By Richard Barker
Depending on our age, 20 years can seem an endless future or a quick march to old age. What will the next twenty years bring the young and the old in the world of health? Journeying into the future of medicine, what do we see? Implanted cells replacing medicines? Personalized therapy? Miniature devices roaming the body to seek and destroy rogue cells? It’s becoming possible to answer such questions.
Consider what we have seen in the last 20 years of information technology: the rise of the worldwide web, putting answers to mysteries instantly at our fingertips; mobile phones and pads giving us instant access to the lives of our friends across the globe; distributed computing power beyond our wildest dreams … the list is endless.
In medicine, twenty years is about the time needed to conceive, design, test and deliver major new health breakthroughs – and so we can already see them on the horizon. They will be based on a new and far deeper understanding of how our biology is wired together. In ‘systems biology’, life is emerging as a staggeringly complex wiring diagram or dynamic metro map, one with 30,000 genes, 150,000 proteins and hundreds of chemical messengers, all of which can affect all the others.
Advances in drug therapy, based on these new insights, will calculate in advance not just where a drug will engage, but what the impact will be on the whole system of health or disease. Replacement genes or cells will regenerate bodily function, with stem cells taken from our own bodies returning as therapies.
New imaging techniques will not just give us finer pictures of our organs, but visualize their biology in action. The ideal of ‘personalized medicine’ will truly be with us, dictating which drugs we’ll respond to, in which doses, and tracking our progress with molecular markers. Smart devices that combine bioengineering with intelligence will be implanted in the body to sense and intervene in disease in real time. Integrated health information, long-promised but finally delivering, will gather the outcomes of each patient’s therapy and become the basis for finally transforming medicine from a local craft industry into a worldwide learning system.
All this sounds astonishing but rather remote from our lives. What will it mean for us as individuals? This is actually where the future of medicine must differ most starkly from its past. For bringing all these technologies to bear to tackle all the diseases which our genes and lifestyles might produce is simply unaffordable. We must use the new technology to manage our lives very differently.
This is beginning to happen, with portable medical records, text messages to prompt us to take our medicines and personal programmes of diet and exercise on our PCs or mobile phones. This is just the beginning. Far from relying on technology to save us from ourselves, it must anticipate our problems on a personalized basis, combining our genetic profile with how we are using or abusing our bodies. It must spell out what we must do to manage ourselves better, prompt us for specific checkups and become our health mentor and manager. It must – to return to the image of the odyssey – finally put us at the controls of the ship.
Dr Richard Barker is the author of 2030 – The Future of Medicine. He has spent most of his career in healthcare, as a leader of organisations, as a board member and as a consultant. His leadership roles have spanned therapeutics, diagnostics and informatics both in the United States and in Europe. He was recently voted as one of the top 50 most influential people in UK healthcare and he sits on several healthcare and life sciences advisory boards on both sides of the Atlantic. This post is cross-posted with permission from the BBC Focus/Oxford University Press microsite.