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An end to organ donors. Surgery from the inside out

An end to organ donors. Surgery from the inside out

Medicine 2030: Goodbye hospital, hello home-spital

However, when I look towards the future I see a very different trajectory. Who needs a hospital when you can prevent or treat conditions from the comfort of your home? The global burden of disease is largely vascular, with heart attacks and strokes the biggest cause of death around the world, and therefore preventable with a better understanding of risk factors. Rates of traumatic injury are falling and will continue to decline as we introduce driverless cars and robot workers for risky tasks. And really: 80 is the new 60, with all of the regenerative options on the horizon.

By 2030, the very nature of disease will be further disrupted by technology. So disrupted, in fact, that we might have a whole lot fewer diseases to manage. The fourth industrial revolution will ensure that humans live longer and healthier lives, so that the hospitals of the future will become more like NASCAR pit-stops than inescapable black holes. You will go to hospital to be patched up and put back on track. Some hospital practices might even go away completely, and the need for hospitalization will eventually disappear. Not by 2030, but soon after.

Organs, tissues and supporting structures like bones or ligaments will be biologically 3D-printed on demand

Instead of a ward filled with patients who have one or more organ system in crisis, space will be dedicated to immediate diagnosis and treatment. A single scanning device will offer metabolic, functional and structural detail – combining the physics of spectroscopy, magnetic resonance and radiation. This will mean you only need one scan, and no biopsy.

Wearable patient-monitoring devices will continuously feed in data from external second-skin sensors and networked neural sensors meshed into the brain will offer incredibly precise “micro-sampling” to be done in real time. Hello, neural lace.

Acute and serious pathologies, ranging from clots to tumours, will be addressed from the inside out. No need for surgeons wielding scalpels with a steady hand, when in a few minutes, tiny robotic endovascular catheters will be widespread.

Instead of doctors considering what medication the patient should take and then nurses or pharmacists administering it, your mobile device will receive the necessary information to print a menu of custom pharmaceuticals and probiotics on demand from your own living room or kitchen. All of this will happen within minutes.

If you think this sounds crazy, think again. Most of these technologies are either almost ready for prime time, or in development. Doctors like me are going back into training to master endovascular techniques and those of us with computer science skills are pushing hard to integrate digital tools into our field of practice. 3D printing is yesterday’s news. On-demand pharma companies already exist. Neural lace – a brain-machine interface – is about to be science fact, and not science fiction. Next stop? Not the hospital but the home-spital.

Of course there are still a few things we need to work on to be sure we can stay apace with innovation: an enabling regulatory environment, funding for research that links the moon-shooters with the people who can make their big ideas happen, and more women in science and technology. One thing is certain: the prognosis for the hospital of the future involves radical change – and a lot more electricity. Let’s dream a little.

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Melanie Walker MD is the co-chair of the Neurotechnology & Brain Science Future Council and Clinical Associate Professor of Neurology & Neurological Surgery at the University of Washington with an adjunct appoint at Johns Hopkins School of Medicine.

And just in case you think doctors are good at change, I would like to point out that we continue to schedule bedside rounds and family meetings around procedure and staffing schedules in pretty much the same way we have done since the early 1900s.

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