Digital diagnosis The development of IT in the field of medicine is hampered not by technological problems, but by legislative problems. How technology will change medicine

Revolutionary changes are taking place today in various fields. Medicine is also trying to keep up in this regard, despite its traditional conservatism. New drugs, new treatment methods, new technologies are being introduced into medicine. Most outdated treatment methods cannot be done without radical changes.

What we could only see a couple of years ago in science fiction books is now being vigorously discussed at medical conferences dedicated to innovation. Great emphasis is placed on Lately on computer technologies that are being introduced into surgery and are used for therapeutic and diagnostic purposes.

In the medicine of the future, an important role is assigned not to the treatment of diseases, but to their prevention and early prognosis. The introduction of diagnostic devices is gaining momentum. Predicting the disease makes it possible to save on treating the patient.

Thanks to the Internet, consultations can be carried out remotely, which saves time not only for the patient, but also for the doctor.

Personal electronic medical record

One of the stages in improving modern medicine is the personalization of data and increased communication between doctors. Easy access to medical history allows you to prescribe timely and effective treatment.

Maintaining medical records can gradually move online. Cloud software is used to store large amounts of information on the Internet. Thanks to the Internet, doctors from different clinics have access to patient data. Electronic medical records make it possible to timely learn about the patient’s health and prescribe effective treatment. Linking the equipment of a medical institution into a single network will make it possible to receive examination data on doctors’ portable devices. In the United States of America, some clinics already operate on this principle. Doctors have tablets that receive information about the patient: what medications are prescribed, test results, etc.

The introduction of Internet technologies saves time for the patient and the doctor. There is no need to get to the clinic; you just need to turn on the computer and you can contact a medical institution. Some doctors in Russia are already practicing consultations via Skype. Video calls make it possible not only to conduct a survey, but also to general examination, which is often sufficient for a general idea of ​​human health. If you still need to see a doctor, you can also make an appointment online. Such a service can already be found today in some clinics, including in Moscow.

How will diseases be diagnosed in the future?

The development of medical technologies is moving towards allowing people to monitor their health on their own. Today in every home you can see tonometers. Diabetic patients use portable glucometers.

Pressure measuring devices, scales and other portable equipment are equipped with wireless transmitters that allow you to immediately transfer data to a computer and keep track of your health.

To the list of publications

The process of medical development is accelerating every year, and 2017 is full of technologies that open up new prospects for treating people. “Futurist” has compiled a selection of the most relevant and significant of them.

Robotics and automation are gradually transforming the way doctors perform both surgery and medical treatments. New systems take advantage of advances in software, miniaturization and robotics, allowing for minimal invasive operations on the most delicate parts of the human anatomy. Every year, robots perform more and more complex tasks with an accuracy impossible for humans.

New da Vinci X surgical system

Successfully implemented models of da Vinci surgical robots continue to be improved. The new representative of the line will provide surgeons and hospitals with access to advanced technologies robotic surgery at a lower price. Intuitive Surgical, a robotic company and a global leader in robotic minimally invasive surgery, announced that its new da Vinci X surgical system has already received CE Mark certification in Europe.

“Over the past 21 years, Intuitive Surgical has become a pioneer in the field of robotic surgery, and we continue to lead the way in developing and bringing to market innovative, results-driven technologies,” said Dr. Gary Guthart ( Gary Guthart, CEO of Intuitive Surgical. “Our surgeons, hospitals and clients around the world have told us that robotic assisted surgery has great value for their patients, emphasizing the importance of providing choice from a clinical, technological and cost perspective.”

da Vinci robotic systems are designed to help surgeons perform minimally invasive surgery. However, they are not programmed to perform surgery on their own. All procedures are performed by a surgeon who controls the system, while Da Vinci provides high-definition 3D images, robotic and computer assistance.

Robot surgeon capable of performing brain surgery 50 times faster than a human

Brain surgery requires extreme precision; one mistake can lead to the death of the patient. Even in one of the most skilled professions in the world, human error can cause a fatal error. Researchers at the University of Utah hope to reduce the impact of human error: they believe that their operating surgeon is able to perform complex operations on the brain, reducing the time required to cut open the skull from two hours to two and a half minutes. Thus, the robot will reduce the time required for a complex procedure by 50 times.

The device moves around vulnerable areas of the skull according to data obtained from a computed tomography scan and transmitted to the robot's software. CT scan shows the programmer the location of nerves or veins that the robot should avoid.

Apart from the obvious benefits of the machine's mechanism, it can also save money in the long run due to shorter operation times. An additional advantage is the reduction in the time the patient remains under anesthesia, which also makes the procedure safer.

Therapeutic nanomaterials

Nanomaterials are devices that are so small that they can only be measured on a molecular scale. These microscopic machines are different forms and can be made from a variety of materials, from gold to synthetic polymers, depending on their intended functions. In fact, more than 50 nanoparticle-based drugs are already approved by the Food and Drug Administration, such as Abraxane for breast cancer and Doxil for ovarian cancer. These machines are now being used to selectively deliver toxic chemotherapy directly to cancer tumors, helping to reduce the doses needed to kill them and the risk of serious illness. side effects for the patient. In the future, nanotherapeutics could be developed to destroy cancer cells.

To this end, the researchers have developed a new platform for non-invasive imaging of the effect of nanoparticles on cancer in mice (in real time), which will help researchers improve them before testing in humans.

"This important step forward in this area,” said the principal investigator Alexander Steg (Alexander Stegh). - “The nanotech area lacks the careful optimization that we see in developing regular medications, and we'd like to change that. The system we've developed here really allows us to support those efforts.”

Steg's team used a new platform to test therapeutic nanomaterials they were developing, spherical nucleic acids (SNAs). They can kill a currently untreatable type of brain cancer by targeting a specific gene. The imaging system helped establish that nanoparticles have the greatest effect between 24 and 48 hours after administration, and therefore determine best time to administer additional chemotherapy.

Artificial intelligence

Another under-the-radar technological innovation in medicine involves the use of artificial intelligence (AI). IBM Watson, IBM's supercomputer, has already demonstrated a keen diagnostic eye, and machine learning and deep learning programs have been used to predict everything from when a patient is expected to die to the next major disease outbreak.

We can expect that the use of AI in medicine will only continue to grow. Especially this year, when the need to select and assimilate great amount health data - on an individual or large-scale, community basis - will become critical. Meanwhile, the fear that potentially flawed machine learning programs will displace human resources will also become more real.

Gene editing

The revolutionary gene editing technology CRISPR/Cas-9 has become a unique breakthrough in the field of biology. She proposes transforming it from a slow, imprecise science into something closer to the physical sciences. The future of gene editing technology is open to wild speculation, despite legal prohibitions in many countries and ethical issues associated with it.

Wider use of the technology in humans is already inevitable. Perhaps 2017 will be the year when this happens for the first time. Most likely are widespread trials of gene editing in the fight against cancer, or the use of CRISPR to eradicate pathogenic human DNA viruses such as HIV or herpes.

But passive measures are also expected, such as simply studying the progress of Alzheimer's disease and other neurodegenerative diseases or even non-medical agricultural and industrial applications of this technology. Understanding how DNA sequences work will allow scientists to solve problems in all areas of biology, from treating human diseases to understanding why certain species go extinct.

Monitoring insulin-producing cells on a smartphone

For people with diabetes, insulin injections are an integral part of life. However, a new device created by Chinese researchers and tested on mice may eliminate the need for constant injections. The team implanted insulin-producing cells into diabetic mice and then used a smartphone app to “turn on” the cells. After two hours, the device, which its creators call HydrogeLED, stabilized the mice's blood sugar levels. Hydrogel capsule the size of a coin. It is implanted under the skin of animals and consists of insulin-producing cells and LED lamps. Cells produce insulin only when the LEDs are turned on.

Blood sugar levels can be monitored using a separate Bluetooth glucose meter, which alerts the app when it gets too high. The app then turns on the LEDs, triggering the release of insulin. The user can manually control the brightness of the LEDs and the duration of their operation, thus regulating how much insulin enters the blood.

However, using the application on humans is not yet possible due to some problems. The mice on which the device was tested are enclosed in a coil electromagnetic field, which is very similar to a smart home hub - this way the application can communicate with the server. LEDs are powered by the electromagnetic field itself, which means the entire system will not be able to work outside the coil. Additionally, at this time, blood sugar levels are still checked using a needle.

Future versions of HydrogeLED will address these issues. Author of the study Haifeng Ye plans to launch 24-hour blood sugar monitoring with a built-in glucometer that can automatically trigger LEDs when needed.

Illustration copyright Getty Images

While society is arguing about the potential “rebellion of the machines” and the threats from big data and artificial intelligence, new technologies are transforming one of the main areas of human life – medicine. What will her future be?

Human health is in the hands of IT giants

This week the media noted that recently Apple company launched her own project without wide publicity medical clinics primary health care for employees and their families. The network was named AC Wellness.

The list of open vacancies for Apple's subsidiary includes the position of a doctor-designer of health programs for the population.

The job description states that this specialist will not only have to monitor chronic diseases patients, but also be responsible for promoting the health of clients, preventing and early identifying illnesses.

As an employer, it is much better for Apple to provide its employees with top-notch health care that is proactive rather than spending money on treating employees who are already sick.

This idea was also seized upon by such large companies, like Amazon, J.P. Morgan and Berkshire Hathaway. Together, the companies decided to develop medical technologies and announced the launch of an independent non-profit organization, which will focus on innovation and improvement of the health care delivery system.

According to the US Centers for Disease Control and Prevention, the annual loss of productivity due to employee illness is estimated at $260 billion. It is not surprising that the largest American companies are seriously interested in the development of preventive medicine.

Speaking earlier at the annual meeting of shareholders, Apple CEO Tim Cook said his company could make a significant contribution to healthcare. It would seem: where is medicine, and where is the iPhone manufacturer?

Doctor in your pocket

Some American hospitals already use special medical platforms on smartphones and tablets, which allow the patient to study their medical history, all doctor’s orders and, if necessary, ask clarifying questions in a chat with a specialist. But this is far from the only thing that new technologies can bring to medicine.

For example, in November 2017, Apple announced the launch of a joint study with scientists from Stanford. Especially for this, the company released the Apple Heart Study application, which allows you to track heart rate deviations in users." smart watch"Apple Watch.

The company, along with FitBit, Samsung and others, is also working on a project to regulate digital medicine. The project is supervised by the Office of Sanitary Supervision of Quality food products and US medicines.

According to Lu Chang, head of Fusion Fund, a venture capital firm that invests in innovative projects, to commercialize a mobile service, it is not important whether consumers like it, but whether they need it.

“Healthcare is definitely something that everyone will need,” Chang concluded in a conversation with the BBC Russian Service.

Chang sees several main aspects of the medicine of the future: personalized treatment, individual diagnostics, the creation of new drugs using artificial intelligence, robotization of surgery and therapy, as well as curation of patient recovery after surgery or illness through digital platforms.

“Humanity dreams of finding the key to the fight against cancer. It lies precisely in the individual characteristics of patients and even in the individual characteristics of their cancer cells. I myself invested in the company Mission Bio, which is engaged in individual cell diagnostics using droplet microfluidics technology and specifically carries out diagnostics small cell cancer, which is so difficult to detect," Chang said.

Such a detailed approach, in her opinion, will make it possible to find a personalized cancer treatment method for each patient.

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Head of the Laboratory of Genomic Geography, Institute of General Genetics. N.I. Vavilova, Doctor of Biological Sciences, Professor of the Russian Academy of Sciences Oleg Balanovsky also believes that an individual approach to the patient is the main direction in the development of modern medicine.

The practice of analyzing large biodata, in his opinion, should lead to improved quality of diagnosis and more accurate prescription of drugs, but this will not happen immediately, but gradually, the scientist believes.

Artificial intelligence should help people not only select treatment more correctly, but also create more effective drugs. "Discovering new drugs using deep learning and the ability to quickly analyze chemical composition[drugs] will allow us to save a lot on research and development work,” Chang is sure.

There are already “pharmaceutical companies of the future”: one, for example, can be called BenevolentAI, although the company is primarily engaged in the development of artificial intelligence.

The company's founder, Ken Mulvaney, believes that the world should and can see much more scientific discoveries, including in the field of pharmaceuticals, than we see now. His company's goal is to increase the productivity of scientists by helping them process the enormous volume of existing scientific knowledge the power of artificial intelligence.

Mulvaney believes artificial intelligence can change the world medical supplies. Moreover, his company’s website suggests that AI can turn anyone into a scientific expert, even if he is not a doctor.

This idea was vividly expressed by Eric Topol, a cardiologist and writer, in the title of his book about the future of medicine, which was published in 2015: “The Patient Will See You Now,” which can be translated as “Now the patient will see you.” Indeed, with the help of innovative services, at some point the patient can feel almost like a doctor.

Artificial intelligence and big medical data

“We live in a happy era: to create personalized medicine, you need to collect huge databases, and this used to be a problem. Now we have many cheap ways to integrate data into different services. Modern technologies allow you to quickly and cheaply send data directly to the cloud service. As a result, we can use a complete set of data about people to develop a personalized treatment plan,” notes Chang.

The capabilities of machine learning already allow computer algorithms to quickly navigate a huge layer of information and draw certain conclusions about the user’s health status.

In Russia, the CoBrain project is analyzing large biodata. Its goal is to create an information and analytical system for processing large neurodata, which should become a kind of signal for the emergence of new medical services, says project manager Dimitry Dozhdev.

CoBrain looks at the human brain as a whole, which will potentially make it possible to observe the patient’s body as a whole, more effectively monitor the state of remission, and also prescribe more precise therapy, Dozhdev believes.

In his opinion, CoBrain should bring closer the creation of personalized medicine in Russia. Not only researchers in medical laboratories, but also local doctors. “The main postulate of the project is that we do not replace the doctor in diagnostic matters. Our task is to provide tools that will free the doctor from routine,” Dozhdev added.

According to Chang, artificial intelligence is necessary in the field of medical imaging.

“There is a huge amount of visual information for each patient, and now it will be possible to “connect” to it computer vision. Computers are not going to put anyone out of work! They can simply quickly scan the images and, from hundreds of options, select a couple that can be shown to the doctor and from which he can make important conclusions. In addition, AI can save the patient in situations where the doctor overlooked something important,” Chang is sure.

Are you your own doctor?

New medical services, which innovators in the healthcare industry are now dreaming of, will not only analyze at lightning speed physical indicators patient, but will also provide him with tools for a healthy lifestyle.

Agree, if the application on your smartphone often sends you a notification that your heart rate is jumping, most likely, you will unwittingly begin to monitor your lifestyle in order to avoid deterioration. Someone may even take up self-medication. And it is this point that causes a lot of controversy among experts.

The case of Sergei Fage, an entrepreneur and founder of the Ostrovok service, is illustrative. His article, “I’m 32 years old and spent $200,000 on biohacking,” sparked heated discussion in the Russian scientific and media community, and received accolades from prominent futurists in Silicon Valley. In it, Fage talks about how he “hacks” the biology of his body (including by analyzing his genome) to make himself “faster, taller, stronger” - or rather healthier, younger and more efficient.

Some experts criticized Fage for overdiagnosis, arbitrariness and pumping his body with a destructive cocktail of drugs. Some transhumanists supported him, while others found flaws in his approach, although they praised him for promoting a personalized “medicine of the future.”

It is almost impossible to understand who is right and who is wrong in this dispute: there are always plenty of scientific arguments in favor of both sides.

As Marina Demidova, director of the portal-aggregator of medical tests and laboratories Lab24, explains, it is really vital for a person to know about a number of mutations in certain genes, but only really significant ones, which has been proven by serious scientific research. Anything else can really lead to overdiagnosis.

For example, the threat may be posed by the gene responsible for the development of breast cancer - the story of Angelina Jolie, who fought against it, is known to many. “It’s good that this is happening. We, of course, are now skeptical about all this, about those [genetic] analyzes that some [commercial] companies do. Especially genetic doctors are looking at all this with questions. But in any case, we We’ll get there,” says Demidova.

Personalized preventive and predictive medicine, which deals with complete monitoring of the body according to various indicators, including from the point of view of genetics, is now a guideline for medical science. Many specialists and visionaries see potential in the transition of medicine online. Services for remote consultations with doctors are already being launched (take, for example, Yandex.Health), and this is just the beginning.

Genome research is now one of the most popular areas not only in laboratories, but also in medicine open to patients. More and more services are appearing that offer to “sort out DNA” - that is, analyze the presence of genetic predispositions to certain diseases.

It is assumed that a person will somehow be able to prevent their development. Which can be simply impossible, as in the case of Alzheimer's disease.

Demidova is confident that personalized medicine is the future, despite the fact that constant monitoring of a patient’s biological indicators, including by himself, can pose a threat to his well-being.

According to Demidova, in the future, all risks of personalized and remote treatment will be prevented through thorough testing of gadgets and mobile applications.