We each consist of approximately 37.2 trillion cells, 200 different types of cell, 78 organs and 206 bones. True to say, there is nothing more complex on this planet than the human body. Each of our biological systems is vital to sustain us, as is the diagnosis, repair or replacement of these systems when needed.
Digital medicine
The 21st century medical environment is complex. To maintain this, the NHS costs £116 billion per annum (2015), of which 75 per cent of this budget is spent on the cost of treating chronic diseases. It is estimated that healthcare costs will rise to 35 per cent of UK GDP by 2050 unless innovative methods of diagnosis and treatment are found.
Because of this, the government has highlighted that the ‘management of chronic conditions is a necessary and key part of achieving sustainable, effective and efficient health and social care services’.
The integration of information technology in the medical sector offers the evolution in information-focused healthcare, which can potentially lead to a revolution in patient treatment.
Computer-aided medicine
The NHS has truly embraced and integrated information technology into all parts of its service. From patient record data, which are now stored electronically, to the potential use of artificial intelligence (AI) technology such as that of DeepMind envisaged by Google (which is planned to directly be able to analyse huge amounts of patient and operational healthcare data). We are now entering into an exciting dawn and the powerful landscape of computer-aided medicine.
In the most fundamental of forms, using computer systems to sift through huge datasets to establish patterns could offer a vital proving ground before its progression into other vital areas. This would lead not just towards the conventional yet vital applications of managing bed space and medication tracking, but this powerful partnership could evolve to identify patterns in degenerative diseases, detect and track ward infection trends and could help the NHS in minimising outbreaks of disease.
Also among the most useful possibilities is in reading medical images and integrating this information to be used in the vital services. This remains to be the most powerful near-term potential for everyday medicine.
Augmented reality interfaces
Although the complexity of modern-day medicine is now becoming increasingly difficult, can we bring all of this information directly to the hands of the medical professional during everyday life to lend a digital hand?
The first current glimpse into this approach is through the use of augmented reality interfaces (ARI), which remains to be the next frontier in on-demand information lead medicine. This can allow for the different elements in the digital medicine landscape to be integrated together.
The efficient use of data to become interactive 3D information can be directly used towards enhancing medical outcomes. The next stepping stone is on towards integrating augmented reality devices for the purpose of the presentation of real time information.
During the preoperative phase of a procedure, the surgeons will have a mental image of what needs to be carried out. Marking structures of interest on radiographic images that can be superimposed on live video camera images allows a surgeon to simultaneously visualise the surgical site and the overlaid graphic images, creating a so-called semi-immersive environment.
ARI offers a revolutionary and dynamic approach towards aiding the execution of complex surgical procedures and can even assist in medical diagnosis. ARI techniques have been tested and successfully validated in cardiovascular surgical procedures, for example, the goal of improving repairs to the heart mitral valves and replacement of aortic valves more efficiently.
At the current rate of evolution on innovative technologies, augmented reality is pitted to become a critical and useful tool in the operating room. ARI offers the following integrated systems:
- Precision multi-axis motion sensing
- High definition integrative displays
- Data handling capability
- Speech recognition
It is important to note that ARI devices include speech recognition technology. This form of non-contact control is vital because it is the most rapid means of accessing information, which does not require any necessary physical contact. Earlier this year the NHS encouraged virtual blood donations with augmented reality outdoor ads via smart phone integration.
In breast cancer surgery, ARI visualisation has been effective in showing superimposed 3D tumour models onto live video images. This has enabled surgeons to see the exact position, in a three-dimensional space, of tumours as if they were visible through the skin.
Although its application is in a preliminary stage, further research is needed to evaluate its long-term clinical impact on patients and surgeons. We have only really scratched the surface of what augmented reality is capable of in the hospital.
Other variables such as graphics quality, processing power, software durability and dynamic object tracking will become important critical factors for the advancement of augmented reality in the medical world.
Point of care for instant diagnosis
In conventional cases, in order to diagnose disease this usually requires time consuming laboratory tests. Subsequently, there is the requirement for interpretation and subsequently relaying these results back to the medical practitioner; this all takes time.
For example, glucose sensors have revolutionised the way in which diabetes is managed. Now point-of-care technology can be used to diagnose conditions, such as - cardiovascular disease, cancer and meningitis to a high degree of sensitivity and selectivity.
An antibody-based biosensor is a device which can detect and quantify target molecules. These systems allow for instant diagnosis to be made through the process of selective sensing of disease biomarker triggers. This highly sensitive means of detecting disease is achieved through monitoring individual antigen–antibody interaction.
These devices are fabricated by attaching a biological receptor material, for instance an antibody onto the surface of a suitable transducer. This converts the biochemical signal when a complementary disease biomarker binds to this surface into quantifiable electronic signals.
To ensure that these devices are able to detect the presence of disease down to the 0.1pg/ml concentration in a sample then high aspect ratio nanowire-based detection strategies provide promising new routes. This allows for the rapid bioanalysis and detection of even serious life threatening conditions in the community, surgery or even at home.
Artificial intelligence
AI has continued to progress towards practical applications in healthcare. The next stage of evolution is on applying machine learning to the fields of disease diagnosis and subsequent treatment.
As AI starts to become present in everyday life, it could be an effective means towards revolutionising the healthcare system. It has already proven useful in various scientific fields and in the elemental diagnosis of cancer, autism and mental health disorders.
It is this data-driven medicine approach that has the potential to boost the speed and accuracy of disease diagnosis. With development this opens up a new paradigm, which is the ability to make treatments patient-specific.
Early integration of AI is now being applied to searching through previous cancer research results to help radiologists in utilising machine learning to monitor the progression of tumours. Subsequently this is evolving towards the development of algorithms to assist in planning treatment options for different types of cancer.
These current artificial-intelligence-driven initiatives are aimed at assisting medical experts in research, diagnosis and progress in looking for potential cures for different cancer types but with existing treatments.
Future perspective
These new information-led technologies for medical assistance offer significant potential. The amalgamation of medical data to form real time information can provide vital knowledge to those who need it, when they need it. Computer aided systems have already revolutionised financial institutions, large international manufacturers and the construction sector.
Although modern healthcare is a multifaceted complex field, there is significant influence that information-led technologies can lead towards. The integration of key technologies and their incorporation into a range of healthcare application has potential to revolutionise and enhance both diagnosis and treatment for a new era.
