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Futuristic Healthcare
Dr JS Murli
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The hospital as center of
care
AcuteEvent
Chronic
Disease
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Care is now decentralized and
fragmented
Treatment
Plus
Acute
Event
Chronic
Disease
Monitoring
http://images.google.com/imgres?imgurl=www.msnbc.com/d/v/250x190/nn_bazell_statins_011113.jpg&imgrefurl=http://www.msnbc.com/news/657081.asp&h=190&w=250&prev=/images%3Fq%3Dstatins%26svnum%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26oe%3DUTF-8http://images.google.com/imgres?imgurl=heart-surgeon.com/Graphik-CA3.gif&imgrefurl=http://heart-surgeon.com/coronary-bypass.html&h=220&w=183&prev=/images%3Fq%3DBypass%2Bsurgery%26svnum%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26oe%3DUTF-8 -
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Dangers of predicting the future
I never make predictions, especially aboutthe future.
Sam Goldwyn Mayer
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Predictions of Lord Kelvin,
president of the Royal Society,1890-95
"Radio has no future"
"Heavier than air flying machines are
impossible"
"X rays will prove to be a hoax
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Looking to the future: common mistakes
Making predictions rather than attaching
probabilities to possibilities
Simply extrapolating current trends
Thinking of only one future
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Looking to the future: common mistakes
People consistently overestimate the
effect of short term change and
underestimate the effect of long term
change.
Ian Morrison, former president of the Institute for the
Future
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Why bother with the future?
The point is not to predict the future but toprepare for it and to shape it
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How best to think about the future?
Think of the drivers of change
Use the drivers to imagine different scenarios of
the future
Imagine perhaps three; each should be plausiblebut different
Extrapolate back from those future scenarios to
think about what to do now to prepare
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Drivers of change in health care
Internet
Beginning of the information age
Globalisation Cost containment
Ageing of society
Increasing public accountability
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Drivers of change in health care
Rise of sophisticated consumers
24/7 society
Science and technology --particularly
molecular biology and IT
Ethical issues to the fore
Changing boundaries between health and
health care
Environment
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Future Developments
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Cyberphysicians
The number and form of infomediaries--
knowledge brokers will proliferate
All the information available to professional will
be available to patients
Cyberphysicians will look after peoples health,
detecting changes through sensors, prompting
preventive activities and treatments
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Infomediaries: doc.coms
People will be able to use doc.coms
to: Ask questions
Interact with others with similar interests
Use software that will help with health risks
Use decision support systems
Consult with professionals
Access their own health records
Buy health related products
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Health records: the problem
Current health records are:
Paper based
Disorganised
Often illegible
Lost
Scattered
Poorly linked
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Health records
Health records might be Electronic, lifelong, perhaps recording all food
and drink consumption, exercise, etc
Accessible from anywhere Linked to other records, like social care
Multimedia
Collect information from sensors in the bodyor home
Data mined
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Information and health: technological
developments
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Robotic Surgery : What can we do
with this technology?
Cardiac
Mitral Valve Repair (dMVR)
Multi Vessel Small Thoracotomy
(MVST)
Totally Endoscopic CAG (TECABs)
ASD Repairs
PDA Ligations
ThoracicLobectomies
Wedge Resections
Mediastinal Mass Removals
Sympathectomies
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daVinci MVR
Peripheral
Cannulation
3-4cm ThoracicIncision
Atriotomy using MIS
instruments
MV Repair using
robotic instruments
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daVinci Mitral Valve Repair
Staged Procedure
Opening and bypass
Atriotomy
Leaflet repair
Annuloplasty
Closure of atriotomy
Removal of bypass
and cavity closure
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Totally Endoscopic CAG
3 or 4 incisions less
than 1cm
With or without
bypass Expensive procedure
Can be staged
conduitharvest/anastomosis
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FOOD FOR THOUGHT
Is Robotic Surgery the beginning of the
evolution of same day surgery for moreadvanced or complex cases???
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Conclusion
The future is highly unpredictable Nevertheless, it is important to think about the future;
those who do prosper
A good way to think about the future is to imagine
different futures
In future, evidence based medicine will become steadily
more important
Technology rules
Need to envision a humane approach and a
technologically advanced healthcare system in the future