the burden of health care records? Voice-to-text technology!
You’re probably familiar with the technology: it’s the same one that you use to do a voice search on Google - the software recognizes what you said and puts it into words. Such voice dictation solutions are already in the market through companies like Nuance and M*Modal and we’re eager to see if this technology will become more mainstream and replace current EHR systems. By lifting the literal barriers which are computer screens for recording data, healthcare professionals will have more face-to-face time with their patients and provide the ever-important human touch.

4. Personalized chatbots: making our lives better

Remember that Black Mirror episode titled “Rachel, Jack, and Ashley Too”? The one with Miley Cyrus? Think about having a similar personalized chatbot as Ashley O but accessible via your smart device and with additional health and lifestyle features. This chatty virtual being can wake you up at the appropriate time based on your sleep pattern and advise you to take your antihistamines as the pollen concentration is particularly high during your commute that day, before you even get out of bed. It can even recommend what you should consume for each meal based off your nutrigenomic profile. Pretty handy, right? But would you rather bend to the rules of an A.I., essentially forgoing your freedom of choice, than experiencing life based off your own will?
that function on the same principle as chatbots are already available, free of charge. However, these rely on the user inputting the symptoms and complaints manually. We yearn for one that can make predictions and suggestions based off user’s data like sleep tracking, heart rate and activity collected via wearables. With such features, those bots can help users make healthier choices without having to drag themselves to their GPs.

5. 5G: gotta go fast!

If the spiky blue protagonist of the Sonic The Hedgehog live action movie adaptation can get a redesign within 7 months after the airing of its first trailer, then 5G can bring an overhaul in medicine and faster! Weird analogy but bear with us. With proper internet infrastructure to support 5G networks, the latter will enable data to be downloaded at more than 1 gigabit per second (1gb/s), allowing for speedier downloads 10 to 100 times faster than the currently available 4G services!

Such a boost will allow for more reliable communication, which is a must in areas like telesurgery, remote consultation and remote monitoring. With bigger bandwidth and faster connection, there might be a boost in wearables as health IoT networks become more stable and reliable, and further help in patient engagement in relation to their health.
Nevertheless, such major applications of 5G are expected to become apparent only around 2021 or 2022. We’ll be here to report on these breakthroughs but until then, as the Blue Blur would say: gotta go fast!

6. At-home analysis of bodily fluids

Bodily fluids often catch a bad rap. Saliva, blood, urine and feces are only some of the many examples of fluids that our bodies naturally produce but they might already have repulsed you just by reading those words. However, those very fluids are treasure troves for medical practitioners as blood samples are essential in chemotherapy, saliva can be used to sequence your genome, while fecal samples can shed light on that unknown cause for a patient’s weight loss. By analyzing those fluids, much information about one’s body can be obtained, which can subsequently help people make healthier choices.
One’s gut microbiome can influence one’s brain function and maintaining a healthy microbiome based on customized probiotics plan is what California-based Thryve proposes. Salivary samples are the staple of the many genomic tests out there provided by companies like 23andMe and Dante Labs, which also subsequently counsel you regarding conditions you might have higher risks of contracting based on your genomic profile.

All of these examples involve kits which require you to only take samples from your home itself and send it back to the company for analysis. With such ease of profiling one’s bodily fluids which can later be interpreted by an expert, people can make healthier choices tailored to their body’s needs.

7. A.I. : putting the ‘A’ in the Art of Medicine

We’ve been quite vocal about the future of A.I. in medicine: it will not replace doctors, but rather they will both form a partnership akin to the stethoscope of the 21st century. If we consider how AlphaGO, the A.I. developed by Google’s DeepMind lab, beat world champion Lee Sedol at the classic Chinese game Go by coming up with inventive moves that took experts by surprise, we can get a glimpse at what A.I. can hold for healthcare. Such moves were made possible by the combination of neural networks and reinforcement learning method that this A.I. uses. This enabled the software to operate without the restrictions of human cognitive limitations, devise its own strategy and output decisions that baffled experts.
When applied to medicine, an algorithm trained via reinforcement learning could discover treatments and cures for conditions when human medical professionals could not. Cracking the reasoning behind such unconventional and novel approaches will herald the true era of art in medicine.

8. Lab-grown food: Make Your Own Food (M.Y.O.F)

As the global population is expected to exceed 9 billion by 2050, developing countries starting to increase their meat consumption, and lands and resources to sustain such trends keep getting scarce, alternative ways to harvest food will take the lead.
Indeed, lab-grown meat could lead to a cut in agricultural greenhouse gas emissions of 78-96 percent while using 99 percent less land. With stats like these, the prospect of investing in lab-grown food is tantalizing and is exemplified by the mushrooming of startups based around this technology. Mosa Meat is commercialising their cultured meat, while companies like BlueNalu and Finless Foods are working on providing sustainable seafood meat by harvesting fish muscle cells to grow in a lab. And you won’t have to wait long before trying out your first lab-grown food and we can’t wait to stimulate our taste buds with these!

9. CRISPR: the crispy possibilities

One of the most recent controversial piece of news in medicine happened about a year ago when a Chinese scientist modified the genetic makeup of babies to make them resistant to HIV. The gene editing technique he used, CRISPR, holds scary possibilities like designer babies or a Gattaca-inspired future where one’s DNA determines one’s position in the societal hierarchy. This year’s notorious experiment might have been an ominous sign signalling the beginning of such a dystopian future. But if CRISPR can be used for these ends, it can also be applied for far more noble purposes.
Fearsome diseases like malaria can be controlled by making mosquitoes resistant to the causative parasite and gene editing can even modify immune cells to better fight against cancer. Advances in gene editing could even treat most genetic diseases which lead to severe debilitating conditions like Duchenne’s muscular dystrophy.

CRISPR promises a lot in terms of gene editing possibilities and to sway it in the direction of the greater good, this technology has to be controlled following a global ethical and legal consensus.

10. Mixed Reality: mixing high-tech with medical education

Before doctors become practicing doctors, they go through medical schools where little has changed for decades. However, with mixed reality, a technology that superimposes virtual, interactive images onto the real world via devices like the Microsoft HoloLens and the Magic Leap, medical education is on track to get a high-tech boost.

Setting the example is Case Western Reserve University which partnered with Cleveland Clinic to integrate new technologies in medical education through the new Health Education Campus. This medical school is equipping its students with the Microsoft HoloLens to teach anatomy via HoloAnatomy, an app they have developed. Now instead of spending time dissecting cadavers and barely seeing certain structures, students are having detailed and accurate, albeit virtual depictions of the human anatomy. This technology can also be put to use in the very near future to train medical students in surgery and expose them to rare medical conditions they would otherwise not even come across in their entire career.

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Such technologies can be considered as extensions of books, where students will be able to visualize and interact with what they come across in their studies. We hope to see more universities adopt such technologies with interaction and visualization at the forefront for a more contemporary approach to medical education system.

Dr. Bertalan Mesko, PhD is The Medical Futurist and Director of The Medical Futurist Institute analyzing how science fiction technologies can become reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is a keynote speaker and an Amazon Top 100 author.

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