Technology promises to herald astonishing advances in healthcare, but delegates to the Knowledge Summit 2016 were told that the rapid pace of change posed ethical and legislative challenges.
Organised by the Mohammed bin Rashid Al Maktoum Foundation (MBRF) – member of the Mohammed bin Rashid Al Maktoum Global Initiatives – the third-annual summit in Dubai from December 5-7 at the Grand Hyatt.
Moderated by Dr. Jamal Mohammed Al Kaabi, Director of Social Development Sector, Office of the Executive Committee, Executive Council of Abu Dhabi, the panel session, titled Knowledge and the Future of Health explored sweeping changes we can expect from scientific advances.
Daniel Kraft, a Stanford- and Harvard-trained physician-scientist, inventor, entrepreneur and innovator, kicked off by saying: “Technology will change whole premise of healthcare.”
“In the US,” he said, “most of healthcare spending is on 20% of the population with chronic conditions.” Technology, he said, offers a route out of that, with wearables and monitoring Apps introducing a new field of preventative medicine. “Smartphones today are healthcare platforms,” he said. “They connect the dots between doctors, between patients and pharma.”
But he warned that human minds still struggle with the sheer pace of change … the world is actually moving at an exponential rate, but we’re still looking at it as linear. He said the next big step would be a full “Uberisation” of healthcare. “Uber did not invent GPS, or online payment, or anything else that makes it function,” he said. “Uber saw what was already there, and simply connected the dots.”
Uberisation, he said, was already already here. “In the US ,there are 5 uber-style healthcare Apps. You press a button, a doctor shows up,” he said.
Wearables, he said are already evolving into “insidables”, such as contact lenses that measure blood sugar. Then there are ‘trainables’ to correct things like posture; ‘shockables’ that provide direct input; “hearables”, “ringables” and more. All this, he said, is creating terabytes and terabytes of data. “The big challenge, is what do we do with this data?”
He said a streamlining is inevitable – we won’t want 10 devices, or 10 apps. They need to be integrated – “In a car engine we have dozens of sensors, but the only one we care about is the check engine light,” he said. This data, once streamlined, can integrate with our healthcare records, and even with automated homes – providing you with your own “check engine” light, or telling you to watch your weight, or when to take medication.
Ultimately, he said, advanced artificial intelligence will be monitoring all these data streams, and making accurate diagnoses on your behalf. “Artificial intelligence won’t replace doctors, but it will augment them,” he assured. As for the data itself, he said that ownership could prove to be a legal challenge. “I personally argue that we should all own our personal health data,” he said.
Hugh Herr, Associate Professor, Media of Arts and Sciences, Health Sciences and Technology, MIT Media Lab, agreed that legislation was among the biggest challenges brought about by the fast pace of change in medicine. Regulation would struggle to keep pace with advances, not just in terms of licencing new drugs and technologies, but also on the ethical side.
His expertise is bionics – the integration of living tissue and synthetic devices, which he said had the capability to fundamentally change what it means to be human – something that society may be unprepared for. “Bionics is the design of constructs attached to or inside the body that extend human capability,” he said. This can mean restoring abilities to the disabled, but it can also take humans way beyond their normal capabilities.”
Herr speaks from experience: a double amputee who lost both legs below the knee in a climbing accident, he says he has “hacked” his body to give him capabilities far beyond normal people. “I now climb better than I did when I had legs,” he says. “Other climbers have threatened to chop their own legs off to compete with me better!”
He said advances in bionics were along four key areas: the brain’s inputs and outputs, which promise treatments for blindness, among other conditions; the body’s inputs and outputs, which promise significant advances in treating paralysis; bionics, where major advances are being made in ‘wearable robots’ and exoskeletons; and organ and tissue repair, which promise complete regeneration of spinal cord damage for example.
Technology has freed me from the shackles of disability,” he said. “And I firmly believe, in the next decade, we will largely solve paralysis.”
Mohamed Ghoneim, Professor Emeritus of Urology at Mansoura University, Egypt, predicted advances in nanotechnology and biotechnology would transform healthcare. In the nanotechnology field, he cited the pioneering work of the Egyptian-American scientist Mostafa El-Sayed in using gold nano-particles to target, and eliminate, cancer cells.
Robotic surgery, he said, was also being miniaturised, requiring one tiny hole where before a major incision would have been needed. In biotech, he said that healthcare had advanced greatly from the discovery of DNA in the 50s, through to the first genome sequencing in the late 1990s, to the present day, where gene therapies and gene splicing now offer real treatments to conditions ranging from haemophilia to type 1 diabetes.
But he said it was stem cells – and especially ““individual pluripotent stem cells” that offered the most promise, in everything from tailored treatments to potentially revising aging. “Individual pluripotent stem cells reverse any human cell back into embryonic cells,” he said. “Then, you can do what you like with them.”
This method offered two major advantages: firstly, by being sourced from the patient there would be no immunosuppression issues; and secondly, by being sourced from any cell, it overcame the ethical questions arising from the use of embryonic stem cells.