How will healthcare improve for 2019 and beyond? What are the top medical innovations? What kinds of changes can you expect to see the next time you see a doctor or go to the hospital? There is a continuous stream of new developments in medicine, many of which are changing the way doctors practice medicine. Every year Cleveland Clinic gathers opinions from their doctors and researchers to determine a list of 10 medical innovations they believe will shape healthcare for the coming year and beyond. Today’s post covers the first 5 innovations for 2019 – next week’s post will cover the remaining five.
#1 Alternative Therapy for Pain: Fighting the Opioid Crisis
I think we all know by now that there is a serious opioid crisis in the US. Every day, an average of 116 people die from opioid-related drug overdoses, most of whom started with prescription opioids. Not only is this ruining many lives, it’s also expensive. To date, it’s estimated that the economic cost of the opioid crisis is $1 trillion.
Alternative pain management remedies, such as electrical stimulation therapy and stress management are not enough to stem the crisis. A new approach to opioid prescription may be the answer. Doctors can now use pharmacogenomics (the study of how genes affect a person’s response to drugs) to find the safest, most effective medication for each patient. Since doctors now have increased access to genetic testing, pharmacogenomics is poised to have a significant impact in 2019.
How does this impact you?
If a doctor prescribes opioids for you, ask him/her if they can use precision medicine to determine the best type and dosage based on your genes. If not, you can take the matter into your own hands. Interestingly, the US FDA just approved the marketing of the 23andMe Personal Genome Service Pharmacogenetic Reports test for limited use by consumers. This test can provide information about genetic variants that might impact a patient’s ability to metabolize some medications. Patients can bring their results to their doctor who can use this information when prescribing medications. NOTE: This is not a foolproof method. Please see the FDA warning on tests for genetic tests to predict patient responses to specific medications.
#2 The Advent of Artificial Intelligence in Healthcare
Artificial intelligence (AI) is making a splash in the world of healthcare. AI can now process unlimited amounts of unstructured data, such as MRI images and appointment notes. Of course, AI will never replace doctors, who use experience, knowledge and instinct to make decisions. But it can help doctors be better doctors. How? Read on.
AI helps doctors make decisions.
Even very experienced doctors can struggle to diagnose and treat complicated cases. Because AI systems can quickly make sense of the large amount of information in electronic health records, they help doctors make decisions.
AI helps doctors analyze images.
AI systems highlight problem areas on images, aiding in the screening process. The AI image analysis gives doctors confidence in their diagnoses and can help them identify issues they may have missed. This is important because diagnostic errors in radiology are dangerous and common enough to cause concern. A 2001 review found that the rate of clinically significant errors in radiology was between 2-20%. (For more information on radiology diagnostic errors, read this post.)
A few success stories: A team of engineers developed an AI system that can find lung cancer on CT scans with 95% accuracy, compared to an accuracy rate of 65% for doctors. Other research suggests that AI can detect colorectal cancer in its earliest stages, before tumors become malignant and harder to treat. In fact, the technology detected cancer with 86% accuracy.
AI helps with patient triage.
AI provides a safe and reliable way for automated outreach to patients to avoid unnecessary patient visits for trivial or nonexistent conditions. Via an app or text messaging, chatbots ask patients a series of questions about their symptoms. The bots then either recommend a visit to the doctor or send the information to the doctor for his/her review. This takes the guesswork out of self-diagnosis and saves time and money for patients and doctors.
What does this mean for you?
AI can reduce the risk of a misdiagnosis and/or improper treatment recommendations. As more doctors and hospitals adopt AI, hopefully the likelihood of misdiagnosis will decrease significantly. Since diagnostic errors occur in 10-15% of cases, this is not an issue you should take lightly. If you are told you have a serious illness, or you sense you may have been misdiagnosed, get a second, or even third, opinion.
#3 Expanded Window for Acute Stroke Intervention
We’ve all heard that timely treatment of strokes can save a patient’s life and reduce impairment. With stroke, blood flow is interrupted to a portion of the brain, which can cause irreversible damage and an associated loss of brain function and disability. Until recently, treatment was only recommended within 6 hours after a stroke. If patients arrived at the hospital more than 6 hours after their stroke, doctors rarely provided treatment. Instead, doctors left the blood clots in place, causing tissue death and subsequent impairment. However, new research suggests that the window for intervention may be much larger. In January 2018, the American Heart Association and the American Stroke Association increased their recommendation for the treatment window for clot removal up to 24 hours post-stroke, allowing treatments for more patients.
How will this impact you?
This change is great news for all of us! Although it is still important to get to a hospital as soon as possible after a stroke, we can now expect treatment up to 24 hours post-stroke. If a doctor refuses treatment based on the 6-hour guideline, insist on a second opinion or get to another hospital ASAP!
#4 Advances in Immunotherapy for Cancer Treatment
When you think of cancer, you often think of chemotherapy, which has killed cancer cells for almost 60 years. However, chemotherapy doesn’t always work. Cancer immunotherapy uses the body’s own immune system to fight cancer by boosting the body’s natural defenses. Immunotherapies either stop/slow the growth of cancer cells, prevent cancer cells from spreading, or destroy cancer cells. Although doctors have treated cancer patients with immunotherapies for some time, researchers are discovering and testing new and novel immunotherapy methods and targets. Hopefully effective therapies will soon exist for all types of tumors.
How does this impact you?
If you, or a loved one, is dealing with cancer, ask your doctor about immunotherapy options. Since immunotherapy is evolving rapidly, your doctor might not know about every treatment available. It’s a good idea to do some online research of your own. Search online by typing in “immunotherapy” and the name of your cancer. Although these treatments are exciting, it’s important to understand that not all cancers, or all patients, can currently be treated with immunotherapy.
#5 3D Printing for Patient-Specific Products
Implanted medical equipment, such as a stent or valve, can be troublesome. Surgical implants often come in standard sizes and configurations, leading to the use of ill-fitting devices, which can cause pain and poor device functioning. In many cases, patients need follow-up surgeries to remove or place the device. 3D printing to the rescue.
Using 3D printing technology, medical devices are now matched to the exact specifications of a patient, improving patient comfort and performance outcomes, while reducing the risk of complications. Additionally, 3D printing is used for surgical planning in complex or new procedures, allowing doctors to hold a physical model of the patient’s anatomy while planning the details of a procedure.
What does this mean for you?
If you need an implant of any kind, ask your surgeon about the use of 3D printing to create a device tailored to your anatomy. If you need a complicated surgical procedure, ask your surgeon about the use of 3D printing to aid in the planning process. This is a relatively new technology, but more and more hospitals and surgeons are using 3D printing.
Side note: It’s important to point out that whenever possible, use a surgeon who has experience with the procedure you need. Before any procedure, read this post to learn about common surgical errors and how you can reduce your risk.