High tech and medicine

High technology is all the rage in many industries. The disruption is not always welcome but the old gives way to the new because it is the most cost efficient way of delivering the best outcomes.

Indeed, in most industries, newcomers have this technological advantage that forces the incumbents to adapt or be left behind.

Sometimes current practitioners are simply hardheaded about new technology. Farmers, for instance, insist on using old rice varieties when new hybrid varieties can dramatically increase their production.

I am seeing that too in medicine. I get the impression that even the most advanced hospitals in Metro Manila aren’t keeping up with the pace of tech advances in healthcare that can be of significant benefit to patients.

They seem to still be exclusively on a hardware buying frame of mind, such as MRI/CAT scan machines. They have yet to appreciate the value of digital cloud subscription services to help in patient diagnosis and treatment of catastrophic illnesses.

This is probably why those who can afford like top corporate executives and not just the expats have been going to Singapore even for their annual check-ups. 

There is little or no incentive for our doctors and hospitals to keep themselves updated with advances in technology. Our hospitals and doctors are so busy attending to an overload of patients. It is tough to get a hospital room and the long lines of patients waiting outside doctors’ offices indicate doctors make more than enough money as it is.

Busy as they are, local doctors must set aside time to update knowledge and skills because it would be unfair for patients otherwise. Doctors today cannot afford to lag behind. In today’s connected world, a patient is likely to have consulted “Dr.” Google before making an appointment to see a flesh and blood doctor.

I know doctors just hate it when a patient comes in with a batch of print-outs from “Dr.” Google about his medical condition. Of course Google itself is careful to say that folks need to talk to their doctors but when they do, patients today come prepared with more questions than doctors can or want to handle.

Beyond Google, however, are more sophisticated tech innovations designed to help doctors make good diagnosis and prescribe treatment.

 The South China Morning Post had this story of how a Chinese doctor who treats cancer patients “often consults another expert – one from America who, despite the distance, never takes long to weigh up the options and reply.”

SCMP reports: Dr. Zhao turns on his computer, types in the patient’s medical data and clicks the button saying “Ask Watson”…it can be as little as 15 seconds before Watson has replied with a comprehensive list of treatment options and detailed explanations.

SCMP describes Watson as an artificial intelligence construct, “born” in an IBM lab and “trained” by cancer specialists at the Memorial Sloan Kettering Cancer Centre in New York City.

Using data from a patient’s file, what Watson does is go through information from over 290 medical journals, 200 textbooks and some 12 million pages of text. It has the ability to analyze the meaning and context of clinical studies and assimilating key patient information written in plain English to help an attending oncologist determine treatment options.

From the patient’s perspective, a computer like Watson can help make informed treatment decisions and protect him from needless or harmful treatment. After all, busy doctors cannot read all the journals and know all the latest developments that could help treat a patient.

 Some 40 hospitals in China are now using Watson. China, the bastion of traditional medicine, is also embracing high technology. Not only that, they are doing their own innovations on Watson.  

The other thing that technology has advanced has to do with significant accomplishments in mapping our DNA. Theoretically, doctors should be able to use your DNA to keep you well.

Genomic medicine or precision medicine is fast transforming health care. Rapid reductions in the cost of gene sequencing now makes it possible to produce cost efficient analysis that will deliver the promise of genomic medicine on a large scale.

For example, computers can help doctors understand how a tumor affects a patient down to the DNA level.  Gene sequencing is used to understand the molecular basis for the cancer.

 This will enable the doctors to find the right treatment based on a patient’s specific molecular profile. And the time needed to find this treatment can be drastically reduced. In other words, it is no longer one size fits all for cancer patients, cross your fingers and hope it works. A treatment plan can be tailored for a patient’s specific needs.

I know it all sounds like science fiction but these are available now and may soon be mainstream. This is good news for patients but only if the health care providers are up to date in the technology they make available.

With the corporate takeover of our major tertiary hospitals, these new kick-ass technologies will be available if a good enough business case can be made. I don’t see cost as a problem because treating a devastating disease like cancer is expensive enough using current therapies.

The problem will be convincing the doctors. Doctors must first be comfortable with high tech and not feel threatened the way many other workers feel about machines taking over their jobs. Our local doctors also do not always appreciate second opinions, not from their colleagues and never from a computer.

Luckily, supercomputers like Watson can only work in conjunction with a flesh and blood doctor. Maybe the current generation of doctors in this country is too comfortable with the practice of medicine as they know it today to innovate.

Maybe it will take a new generation who grew up with these new technologies from med school before we can benefit from the likes of Watson. In the meantime, we have to look to neighbors like Singapore, Thailand and even China and that’s a real pity. 

Boo Chanco’s e-mail address is [email protected]. Follow him on Twitter @boochanco