From the smartphone in your pocket to 3D printers and nanorobots, technology is transforming healthcare around the world. Adam Oxford puts some groundbreaking innovations under the microscope
Medical science and technological innovation have always been closely related. From Hippocrates and Asclepieia, through da Vinci"s anatomical studies, to Marie Curie and big pharma today, the basic human desire to live longer and live better has drawn curious minds to focus their research on medicine and healthcare.
Even by historical standards, however, the opportunities for technology to improve our wellbeing seem, from a layman"s point of view, to be in a period of stunning growth. In the last eight years alone, scientists have profiled the human genome and grown skin tissue from stem cells.
One of the most interesting areas of development is where connected technologies and healthcare are colliding. Our ability to fit sensors into just about everything and process the data they collect has enormous implications for healthcare.
In July, for example, internet giant Google and healthcare company Novartis announced that they had entered a partnership to develop "smart lens" contact lenses for diabetics. The lenses, which were originally developed in the same lab as Google"s self-driving cars, contain a microscopic sensor able to detect glucose levels in tears. Almost as improbable is that they are then able to relay that data back to doctors using antennae thinner than a human hair that are embedded in the lens.
The inventors, Brian Otis and Babak Parviz, said that they had originally looked at putting LEDs on the lenses too, which would warn people if the wearer was about to enter a hypoglycaemic state.
Smart lenses may sound like something from the future, but they"re far from the most outlandish project currently being developed for healthcare. In 2012, Dr George Church of Harvard Medical School was the principal investigator for a team that created "DNA nanorobots" of molecular size, which are capable of destroying "cells in distress".
As Church explains: “We can finally integrate sensing and logical computing functions via complex yet predictable nanostructures, aimed at useful, very specific targeting of human cancers and T-cells.”
While cancer-hunting nanobots and smart lenses may still be a few years off general use, there"s one device that"s delivering unforeseen amounts of benefit today - the humble smartphone.
Thanks, in part, to a profusion of sub-$100 handsets aimed at developing countries, market research firm GFK is predicting that 5.2 billion people - 69 per cent of the entire planet"s population - will own a smartphone by the end of 2017. And that has huge implications for health. As well as being excellent conduits for putting lifesaving information and medical advice into people"s hands, smartphones can employ all kinds of other sensors used for monitoring people"s health.
Back in 2011, researchers at MIT were able to accurately predict an owner"s activity by analysing the real-time information generated by a particular sensor, which can turn a phone into a pedometer. High-end phones today, like the Samsung Galaxy S5, even come with sophisticated heart-rate detectors built in, and there"s a burgeoning market for "wearables" like fitness bands, smartwatches or blood-pressure monitors, which connect to smartphones for data-gathering purposes - keeping an eye on what we eat, how fast and far we run, and encouraging us to do more of the things that are better for us.
For the most part, says consultant cardiologist Andrew Mitchell, the phone add-ons and apps available today aren"t just cheap gimmickry. “It"s mostly high-quality stuff that"s coming through,” he says. “The FDA in the US has cottoned on to the development of applications that might be termed a health device. So a lot of the applications and hardware have to prove themselves to be of the quality the FDA would approve.”
And Mitchell says that Jersey is becoming a prime location for testing new healthcare technologies, particularly those that rely on acquisition and analysis of large data sets through smartphone apps.
“In the last few years, things have exploded in mobile health technology and wearables,” he says. “About three years ago we started looking at what Jersey can provide. It has a small stable population that is relatively affluent, and that"s a good environment for testing new technologies.”
Many of Mitchell"s own patients are recording data using common smartphones and wearables, which have proved useful in monitoring exercise levels.
“A patient of mine came to clinic recently having recently undergone heart surgery,” Mitchell says. “Exercise is an important part of his rehabilitation and when I asked how much exercise he does, he was able to share with me the readout from his fitness tracking device. We know that people who use these become incentivised to do more, and there is some work looking at using these devices to enhance recovery from certain types of surgery.”
One of the biggest issues at the moment, he says, is the lack of a common set of reporting standards for health information so that different services can share data with each other. “We need a uniform language for health devices, so data can cross talk using different applications,” he says.
Delivering with data
Mark Cooke is Head of IT services and operations at C5 Alliance, a Jersey-based solutions provider and high-tech consultancy. Prior to his current position, he was Chief Officer of the States of Guernsey Health and Social Services Department, and before that he spent five years as CEO of the NHS Dudley Primary Healthcare Trust. Over the course of his career, he"s been involved with evaluating and implementing cutting-edge healthcare on behalf of hundreds of thousands of people.
Cooke is a proponent of the use of big data to improve the delivery of healthcare. His experience of using Mosaic, the NHS"s data-analysis tool, convinced him that the potential for using large data sets, like those captured from personal fitness apps, will be an essential tool for making the most out of public healthcare budgets in the future.
“The NHS is already using those tools to predict down to postcode level how many people in a 10-house area will develop type 2 diabetes and respiratory problems in 20 years,” Cooke says. “I think it has huge benefits. Predicting down to that level can save millions on future operations.”
And that, says Cooke, is key. As populations age and healthcare needs increase, bringing the costs of care down is critical - and technology will play a vital role.
“The most exciting technology right now is 3D printing, because it"s something that can be done at all levels,” says Mark Cooke, Head of IT Services and Operations at C5 Alliance. “Researchers are creating nanotechnologies and implants, and bioengineering muscles and teeth all using 3D printing.”
There are many advantages that recent breakthroughs in 3D printing bring to healthcare. Last year, US biotechnology company Organovo revealed that it had 3D printed a functioning human liver - albeit a scaled down one - by layering individual cells on top of each other. The tiny liver survived for five days in a laboratory, and the company is currently working towards producing tissue suitable for drug research, which could one day replace animal testing for some trials. CTO Sharon Presnell told journalists that she expected to be able to produce directly implantable material “within my lifetime”.
In South Africa this July, doctors performed surgery to implant 3D-printed jaw implants as part of facial reconstruction surgery for cancer sufferers in the poverty stricken Eastern Cape. If this is what 3D printing can do now, just where could it go in the years to come?