Technologies Emerging in Healthcare:
An Incomplete List
- Prevention
- Imaging
- Diagnostics
- Therapeutics
- Pharmaceutical research
- Health Informatics
Screening for genetic markers of major diseases -- and early,
ongoing health management of those at risk.
Implanted or home-use biosensors will signal key changes in the
bodies of those at risk.
Genetic vaccines consist of the specific antigens that will cause
an immune response, rather than the whole organism.
Cancer vaccines are showing increasing promise.
Vaccines against immune inflammatory responses are
being tested in cases of sepsis, rheumatoid arthritis, multiple sclerosis, and
allergies.
Magnetic Resonance Angiography (MRA) is 90 percent effective in
identifying coronary disease, and is much safer and less invasive than X-ray
angiography.
Magnetic Resonance Spectroscopy (MRS) produces in vivo
biochemical analyses of body fluids, cells, and tissues.
A high-speed upgrade to MRI, Echo-Planar Imaging (EPI) produces
30 images per second.
MRI/EEG, which combines two veteran technologies, could replace
many uses of positron emission tomography (PET).
The Super-cooled Quantum Interference Device (SQUID), used mostly
in brain scans of epileptics, is so sensitive it can detect the firing of a
single neuron -- and its very sensitivity may confine it to the lab.
Optical Coherence Tomography can produce images that resolve
objects as small as ten microns. May be used to prevent blindness before
physical symptoms occur and, in combination with endoscopic fiberoptics, to
perform in-vivo biopsies, examine arterial plaques, and localize stroke
sites.
The Polymerase Chain Reactor (PCR) multiplies tiny amounts of
DNA, making possible the rapid definitive diagnosis of bacterial, fungal, and
viral infections, as well as a number of cancers, without relying on
interpretations.
Biosensors based on DNA sequencing chips can
directly read bits of unidentified DNA.
Genetically engineered cytokines such as blood cell growth
factors EPO and G-CSF, and coming epidermal and nerve growth factors, promise a
wide range of uses, as do new generation immunosuppressants, such
as OKT3, FK506 and rapamycin, leading eventually to organ-specific, and even
donor-specific immunosuppressants.
Gene transfer therapy has shown experimental success in (among
others) cystic fibrosis, muscular dystrophy, familial high cholestrol,
Gaucher's disease, asymptomatic AIDS, and brain, lung, and breast cancer,
HV-tk gene therapy implants the gene for herpes virus thymidine
kinase enzyme into (for instance) brain tumor cells or ovarian cancer cells,
altering them so that they become targets for ganciclovir and other anti-viral
drugs.
"Antisense" compounds mirror and bind to specific bits of
messenger RNA necessary for the reproduction of a disease-causing protein,
rendering it impotent; in development for HIV, Alzheimer's disease, numerous
cancers and autoimmune disorders, viral diseases, malaria, coronary artery
disease, and even obesity; may replace gene therapy in coming years.
In situ gene alteration seeks to repair the existing
mutated genes underlying many disease forms, rather than replace them -- unlike
those accomplished by gene transfer therapies, cures by gene alteration would
be permanent.
Next-generation Laparoscopic surgery is enhanced by 3-dimensional
vision and computer-controlled, jointed tools.
Rational drug design is possible now that we can detect and
manipulate single molecules: the task is to find the causative agent, then
design and manufacture a molecule that will bind with it, mimic it, destroy it,
modify it, or slow it down.
Directed molecular evolution using PCR technology takes specific
bits of protein through multiple cycles of growth and selection, introducing
random genetic changes and using a specific task as the selector -- after many
cycles, the proteins have evolved to be much more efficient at the intended
task.
Usually thought of in separate categories and systems (administrative,
clinical, professional, and consumer), health information systems are
increasingly trending toward cross-platform, scalable technologies that can be
used in all areas. Here are some of the new technologies, and their uses,
arranged by bandwidth -- the size of the communications "pipe" that they need:
| | | Bandwidth |
|
| Use | Low | Medium | High
|
Administrative - System simulations
- Outcomes management
- System simulations
- Outcomes management
- Low-speed videoconferencing
- System simulations
- Outcomes management
- Videoconferencing
| Clinical | - Expert systems
- Autonomous adaptive systems
- Home health care support via screen phones and modem-based computer access
- "Smart" hospitals
- Clinical practice guidelines, current journals and abstracts, research databases, referral services and consultations on-line
- Telemedicine (consultation, exchange of data)
- Home health care support
- VRML and other 3-D protocols on the Net
- Low-speed videoconferencing
- Telemedicine (consultation, exchange of data and images)
- Video on demand
- Videoconferencing
- Telemedicine (consultation, exchange of data and high-resolution images)
- Home health care support
- Simulated operations
- VRML and other 3-D protocols on the Net
| Professional | - Cyberspace discussion groups
- Online reference and medical librarian services
- Job and grant information
- Calls for papers and announcements of meetings
- Electronic communications with peers, patients, pharmacies, payors, home offices
- Continuing education and mentoring
- "Professional desktop" Internet access
- The World Wide Web
- Low-speed videoconferencing
- Video on demand
- Videoconferencing
| Consumer | - Touch tone health information and retrieval
- Personal Health Information Systems
- Cyberspace discussion groups
- CHESS from the University of Wisconsin at Madison.
- Home health care support via screen phones and modem-based computer access
- Community-based directories and networks
- The World Wide Web
- Home health care support
- VRML and other 3-D protocols on the Net
- Community-based directories and networks
- Interactive kiosks
- Interactive television (ITV)
- Video on demand
- Videoconferencing
- Home health care support
- VRML and other 3-D protocols on the Net
- Community-based directories and networks
-
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