When people think about the future of healthcare, they generally tend to think the future is bright. If they’re basing their decisions off of empirical evidence, looking to the past to determine the future, the common person might agree—we’ve eradicated many deadly diseases, and successfully neutered ones that used to prove fatal. We can attribute extended lifespans to advancement in medical technology, as well as improved standards of living, so the logic only follows that as we continue to advance medical science we’ll see nothing but good things.
Unfortunately, like Icarus who flew too close to the sun, our waxwings may not hold us forever. Artificial Intelligence (A.I.) is revolutionizing everything, while the Internet of Things (IoT) connects us and devices in ways that we’ve never been connected before. CRISPR is on the verge of providing gene editing capabilities reserved for science fiction, allowing doctors to genetically dispose of cancerous cells, or even reverse a birth defect before a child is born. While these sound like insurmountable positives, are we ready also to adopt the unforeseen consequences that will inevitably bundle with such powerful healthcare solutions?
Once thought an impossibility, A.I. has become a reality in conjunction with the rise of Big Data and predictive analytics. In fact, according to Regis College, 43% of U.S. healthcare organizations are currently using predictive analytics, while 51% plan on implementing business intelligence and analytics solutions in the near future.
Due to its power, A.I. in healthcare has been beneficial so far. IBM’s Watson is one of the most prevalent examples of this, showing its efficiency versus human doctors at the University of North Carolina School of Medicine. Provided with the records of 1,000 cancer patients, Watson was able to provide treatment plans that concurred with human oncologists’ actual recommendations 99% of the time—on top of that, Watson was able to provide additional recommendations missed by human doctors in 30% of the cases.
Unfortunately, Watson (and healthcare A.I. in general) isn’t perfect. MD Anderson, the cancer center that is part of the University of Texas, recently ended its partnership with IBM over issues of compatibility with Anderson’s electronic medical records system. This is an illustration of some of the examples of the downsides of A.I. provided by CEP America, particularly that “A.I. implementation can greatly enhance care delivery, but it can also be disruptive and divisive.” Other concerns include A.I. not understanding or making decisions within the right context, or that they may not be programmed to “first do no harm,” but instead maximize healthcare profits at the cost of the best decision for the patient economically.
A major component of A.I. and the fueling force behind it is Big Data and the connected world of sensors and information. We see evidence of the IoT in action when we enter our smart homes, use internet-connected baby monitors or cameras, or in select cities where they’ve implemented smart stop lights and trash cans. In healthcare, the IoT is revolutionizing the way that nurses and doctors work as well. Examples include:
- In-hospital medical sensors that have been compared to air traffic control. These sensors can not only improve staffing, medication, and supply deficiencies, but are also present in the form of cameras that measure neonatal health when the baby is too delicate for on-skin sensors.
- Flexible monitoring of patients from home can be achieved via IoT sensors, saving patients hundreds of dollars on room fees (between $1,800 and $2,000 a day in 2014). An example might include a pillbox that alerts patients when it’s time to take meds, and then sends a message to doctors and care providers when they’ve been taken.
- Wireless implant sensors can help keep an eye on patients long after their hospital stay and recommended monitoring period is over. Wireless artificial pancreas systems that deliver insulin and Internet-connected pacemakers can enjoy constant monitoring by healthcare professionals so that if any problems develop, the patient and doctor will know as soon as possible.
The big problem with the IoT, unfortunately, is malware and the unsecured nature of the network. The recent WannaCry ransomware attack is proof of that, with 48 U.K. medical facilities falling victim to the virus. Unfortunately, as hospitals become more connected, they are becoming less secure, making them the perfect targets for ransomware.
The problem with the IoT is that you open up your health—and perhaps even your body if you have implantables—to hacking. Interestingly, CRISPR’s main selling point is that you can hack your body, albeit in a very different way.
CRISPR stands for clustered regularly interspaced short palindromic repeats. It represents a new method by which scientists can accurately edit specific genes. The best explanation that I’ve seen for what CRISPR is and how it works comes from this Kurzgesagt video. For those unable to view the video, the idea is that by being able to so deftly manipulate minute parts of the genetic code, we are able to exact massive change that we only dreamed about before. For example, these gene-targeting measures have proven effective against HIV and Zika and have shown promise against mesothelioma among other diseases.
The downside is that once we begin editing our own genetics, there’s no rulebook on when and where we should ethically stop. If you were able to predetermine your child’s hair color, eye color, sex, and athletic ability, would you? It’s only natural that you’d want the best for your child—but what if you couldn’t afford for your child to be perfect? Would all of the other “genetically superior” children make fun of your child because they are “inferior”? Even if there are ethical boundaries put in place by some countries, the reality of medical tourism would mean that gene-edited humans will begin to permeate the population, regardless, and could being spreading “edited” genes. We may not discover the consequences of such an action until it’s too late.
It’s important to remember that wherever there is light, shadows will also ultimately materialize. While the future of healthcare is exciting and full of promise, we must first take into account the risks inherent in arming ourselves with these burgeoning new technologies. In the face of incredible opportunity, we must remember the Hippocratic Oath and “first, do no harm.”