future hosp.murli

8/9/2019 Future Hosp.murli

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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

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