Friday, June 22, 2012

Medicine of the Future

If you are my age, and reading this blog, you may remember the original Star Trek series (I watched it in reruns).  And in it you recall that away teams always carried powerful communication devices that could support communication around the planet.  Just flip it open and talk.  Or tap a device, speak the address of your connection and talk.  We have these now in cell phones and blue-tooth headsets.  Granted, Kirk's devices didn't require a complex cell-tower infrastructure to support them, but we still have the same capability in many populated places in the world.

McCoy had some pretty complex devices as well which supported remote monitoring of the patient built right into the beds of his sick bay.  And he had a hand-sized diagnostic scanning device which could tell him what was wrong with a patient relatively quickly (It was originally supposed to be a salt shaker).  We aren't there yet, but we are starting to see technology like this be developed. Today, in various cell-phone sized devices, we can perform ultrasounds, evaluate EKG results, record temperature, blood pressure, pulse, respiration rate, and O2 Saturation, even take and send images for evaluation.  There's even a prize for putting them all together into a single device with advance clinical decision support capabilities.

McCoy also had a hypospray which he used to inject drugs.  MIT has developed one of those.

Star Trek spent a lot of time looking at the DNA of patients.  Have you sent your DNA out to be looked at?

What I find interesting about this is that all of this technology was envisioned by science fiction writers in the mid- to late-60's, almost 50 years ago.  The speed of adoption seems to be increasing though.  

We've  seen the beginnings of bionic limbs, hearing and vision popularized by Steve Austin and Jamie Sommers in the mid- to late-70's.

And IBM's Watson is being heralded as the one of the greatest advances in AI today, especially in medicine.  But it's not yet ready to pass the Turing test. Even so, could we be on the verge of Star Trek Voyager's Holographic Doctor from the mid- to late-90s?  The entertainment industry has already started experimenting with holographic technology.

And for all you Doctor Who fans out there, you might wonder, what his sonic screwdriver has to do with medicine?  Check out what these Scottish Scientists think about the idea.

What advances from Science Fiction do you see on the horizon? 


  1. What about a mental-health pacemaker? It would be an implantable device that monitors the level of brain waves, neurotransmitters, and other relevant biomarkers for mental status, and stimulates/medicates appropriately. There are already similar devices emerging for monitoring and controlling diabetes and, I think, other metabolic illnesses. Som inherited diseases, such as cystic fibrosis, might also be eased that way.

    Of course, such technology could also be used for recreational purposes... like a push-button drug trip. I suspect that would become the primary economic model, with health care being very much secondary.

  2. I was thinking... Did you ever notice that privacy and security are NEVER discussed relative to communications or healthcare... so clearly it is not needed (you have no privacy, get over it); or it is perfectly and frictionlessly solved.

    My goal in my engineering endeavors is to define how Privacy and Security can be designed into the system such that it is perfect and frictionless. This can't be done through bolt-on security/privacy; it can only be done by designing it in from the start.

    Okay, I admit that the reason it isn't discussed is because security and privacy are simply not sexy. But I am going to mentally stick with transparent.

    1. Well John, none of the infrastructure stuff is sexy. This blog post talks about all the sexy stuff from StarTrek (I watched the original runs). The reality is though that no matter how many cool toys are built. The really accurate decision support needed for personalized medicine will not happen without huge volumes of "semantically interoperable" data analysis.

      So, you keep working on the security, de-identification, privacy stuff and I'll stick with the infrastructure for semantic mobility. We won't be sexy but we'll deliver Dr. McCoy the information he needs. :-)

  3. A few years ago I read a critical commentary by a couple of physicians on the state of EMRs. In describing what they were looking for they used some Star Trek analogies.

    My reaction at the time was: "These are not serious people. This is just a backhanded way of saying that they have no real interest in using an EMR of any kind—a bit like obliquely declining a job offer by making outrageous compensation demands that one knows will never be met."

    I'm afraid I am still inclined to react that way. Our health care system, and our society as a whole, has major problems just executing the fundamentals. I find myself thinking of what Vince Lombardi did when he took the helm of the Green Bay Packers. He threw out much of the playbook, and insisted on near flawless execution of what was left. If we're lucky that's what we'll end up doing, if only because we won't be able to afford anything else. For now we're still coming to grips with that hard reality; we have a long way to go.