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Imagine being paralysed and having an implanted microchip that might motion a message out of your brain to maneuver your prosthetic arm. Or a diagnostic system that might pick up Alzheimer’s a decade before you develop any symptoms. Or a 3D printing machine that might print a pill with a mixture of medication tailored only for you.
Sound far-fetched? Then meet Dr Daniel Kraft, a Harvard-trained oncologist-cum-entrepreneur-cum-healthcare futurologist. The faculty chair for medicine and founding father of Exponential Medicine on the Silicon Valley-based Singularity University, nobody may very well be more serious – or ambitious – in regards to the revolutionary impact that technology may have on the longer term of healthcare.
The web of things, constant connectivity, ever cheaper hardware, big data, machine learning: Kraft’s list of converging “meta-trends” goes on. “This set of technologies, especially when meshed together, offers an actual opportunity to reshape and reinvent healthcare across the planet,” he says. Kraft’s vision is of a patient-centred, tech-led healthcare system (versus “sickcare”, as he defines the present system) that guarantees to show the medical world on its head. But what implications does it hold for future business of healthcare?
Big pharma is one among the primary in line for a shake-up, Kraft warns. Today drug firms’ profits are based on blockbuster drugs for pervasive diseases. But what if medical science reveals (because it is doing) that there are really a whole bunch of sub-types of diabetes, say, or lung cancer? And what if a patient’s full genome sequence can show the likelihood of a blockbuster treatment not working?
“There’s a spectrum of diseases with different molecular pathways and pharma goes to must adapt to smaller markets when it comes to individual drugs,” Kraft says.
On the flipside, the prospect of individuals with the ability to participate in clinical trials on their smartphones guarantees to drastically speed up the time drugs can get to market. Prescribing an app together with a pill may also turn out to be commonplace, he suggests, enabling patients to maintain on target with their medicine and adjust their dosage if required. Both potentially promise big returns for the pharmaceutical industry. Drug distribution is about for a radical overhaul too. Digital device manufacturers are already experimenting with so-called “implantables” that use bioelectric sensors to trace patients’ vital signs and release a drug dose as and when required. At the opposite end of the spectrum, drones at the moment are getting used to deliver drugs to distant areas or disaster zones. Matternet, one among 50 or so start-up firms to have spun out of Singularity University, has been doing exactly that in Haiti recently.
Kraft warns that radical change is afoot for healthcare providers as well. Imagine a scenario where patients can compare the outcomes of various hospitals and even individual doctors? Or where patients don’t need to return to a clinic once a month for an electrocardiogram but as a substitute wear a wise Band-Aid “patch” that sends the identical information 24/7 to their doctor’s surgery? Patient power, in other words.
Expect a brand new age of “value-based medical care”, he says. Consider hospitals. Instead of being paid on what number of beds they fill or what number of surgeries they perform, as now, market incentives will exist to do the other – that’s, keep people from ever coming to hospital by anticipating their illnesses and providing them with preventative solutions. “Hospitals within the US at the moment are beginning to send patients home with an app, a set of [WiFi] connected scales and a blood pressure cuff, in order that they can higher manage their medications and their eating regimen,” says Kraft, who claims the approach “stops them bouncing back to hospital”.
In New Orleans, Ochsner Health System has been piloting Apple’s recent HealthKit and Watch to only such a scheme.
Looking ahead, Kraft’s smart money is squarely on medical software innovators, digital device manufacturers and “precision medicine” providers. This isn’t a startling revelation. Analysts have estimated that the already huge US$55bn global digital health market will grow at a staggering 21.4% per 12 months.
Few have as clear vision of what the longer term could appear like as Kraft, nonetheless. He pictures doctors being held medically negligent for not using artificial intelligence to diagnose cancer; surgeons having CT scans layered over a patient’s body via augmented reality; medical students using Oculus Rift to explore the inside the center; burn victims being virtually transported to a snow-coated mountain top as a pain therapy. It’s dizzying stuff.
“The opportunity now’s for the medical student, the nurse, the doctor, whomever, to create recent solutions using a few of these technologies, particularly once they converge,” he says.
The idea of convergence (or “super-convergence”; Kraft is keen on superlatives) is critical to his considering. Bespoke business opportunities abound, but the unconventional overhaul of tomorrow’s healthcare will only occur when technologies start interweaving. And that may only occur when the worlds of business and medicine start talking.
“We have to let doctors and nurses and patients and technologists and pharma and biotech understand where technology is and where it’s going,” he says. He points to clinicians accessing technology corresponding to IBM Watson, the self-learning artificial intelligence tool that may “read” 100,000s of educational papers in seconds, amongst other things. “If you realize IBM Watson will available in your smartphone or within the cloud, what could you as a clinician do with that?”
The exponential medicine programme that Kraft founded at Singularity five years ago sets out to attain precisely this sort of cross-fertilisation between technologists, business folk and clinicians. To date, the initiative has spawned around 50 start-ups.
“The future is coming faster than you would possibly think,” he says, with characteristic optimism. “Soon we won’t wait for disease to occur. We’ll take care of ourselves before we get sick.”
Daniel Kraft might be speaking at Creative Innovation 2016, which might be in Melbourne from 7 to 9 November
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