In two decades, access to the best healthcare will become universal, regardless of your income or where you live. Ironically, your need to visit hospitals, and even meet with doctors at all, will decline over those same two decades.
Welcome to the future of decentralized healthcare.
Today's healthcare system is largely characterized by a centralized network of pharmacies, clinics, and hospitals that reactively provide one-size-fits-all medicine and treatment to address the existing health issues of a public who are unaware of their health and ill-informed about how to effectively care for themselves. (Whew, that was a doozy of a sentence.)
Compare that system to what we’re currently heading towards: a decentralized network of apps, websites, clinic-pharmacies, and hospitals that proactively provide personalized medicine and treatment to prevent the health issues of a public who are obsessive about their health and actively educated about how to effectively care for themselves.
This seismic, technology-enabled shift in healthcare delivery is based upon five principles that involve:
Empowering individuals with tools to track their own health data;
Enabling family doctors to practice health maintenance instead of healing the already sick;
Facilitating health consultations, free of geographic constraints;
Dragging the cost and time of comprehensive diagnosis down to pennies and minutes; and
Providing customized treatment to the ill or injured to promptly return them to health with minimal long-term complications.
Together, these changes will massively reduce costs throughout the healthcare system and improve its overall effectiveness. To better understand how this will all work, let’s start with how we’ll one day diagnose the sick.
Constant and predictive diagnosis
At birth (and later, before birth), your blood will be sampled, plugged into a gene sequencer, then analyzed to sniff out any potential health issues your DNA makes you predisposed to. As outlined in chapter three, future pediatricians will then calculate a “healthcare roadmap” for your next 20-50 years, detailing the exact custom vaccines, gene therapies and surgeries you’ll need to take at specific times of your life to avoid serious health complications later on—again, all based on your unique DNA.
As you grow older, the phones, then wearables, then implants you carry around will begin monitoring your health constantly. In fact, today’s leading smartphone manufacturers, like Apple, Samsung, and Huawei, are continuing to come out with ever more advanced MEMS sensors that measure biometrics like your heart rate, temperature, activity levels and more. Meanwhile, those implants we mentioned will analyze your blood for levels of toxins, viruses, and bacteria that might raise alarm bells.
All that health data will then be shared with your personal health app, online health monitoring subscription service, or local healthcare network, to notify you about an impending illness before you even feel any symptoms. And, of course, these services will also provide over-the-counter medication and personal care recommendations to head off illness before it fully sets in.
(On a side note, once everyone shares their health data with services likes these, we’ll be able to spot and contain epidemic and pandemic outbreaks much earlier.)
For those illnesses these smartphones and apps cannot fully diagnose, you'll be advised to visit your local pharmacy-clinic.
Here, a nurse will take a swab of your saliva, a pinprick of your blood, a scrape of your rash (and a few other tests depending on your symptoms, including x-rays), then feed them all into the pharmacy-clinic’s in-house supercomputer. The artificial intelligence (AI) system will analyze the results of your bio-samples in minutes, compare it with those of millions of other patients from its records, to then diagnose your condition with a 90percentt plus accuracy rate.
This AI will then prescribe a standard or customized medication for your condition, share the diagnosis (ICD) data with your health app or service, then instruct the pharmacy-clinic’s robotic pharmacist to prepare the drug order quickly and free of human error. The nurse will then hand you your prescription so you can be on your merry way.
The omnipresent doctor
The scenario above gives the impression that human doctors will become obsolete … well, not just yet. For the next three decades, human doctors will just be needed less and used for the most pressing or remote medical cases.
For example, all the pharmacy-clinics described above would be managed by a doctor. And for those walk-ins that can’t be easily or fully tested by the in-house medical AI, the doctor would step in to review the patient. Moreover, for those older walk-ins who are uncomfortable accepting a medical diagnosis and prescription from an AI, the doctor would step in there as well (while stealthily referring to the AI for a second opinion of course)
Meanwhile, for those individuals who are too lazy, busy or weak to visit the pharmacy-clinic, as well as for those who live in remote areas, doctors from a regional health network will be on hand to serve these patients as well. The obvious service is to offer in-house doctor visits (already available in most developed regions), but soon also virtual doctor visits where you speak with a physician over a service like Skype. And if bio samples are needed, especially for those living in remote regions where road access is poor, a medical drone can be flown in to deliver and return a medical testing kit.
Right now, around 70 per cent of patients don’t have same-day access to a doctor. Meanwhile, the vast majority of healthcare requests come from people needing help addressing simple infections, rashes, and other minor conditions. That leads to emergency rooms being unnecessarily clogged with patients who could easily be served by lower level health services.
Due to this systemic inefficiency, what’s truly frustrating about getting sick isn’t getting sick at all—it’s having to wait to get the care and health advice you need to get better.
That's why once we establish the proactive healthcare system described above, not only will people get the care they need faster, but emergency rooms will finally be freed to focus on what they were designed for.
Emergency care speeds up
The paramedic’s (EMT) job is to locate the individual in distress, stabilize their condition, and transport them to the hospital in time to get the medical attention they need. While simple in theory, it can be horribly stressful and difficult in practice.
First off, depending on traffic, it can take between 5-10 minutes for an ambulance to arrive in time to assist the caller. And if the affected individual is suffering from a heart attack or gunshot wound, 5-10 minutes may be far too long a wait. That’s why drones (like the prototype presented in the video below) will be sent out in advance of the ambulance to provide early care for select emergency situations.
Alternatively, by the early 2040s, most ambulances will be converted to quadcopters to offer faster response times by avoiding traffic altogether, as well as reaching more remote destinations.
Once inside an ambulance, the focus shifts to stabilizing the patient’s condition for long enough until they reach the nearest hospital. Right now, this is generally done through a cocktail of stimulant or tranquilizing drugs to moderate the heart rate and blood flow to organs, as well as using a defibrillator to restart the heart altogether.
But among the trickiest cases to stabilize are laceration wounds, commonly in the form of gunshots or stabbings. In these cases, the key is to stop the internal and external bleeding. Here too future advances in emergency medicine will come to save the day. First one is in the form of a medical gel that can instantly stop traumatic bleeding, kind of like safely supergluing a wound shut. Second is the coming invention of synthetic blood (2019) that can be stored in ambulances to inject into an accident victim with already substantial blood loss.
Antimicrobial and maker hospitals
By the time a patient reaches a hospital in this future healthcare system, chances are they are either seriously sick, being treated for a traumatic injury, or are being prepped for routine surgery. Looked at from a different perspective, this also means that most people may only ever visit a hospital less than a handful of times over their entire lives.
Regardless of the reason for the visit, one of the major causes for complications and deaths in a hospital are from what’s called hospital-acquired infections (HAIs). A study found that in 2011, 722,000 patients contracted an HAI in US hospitals, leading to 75,000 deaths. To address this horrifying stat, tomorrow’s hospitals will have their medical supplies, tools and surfaces entirely replaced or coated with anti-bacterial materials or chemicals. A simple example of this would be to replace or cover hospital bed bedrails with copper to instantly kill any bacteria that comes in contact with it.
Meanwhile, hospitals will also transform to become self-sufficient, with full access to once-specialized care options.
For example, providing gene therapy treatments today is largely the domain of only a few hospitals with access to the largest funding and best research professionals. In the future, all hospitals will house at least one wing/department that solely specializes in gene sequencing and editing, capable of producing personalized gene and stem cell therapy treatments for patients in need.
These hospitals will also have a department devoted entirely to medical-grade 3D printers. This will permit the in-house production of 3D printed medical supplies, medical equipment and metal, plastic, and electronic human implants. Using chemical printers, hospitals will also be able to produce custom-designed prescription pills, whereas 3D bioprinters will produce fully functioning organs and body parts using stems cells produced in the neighboring department.
These new departments will substantially cut down the time needed to order such resources from centralized medical facilities, thereby increasing patient survivability rates and decreasing their time in care.
Already available in most modern hospitals, robotic surgical systems (see video below) will become the worldwide norm by the late-2020s. Instead of invasive surgeries that require the surgeon to make large incisions to get inside you, these robotic arms only need a 3-4 one centimetre-wide incisions to allow the doctor to perform surgery with the help of video and (soon) virtual reality imaging.
By the 2030s, these robotic surgical systems will be advanced enough to operate autonomously for most common surgeries, leaving the human surgeon in a supervisory role. But by the 2040s, an entirely new form of surgery will become mainstream.
Fully described in chapter four of this series, nanotechnology will play a big role in medicine over the decades to come. These nano-robots, small enough to swim inside your bloodstream, will be used to deliver targeted medicines and kill cancer cells by the late 2020s. But by the early 2040s, hospital nanobot technicians, collaborating with specialized surgeons, will replace minor surgeries entirely with a syringe filled with billions of pre-programmed nanobots injected into a targeted region of your body.
These nanobots would then spread out through your body searching for damaged tissue. Once found, they would then use enzymes to cut the damaged tissue cells away from the healthy tissue. The body's healthy cells would then be stimulated to both dispose of the damaged cells and then regenerate the tissue around the cavity created from said disposal.
(I know, this part sounds overly Sci-Fi right now, but in a few decades, Wolverine’s self-healing ability will become available to all.)
And just like the gene therapy and 3D printing departments described above, hospitals will also one day have a dedicated department for customized nanobot production, enabling this “surgery in a syringe” innovation to become available to all.
If executed properly, the future decentralized healthcare system will see to it that you never become seriously ill from preventable causes. But for that system to work, it will depend on its partnership with the public at large, and the promotion of personal control and responsibility over one’s own health.