Technological and Societal Trends and Their Implications for Medical Device Design, Part 5

The final part in a series that discusses more than two dozen areas that will have the most significance for medicine and for the requirements of medical devices and products. Part 1 discussed factors that will influence the future of care delivery. Part 2 focused on new developments in technology. Part 3 was about the impact of Big Data. Part 4 discussed how medical research will focus on the brain. The subject of part 5 is Personalized Medicine.

Part 5: Personalized Medicine

We are experiencing rapid technological change in many areas that will have an effect on the practice of medicine. Societal changes are also taking place that will impact how health care is delivered in the future. As our knowledge grows, technological advances are speeding up geometrically. This whitepaper series discusses more than two dozen areas that will have the most significance for medicine and for the requirements of medical devices and products. Part 1 discussed factors that will influence the future of care delivery. Part 2 discussed new developments in technology. Part 3 discussed the monitoring and analysis of physiological and health data. Part 4 discussed how research into how the brain functions will have a dramatic effect on medicine. Part 5 will focus on personalized medicine.

Genomics

 Sequencing a person’s genome will continue to get faster and less expensive, to the point where sequencing will become a routine procedure. Advances in genomics will lead to a greater share of medical spending going to diagnostics and a lesser share to therapeutics.

As of this writing, the bottleneck in genomics is not in sequencing, but in analyzing and interpreting the sequenced data. Genetic analysis will allow people to focus preventative care on their individual aspects of greatest risk. But the promise of genomics in medicine will not be attained until the analysis/interpretation problem is solved. We expect that to happen in the relatively near-term (three to five years).

Another challenge facing genomics is in simply storing and managing the vast amounts of data that sequencing generates. Cloud computing and advances in data compression and storage technology will evolve to accomplish this.

As gene sequencing becomes less expensive and more commonplace, and as sequence analysis gets faster, the data will add to our knowledge of the human body and what affects it by orders of magnitude. Genetic sequencing and analysis technology is estimated to be at the same point now as computer technology was 50 years ago. But the rate of technological advancement is constantly speeding up. Though it took 50 years to get from room-sized computers to smart phones, it will take a fraction of that time to achieve similar advances in genetic sequencing and analysis.

Ethical and privacy issues will abound, which in turn will impact the regulatory environment.

Personalized Medicine

 Health data tracking and genomics will combine to enable medicine to be personalized. Generalized treatment will be replaced by treatment and preventative care that is customized to the specific individual. Genetic makeup and history, environment, lifestyle habits, and biometric data will be used collectively to create a “digital you,” against which predictive models can be run to forecast health risk and advise on measures that can be taken to prevent potential health problems. The concept of Systems Biology will expand to encompass all factors that interact to impact an individual’s health. When treatment/therapy is required, it will be targeted, precise, and customized to the individual.

Advances in desktop printing of device components will allow wearable devices to be tailored to the individual. Desktop printers will be used increasingly to design customized orthotics for individual patients.

Nanomedicine will be used to develop devices for targeted therapies: pinpoint treatment vs. the current shotgun approach.

Preventative health

The emphasis in health care is changing from reactive to proactive. Containing health care costs will increasingly rely on maintaining wellness rather than curing a problem that has already arisen. Genomics will form the basis for determining measures that individuals can take to help prevent diseases for which may have a predilection. Ubiquitous health data tracking will enable us to constantly monitor our vital physiological processes over a long period of time. We will have a vast data history for reference and comparison. Health problems will be spotted earlier. Precursors to disease will be recognized and preventative measures undertaken.

As we move from the current mode of reacting to existing health conditions to prevention, our medical and health infrastructure will also change. Traditional sources of healthcare will need to compete with new entrants from other industries such as consumer products and telecommunications.

Finding ways to encourage behavior change will be the key factor in getting people to live healthier lives. This is a difficult, intransigent problem. There is opportunity for innovative thinking in this area, with few if any realistic, workable solutions currently in place.

Self-Care

Advances in personal health technology, combined with the high cost of conventional modes of healthcare delivery, will both enable and force individuals to take more responsibility for their own well-being and disease treatment. Rather than relying exclusively on the expertise of their doctors, patients will become active partners in their own health care. The traditional healthcare community will transition to act more in the role of advisor than interventionist.

Patients will be demanding access to and control of their own health data, and will be looking for complete solutions to their health problems, rather than treating various symptoms in isolation.

 Summary

The future of medicine is personalized and proactive. Those involved in the health care industry will be successful if they anticipate and plan for these changes.