And how about the magical diagnoses from Star Trek's tricorder, Quantum Leap's Ziggy, and the tuning fork of "Bewitched" medic Dr. Bombay? Fact is, the realities, resources and promise of today's medicine leave those TV doctors in the dust. And every other one you've ever seen.
An ambulance drone invented by Alec Momont of Delft University of Technology in the Netherlands can fly at 60 miles per hour to the scene of a heart attack, carrying a defibrillator and a live link to medics to talk rescuers through the first few critical life-saving minutes. [Photo: TU Delft]
1. Mobile Apps and Telemedicine
"Shouldn't you be doing this?" We all laughed at the investment firm ad a few years ago showing a skeptical patient holding a huge knife while on the phone with a doctor attempting to talk him through self-surgery. The idea was to underscore the need for expert advice. The message still rings true: even though we can learn a lot from smartphone diagnostic attachments and apps such as the CareSync app, which integrates with many wearable devices, we still need doctors. But actually showing up in the doctor's office might not be necessary.
Telemedicine, a term that typically refers to video consultations, is rapidly becoming mainstream - from kiosks at the office for no-appointment-necessary consultations, to Google Glass and other live connections offering experts, such as the Mayo Clinic Stroke Team, to advise healthcare providers in remote locations on what to do when no one with the right training is on the scene.
A Dutch variation on this theme is especially impressive: the ambulance drone, invented by grad student Alec Momont of Delft University of Technology. It can't take you to the hospital, but the device (see photo above, or video here) will carry a defibrillator to the scene of a heart attack in remote locations and talk whoever's at the scene through the steps needed to help the victim until emergency medical workers arrive.
2. Shared Science and Robot Research
Everyone working in medical research probably dreams of winning a Nobel prize, and some of them really will. But the old model of being "the one" to discover a particular medical breakthrough is mostly over, and the new ideal is "shared science" - many teams working together to pool their knowledge, to greatly speed the pace of innovation and acquisition of new knowledge. UCSF, for example, recently pointed to studies on autism involving 50 labs around the world which together identified over 100 genes that might be involved in the disorder. Earlier studies lacking this type of collaboration were only able to point to 11 genes that might be significant.Then there's the non-human factor. IBM's Watson supercomputer has graduated from the fun and games of winning "Jeopardy" and has partnered with major cancer hospitals on research that would take humans many long years. Meanwhile in the U.K., a robot scientist at the University of Cambridge has been put to work checking new combinations of drugs - ten thousand a day, compared to the ten to twenty a human can investigate in a year. So far, the robot has discovered a potential new treatment for malaria.
3. Say Goodbye To Hunches, And Hello to Facts
It makes for great TV when the daring doctor makes a last-ditch try to save a patient based on a diagnosis short on the patient's medical history and long on guesswork on whether it might grant a desperately wanted extension of his or her time on earth. Thanks to CareSync's services and apps for doctors and patients, it's no longer necessary to just cross your fingers and hope some smart and caring doctor has enough intuition and time to track down your medical history and allergies fast enough to find out what you might and might not have, and take action in time to save your life, or keep it from getting a whole lot worse. We find and digitize medical records, put them on our secure server, accessible via web, smartphone or tablet, anytime, anywhere, day or night, and immediately shareable with any caregiver, family member, doctor or healthcare professional - if, and only if, they have the patient's permission. All that for just $99; suggest you give us a call today at 800-587-5227.
4. New Approaches To Excellence In Medical School
Medical school is no longer just about seeing how much information, experience and collegial attitude can be packed into each of the aspiring healers. Medicine changes too fast for any one person or group of persons to keep pace, so it makes sense instead to learn the basics, especially how to search for, and evaluate, the best answers on options for diagnosis and treatment. Social media, including Twitter chats and physician-only networks like Sermo, Doximity and Figure1 can be a great way for doctors to crack difficult cases and keep up with breaking news in their specialties.
Ever look a doctor in the eye and wonder just how much he or she knows? We can't always do that with the pilots of the planes we take, but we know flight simulators are part of their training. Technology is now allowing similar advances in medicine, through new learning environments, such as the COACH system at Columbia University New York Presbyterian Medical Center in NYC, where medical and surgical residents can ramp up their knowledge via computerized models before trying out their new skills on actual patients.
And how about those brilliant doctors who are, shall we say, brusque to the point of just plain mean? That worked pretty well for Hugh Laurie in his award-winning performance as Dr. Gregory House, but in the real world, it's an impediment to questions patients, colleagues and others need to ask, discussions that need to happen, decisions doctors and patients need to make together, and to the quality of treatment overall. Med schools are catching onto that, too, adding curriculums teaching kindness and personal growth. At Oakland University William Beaumont School of Medicine in Michigan, "I will care for myself so that I am able to care for others" has been added to the oath to be taken by the first graduating class later this year. Definitely a step in the right direction, given rampant MD complaints of burnout and physician suicide rates higher than in other occupations.
Helping doctors think more clearly about their own lives and connect more strongly with their patients may be good for everyone. At the Mayo Clinic, chief residents - who each year invite a visiting professor - are making history in 2015 with their choice of ePatient Dave deBronkart, the world's best known advocate for patient rights, patient access to medical records, and participatory medicine: patients and doctors working together to identify the best options to address the patient's goals.
5. Keeping Your Doctor In The Loop Between Appointments
Long after he was Mr. Achy Breaky Heart, and not long before daughter Miley became Hannah Montana, country music crooner Billy Ray Cyrus was TV doctor Clint Cassidy, known for his charming follow-up care for patients young and old, even finding excuses to visit their New York apartments.
While many of us have met doctors we'd love to invite into our homes, truth is: very few have a moment to spare, and if they were to come, they'd probably be letting down some other patient. Fortunately today, there's CareSync coordinated care, with 24/7 web and mobile access to your medical records, including any daily notes and data you may have, for you and any doctors, caregivers or family members that you authorize. It's far more likely that your doctor really will be able to check on you when he or she gets regular updates from CareSync, coordinating with all your other doctors, for reports on your care and progress.
6. 3-D Printing For Surgical Rehearsals, Medical Devices And New Body Parts
We're officially in awe of the technology known as 3-D printing, which resembles ordinary paper and ink printers only just a bit, in that instructions for what is to be created are transmitted from a computer to the "printer," in this case a relatively affordable machine (many cost less $3,000) that can make all sorts of things based on precise imaging and instructions, using a variety of manufacturing materials.
The medical uses are many: from creating exactly the right size and shape medical device to save a life; building life-scale models of an individual patient's problem area, to allow surgeons to experiment and refine their techniques in advance of a tricky procedure; making images more understandable to improve diagnosis (take a look at how this husband saved his wife's eyesight); creating prosthetics (kids are enjoying superhero-styled hands, made in a process that allows them to participate in the design); and, it is hoped, making other body parts not yet perfected but very much on the drawing board.
7. How Well Does This Treatment Work On Patients Like Me?
How many times have we seen medical dramas turn on the bravery of doctors and patients willing to try new treatments when nothing else seems to have worked? That happens in real life, too, but both doctors and patients now have new resources to find out a lot more about whether a treatment for a specific problem is likely to work.
For some drugs, there are tests that can indicate whether they might be a successful treatment for individual patients. Patients can also go online, in communities like ACOR.org and SmartPatients.com and find out what others with similar illnesses are experiencing, and what resources they recommend. Doctors and nurses may also log on, sometimes pointing patients in a helpful direction or offering skepticism where needed.
Other online communities, such as PatientsLikeMe.com, collect data patients volunteer on their experiences with various illnesses, with the aim of speeding up the knowledge curve for science. Doctors, too, are closer than ever before to much better information on exactly how well specific treatments work. Hundreds of organizations around the world have signed on as part of the All Trials movement, which is working to get all medical research made public, whether or not the results are favorable to the sponsors of the research. And big data ventures like FlatironHealth.com in New York, founded by two ex-Googlers, are gathering statistics on care quality and clinical outcomes in cancer care. This is all just a beginning, but it's very exciting.
8. Precision Medicine
It's going to take some time before precision medicine - also known as personalized medicine - becomes commonplace, but the $215 million in President Obama's 2015 budget plan earmarked for research and development ought to help a lot. It's already created a lot of walking medical miracles (click here for a detailed medical account of the many treatments based on genetic information).
Money and public awareness aren't the only things we'll need for this to be widely available: a culture change in medicine to healthcare based on the patient's specific needs, wants and goals - as he or she defines them - is also essential. The precision medicine plan is expected to get some bipartisan support. Doctors, patients and the public at large can speed up the wider availability of this approach to medicine by always asking questions about treatment options, remembering that science and medicine are always changing.
9. Medicine's Money Quake: Obamacare And Beyond
We loved it when Rosa Blasi and Patricia Richardson fought hospital administrators and Congress over money matters in "Strong Medicine," Whoopi Goldberg's medical drama a decade ago, radical at the time for putting female doctors at center stage. Truth is: we can all relate, because money is the medical matter no one can escape.
But the dynamics of money in medicine are changing. At least 15 million Americans who didn't have health insurance now do. Doctors and hospitals are shifting to new results-based payment models. And today, a doctor who couldn't convince the powers that be to fund a rolling clinic or genomics experiment could crowdfund the project on Kickstarter, Indiegogo (which came through for Scanadu) or MedStartr - like "The Walking Gallery" founder and artist Regina Holliday, who watched small donations add up to fund projects including a documentary on the personal struggle for access to medical records which led her to become a prominent activist for patients and healthcare reform.
10. Patients As Educated Consumers And Drivers Of Information
Increasing numbers of patients are getting involved in their own care - jumping onto Google, talking to other patients, making sure they have a complete copy of their medical records, checking it for mistakes, asking questions, shopping around for expertise and cost, and working in partnership with their doctors to find and decide on the best options for the best possible health.
Other patients and caregivers, like CareSync's Chief of Operations, Amy Gleason, are taking things a step further, attending medical conferences and innovating to build businesses to meet patient needs identified through personal experience. Amy's background as a nurse, and her advocacy for her daughter as a rare disease patient has been helpful, too - allowing Amy to see and respond to holes in the delivery of healthcare from the patient, caregiver and healthcare provider points of view.
What Did We Miss?
CareSync is all about innovation and collaboration! Please tell us if we forgot to mention your favorite bright spot in medicine today: for patients, doctors, nurses, medical practices, hospitals, medical schools, researchers, labs, and everyone and everywhere else working to make our healthcare system healthier.