As we turn the calendar page that divides the teens of this century from the twenties, I have some predictions to offer on developments in healthcare in the year to come.
AI will evolve from being a mythical disruptor into a tool that incrementally impacts evidence-based medicine but transforms mundane administrative tasks
I believe this is inevitable, but it won’t move at the same pace across healthcare. Privacy concerns, and fear of ceding decision-making to machines, might hamper progress in diagnostics, robotic surgery and medication management. At the same time, I predict rapid and dramatic advances in healthcare administration, where AI will displace old-school processes. Speed and accuracy will rise in registration, scheduling, and health information management, plus charge capture, billing, and collections. Already, inbound and outbound language processing helps patients find specialists, set scheduling, and get reminders and follow-ups. One tool working its way into daily practice: an AI-powered smart device for exam rooms that listens to the conversation between doctor and patient. The device uses natural language processing to pick up on key words and phrases, and automatically enters notes, diagnoses, and orders directly into the EHR.
Genome editing will take center stage, forcing an ethical dialog that ranges from the ethics of individual techniques to the very future of the human race
Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) is presently the most widely known genome editing approach, but it’s just one of several techniques currently advancing from experimental toward clinical application. Others include zinc-finger nucleases (ZFNs), and transcription activator-like effector-based nucleases (TALENs). The potential for medical advances (and massively profitable healthcare applications) is enormous. This throws a bright spotlight on ethical considerations that swirl around the notion of editing away unwanted traits that cause disease, deterioration, and perhaps even aging. The World Health Organization’s latest background paper on the ethics of genome editing outlines two sides of a lively debate about the development and use of germline editing technology. One regards this as part of a continuum with existing gene therapies—thus, not a reason for raising novel ethical concerns. The other side considers CRISPR to be unprecedented, which demands new ethical and regulatory frameworks. Whichever school of thought is to prevail, the bodies tasked with devising global standards for governance and oversight must act quickly. A look at the global distribution of research activity shows the U.S. in the lead, with China in second place, trailed by Germany and Japan. Who will set the practical, ethical and regulatory standards for genome editing? Reports show clinical trials in China have moved to human applications, while trials in the U.S. are just beginning. My take: if America and Europe don’t seize the moment to establish some clear standards of experimental and clinical behavior, China will.
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