In today's world, more and more researchers are focused on producing new products, methods and technologies for Healthcare. It is a major challenge for healthcare providers to keep abreast of new technologies and methods, training in their use, and budgeting for their acquisition.
It is one of the paradoxes that increasingly powerful computer-based technologies are declining in cost and hold out hopes of reducing healthcare costs in future.
Some trends as given below point to growing automation and designer healthcare based on the trends towards smaller, more mobile, more communicative, interconnected and autonomous and definitely more complex computers and related technologies.
Smart Intensive Care Units
In an Intensive Care Unit, heart rate, blood pressure, blood flow and other measurements are carried out routinely. The analysis of these parameters is quite time consuming and very much clinician dependent for the purposes of analysis and continuing therapy.
In an Intensive Care setting, there could be wide variations of the patient's vital signs and it is critical for the nurse or doctor to be alerted quickly for deterioration of the patient's condition.
In modern days a relatively new introduction is the " Smart ICU" which contains a neural network operating on " fuzzy logic" - in simple terms this is a method to represent mathematically vague and imprecise human measures such as " almost", " very" and " quite far away" which cannot traditionally be designed in digital systems, which operate on "on-off" conditions.
Fuzzy logic extends the machine's ability to reason almost like a human being, and this sophisticated reasoning method enables the neural network to continuously and accurately assess the patient's condition and variance with vital signs and parameters. This information will enable a clinician to make qualitative better decisions in the treatment of patients.
Smart Operation Theatres
The operation of the Operation Theatre - which is usually a massive collection of discrete systems - is being streamlined with the advent of Smart Operation Theatres.
In the new Smart Operation Theatres, the surgeon issues voice commands that are interpreted by an automatic speech recognition system, and control an integrated network of Smart OR devices. A voice controlled set of medical devices is being created so that surgeon's verbal commands can guide the activity of the Operation Theatre.
The systems are being designed as open systems to enable working with a wide range of medical devices of different manufacturers and an industry standard is being established for communication between different devices.
The Smart OT promises to make operations faster and more efficient and dramatically increase productivity and reduce fatigue in the OT.
Non Invasive Surgery
Surgery is often fraught with risk. It is generally perceived that the risks of these are because of anesthesia risk, long stay in hospital (where cross infections could be hazardous) and size of incisions.
Robotic Surgical Systems are becoming prevalent because they offer the potential to reduce the complications of surgery. This basically consists of three interactive robotic arms placed at the operating table, a computer controller and an ergonomically designed surgeon's console. One robotic arm is used to position the endoscope (device for minimal access surgery) and the other two terms manipulate surgical instruments.
The surgeon's arms and hands have been improved in the robotic arms and this results in precise, minimally invasive surgical procedures. The surgeon continuously views the Operation Site in 2 or 3 Dimensions and operates this device continuously using voice commands.
The above techniques began with minor surgeries but has quickly progressed to major surgeries including gall bladder removals, pacemaker implantation etc and it is estimated that over 70% of all surgeries will be performed in a minimally invasive manner, which will ensure that patients are exposed to less risk in surgical interventions.
New Magnetic Resonance Imaging Systems enable the surgeon to see inside the body in real time. Needle biopsies and catheters can be under MRI guidance and this is often used to administer laser therapy in situ to destroy local tumors. This is effective and safer than irradiating the entire area with radiation.
New Horizons in Cancer Therapy
Microwave Therapy
It has now been proved that it takes only 10 minutes for a microwave therapy to kill a tumor, and any pre cancerous cells without damaging healthy neighboring tissue. Being non invasive, the procedure eliminates metastasis - the spread of cancer within the body - from the accidental dislodging of cancer cells by a scalpel or needle during surgery.
Proton Beam Therapy
An existing alternative to microwave or standard high-energy x-ray therapies, proton beam therapy employs protons to obliterate cancerous tissue. The key feature of Proton Beam Therapy is that it is extremely accurate and has a robotic delivery system that can manipulate a patient at the end of a 12 feet long arm to within 0.3 mm.
Multileaf Collimators
This sculpts the radiation beam from a 3 D computer model into the exact shape and size of the target tumor, thus permitting higher dosages and more effective treatment, which reducing damage to surrounding healthy tissues.
Biochips
Biological Research tools have been married to microchip technology to create a set of novel micro machines. These tiny gadgets do the work of many lab technicians performing tasks including DNA, screening blood samples, scanning for disease genes, and surveying gene activity in cells. Major microelectronic companies have entered the market for Biochips as they perceive that this technology has tremendous potential.
New Horizons in Neurosciences
There has been a significant evolution of new techniques of brain scanning including Magneto encephalography, 3D Encephalography, functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), Magnetic Resonance Spectroscopy (MRS) and the PET Reporter gene/PET Reporter probe.
These machines do all manner of things including mapping blood flow and chemical changes in the brain to showing a video of specific genes in real time, as they are expressed inside the brain.
Telemedicine and Telesurgery
Telemedicine spans every echelon of healthcare from first provider/emergency medical systems to tertiary medical speciality consultation and home care to the collection and analysis of epidemiological and environmental data.
Telesurgery a method by which surgeons will be operate on patients in another corner of the world using data gloves, high speed communication links, 3 D imaging and cameras and robots at the patient's location has advanced to animal research stage. This will become more valid if bandwidth and speed is increased.
Conclusion
With more and more research taking place, the healthcare provider has major challenges in planning, budgeting and training for all these new technologies.
In favor of the provider is the fact that all these technologies are very much dependent on computers - wherein the prices are dropping all the time as well as making these new devices easier to use.
The future may bring about a revolution that consumers may use some of these devices directly on themselves that were once the exclusive preserve of the Healthcare provider.
-- The author is Vice President - Quality and Information Systems, Manipal Enterprises, Bangalore