Becker's ASC Review

July/August 2023 Issue of Becker's AS...

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27 HEALTHCARE NEWS 27 Hospitals will be 'rare exception': What healthcare will look like in 100 years By Mariah Taylor, Ashleigh Hollowell and Giles Bruce H ealthcare is advancing more swily by the year with new technologies, treatment options and artificial intelligence models hitting hospitals across the world. With the acceleration of advancements, it is hard to imagine how the industry will change. While some believe racial equity challenges might remain, others expect personalized care by genomics to be the standard and that there will be medications that will prevent disease before it takes root. Becker's asked eight leaders to speculate on what healthcare might look like in 2123: Tony Ambrozie. Senior Vice President and Chief Digital and Information Officer of Baptist Health South Florida (Coral Gables): One hundred years is a very long time to predict anything given the exponential rate of developments in technology, bioengineering and medicine. But I think we will see a number of trends that will probably happen in the next 50 years or less: — Healthcare and well-being will be personalized to the extreme, driven by personal genomics as well as continuous and comprehensive real-time monitoring based on a variety of sensors, worn or implanted, as well as fixed diagnostics devices in homes and other locations. — AI will, based on the real-time data, diagnose anomalies and afflictions and provide and continuously adjust treatments. — A variety of diseases, including cancer, will either be avoided altogether through gene therapy or treated and cured through biomedication. — Surgeries, if required, will be performed by AI-enabled robots. — Hospitals will be the rare exception and not the norm for care. All these trends combined will lead, I strongly believe, to much longer and of higher quality life spans for humans. Scott Arnold. Executive Vice President and CIO of Tampa (Fla.) General Hospital: In our near future, I expect AI will continue to play an assistive role on clinical and administrative fronts like it does today, but even better. For clinicians, AI used properly should support quicker decisions for clinical diagnosis and treatment by summarizing data in milliseconds and replacing the lag that exists for hunting and gathering data, reviewing data, making sense of data and narrowing possible diagnosis and treatment tracts for human consideration. I don't expect AI will replace humans in the process, rather it will maintain an assistive role. In healthcare, humans play an important role in knowledge, critical thinking, intuition, treatment empathy and understanding. AI has the potential to create additional capacity for humans in a high- demand environment — that is value. Atul Butte, MD, PhD. Chief Data Scientist at University of California Health (Oakland): One hundred years ago, the 1923 Nobel Prize in physiology or medicine was awarded to Dr. Frederick Grant Banting and professor John James Richard Macleod for the discovery of insulin. So now imagine how far medicine would seem to have been unrecognizably transformed in the subsequent 100 years, if one were present in those days for that significant, lifesaving discovery. In other words, medicine in 2123 will likely be barely recognizable to us. Surely we will have more medicines and medical devices to use. We will certainly have medicines that target proteins and DNA in ways we can't imagine today. … I'm imagining magical "scalpels" for tomorrow's genomic surgeons, to fix things in utero or in cancer. I am also guessing we will have more medicines to compensate for our environment: drugs that protect our lungs from airborne pollutants and drugs that protect our organs from chronically ingested and imbibed toxins. We will be measuring much more from patients (think about serum proteins and molecules, circulating DNA, sugars and fats), and measuring those components much more frequently. If so many people today are already thinking about continuous glucose monitoring even before they have diabetes, imagine how many molecules we will want to measure continuously in 100 years. Networks of clinical data sharing will exist to help share the very best medical care practices, so that more care providers can see how to provide care in unfamiliar cases. Anthony Chang, MD. Chief Intelligence and Innovation Officer of Children's Hospital of Orange County (Orange, Calif.): In 2123, healthcare will be about the convergence of historically separated paradigms: 1. Healthcare and artificial intelligence will involve advanced AI tools, such as deep reinforcement learning, routinely embedded within most if not all aspects of healthcare so there are no longer discussions about AI in healthcare. 2. Health delivery and clinical research will be intertwined with deployment of health digital twins so "researchers" will be more reliant on real-world data and experience versus the current structured randomized controlled trials that have become obsolete. 3. Precision medicine and population health will be an intimate dyad so both are carefully monitored with both genetic profiles including pharmacogenomic information and social determinants of health so there is a global health learning system. 4. Human-centered healthcare and virtual health will be deployed to maintain the human-to-human touch in medicine, and concomitantly healthcare will be primarily delivered via extended reality to improve the quality of the experience. 5. Healthcare and medical care will be mainly focused on preventive physical and mental health due to advances in AI and emerging technologies and will no longer be concentrated only on the delivery of acute medical care. John Halamka, MD. President of Mayo Clinic Platform (Rochester, Minn.): One hundred years from now, every human will be fully sequenced at birth and a care journey will be laid out looking at all the probabilities from phenotype, genotype and lifestyle. Rather than treat disease, we will prevent disease. Not only will longevity increase, but the number of quality years of life will markedly increase. We will democratize access to this kind of knowledge and care via extensive use of automation so it will be available to most humans on the planet. Christopher Longhurst, MD. Chief Medical Officer and Chief Digital Officer

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