DOCTOR'S VIEW ARCHIVE
Nov 12, 1999 -- Medicine is changing fast. The state of healthcare today will soon be outdated by new technologies. Tomorrow's issue of the British Medical Journal (the BMJ) is devoted to the subject of "The Impact of New Technologies in Medicine". Some of the major areas considered by the BMJ concern the technologies of the future, the hospitals of the future, the future of genetics, the impact of informatics on medicine, and the transfer of new technologies into the practice of medicine. Highlights of the technological developments and ethical issues raised include the following:
Technologies of the future?
Diabetic patients will soon be wearing a monitoring device on their wrist which checks glucose levels and raises an alarm when levels are too high or low.
Ultimately, diabetics will have a glucose monitoring sensor implanted under the skin and an internal insulin reservoir that automatically adjusts insulin doses.
Toilets will no longer be passive but will analyze urine (and perhaps stool) samples and, if necessary, automatically send a report to a user's doctor.
Minimally invasive hi-tech surgery will become the norm.
Robots and More
Robots will be deployed in hospitals, running central supply services, filling requests and orders in the hospital pharmacy and carrying out a great range of tasks.
Xenotransplantation (of organs and tissues from animals into humans) will be available on a large-scale by the end of the coming decade.
Electronic noses will detect and differentiate the odors of growing bacteria and instantly identify the bacteria causing ear, nose and throat infections.
New wheelchairs will enable users to go up and down stairs, reach for items on high shelves, and talk to others who are standing at eye level.
In-patients will be implanted with sensors when they are admitted to do 40 or more lab tests.
Hospitals of the future?
Separate hospital beds, operating tables and stretchers will be replaced by one multi-purpose piece of equipment which will be embedded with sensors to monitor vital signs and provide mechanical ventilation, intravenous infusion and cardiac defibrillation, such that central intensive care units may no longer be needed.
Ceiling vents in hospital lobbies will monitor visitors for any infections they may be carrying into the premises.
The future of genetics?
Tensions between raw scientific optimism and a desire to avoid potential adverse social and ethical consequences will affect the pace of development in studies of the human genome.
Genetic testing and gene manipulation could transform medicine so that medicine will no longer be "diagnosis and treatment" but "prediction and prevention."
Future generations will have the heavy responsibility of knowing their genetic makeup.
The impact of informatics on medicine?
Making medical decisions has become too complex and time consuming for the unaided human mind to accomplish reliably. Software tools are needed and will be developed to help doctors negotiate their way through the enormous body of medical knowledge.
Consultations with clinicians based overseas will become the norm, either by video-conferencing or via email.
Patients who have an ongoing illness and have a routine question about their condition or treatment will be able to email their doctor instead of going to see them.
Bringing new technologies into medical practice?New healthcare technologies are becoming more numerous -- but how do we decide how effective they are, which patients will benefit the most, and how healthcare systems will pay for them?
Before we expend yet more resources in the pursuit of new technologies, medicine certainly will need to adopt new methods to make better use of the resources that we already have.
Editor, MedicineNet.com -- This article was written exclusively from the viewpoint of the British Medical Journal (the BMJ). However, the matter of "New Technologies in Medicine" is being treated as a "global theme" issue. In addition to the BMJ, the Journal of the American Medical Association (JAMA) and 40-some other journals are participating in this global theme issue. Follow the links to a list of articles being published by each journal.
- American Journal of Public Health
- Annals of Medicine
- Archives of Surgery
- Australian Family Physician
- British Journal of Ophthalmology
- Canadian Family Physician
- Canadian Medical Association Journal
- Critical Care Medicine
- Croatian Medical Journal
- Dutch Journal of Medicine
- The Hastings Center Report
- Hong Kong Practitioner
- Hospital Medicine
- Icelandic Medical Journal
- Infection Control and Hospital Epidemiology
- International Journal of Dermatology
- International Journal of Psychiatry in Medicine
- Irish Medical Journal
- JAMA Italy
- JAMA Pakistan
- Journal of Allergy and Clinical Immunology
- Journal of the American Academy of Dermatology
- The Journal of the American College of Cardiology
- Journal of the American Dietetic Association
- Journal of the Danish Medical Association
- Journal of the Formosan Medical Association
- Journal of Molecular Medicine
- The Journal of the Norwegian Medical Association
- Lebanese Medical Journal
- Malaysian Journal of Pathology
- The Medical Journal of Australia
- The National Medical Journal of India
- Primary Health Care
- Scientific Medical Journal, Egypt
- South African Medical Journal
- Swiss Medical Weekly
- Western Journal of Medicine (WJM)