Up close with HealthTech's research team: gazing into the crystal ball of technology trends

Healthcare Purchasing News, August, 2005 by Rick Dana Barlow

For San Francisco-based Health Technology Center (a. k. a. HealthTech) analyzing past trends, observing and interpreting current trends and integrating all of that to forecast future trends not only is a way of life but a lot of fun.

Still, it represents a lot of hard work and painstaking research and sourcing, which healthcare providers and suppliers routinely rely on to make business decisions for the good of their organizations and patients.

Healthcare Purchasing News Senior Editor Rick Dana Barlow posed a series of thought-provoking questions to HealthTech research project managers Jennifer Monti, Ateret Haselkorn, Anil Rao, Katherine Homey and Kent Soo Hoo about technological concepts and adoption and implementation trends among healthcare providers. As the quintet stretched their imaginations they offered some valuable insights about what potentially lies ahead.

HPN: You work with healthcare facilities to help them make decisions about improving their operations and outcomes through the use of advanced technology. What are some of the key trends you see in the technology arena that will impact how hospitals and outpatient care facilities deliver care and treat patients?

MONTI: Genetic testing will allow for stratification of patients based on predisposition to disease; care pathways will be modified based on which cohort your genetic profile suggests. Pharmacogenomics will allow for more effective drug treatments. Minimally invasive and non-invasive surgery will be responsible for a lot of the shift of surgery from inpatient to outpatient and even medical office building space. We'll see improved equipment as well as more control of radiosurgery, cryoablations, radiofrequency ablations, etc. In the materials sciences area we'll see improved biomaterials allowing for devices to be more compatible with body tissues. Drug-eluting stents are great examples, as well as LVADs [left ventricular assist devices], bone scaffolds, etc.

If you were to strap on a pair of 3-D goggles and peer 20 years into the future what does the next-generation hospital and outpatient care facility realistically look like in your mind? How do they function differently in 2025 than today for maximum effectiveness and efficiency?

MONTI: Most care will be given in the outpatient setting, a setting that is physically and operationally separate from the inpatient space. With advances in sensing and remote patient management, patients that finally do end up in the hospital will be highly acute. Outpatient care facilities will subsequently have much more advanced equipment in them for performing surgeries and other interventions that were once conducted in the inpatient space. You can imagine a third space that is like a 'command and control center'--with the IT system being used to constantly monitor patients. Data flows back in real time, and a clinician is constantly available to monitor any red flags. This is already beginning to happen with the eICU--and health delivery systems will, 20 years from now, be making more concerted efforts to retain the remote monitoring business.

What are some of the key technological trends you foresee? Device and equipment miniaturization? Multifunctional devices and equipment? Patient biosensors (external via clothing, for example, and implantable)? Micro robotics and nanotechnology? 'Smart' instruments with tactile sensitivity to discern organs and tissues? Adaptive imaging modalities that track motion for more effective therapy and treatment? Non-invasive surgery (via lasers, etc.)? Intuitive computers? Interconnectivity and integration of information? Plug-and-play ease of use?

HASELKORN: In the next two to five years, use of sensors for continuous patient monitoring will allow treatment to be more predictive in nature, often taking place before the onset of symptoms. This will improve patient quality of life, decrease length of stay, and reduce morbidity and mortality. Non-invasive monitors also represent great areas of progress. For example, in the short-tetra, non-invasive acoustic brain monitors will be able to distinguish an ischemic stroke from a hemorrhagic stroke, avoiding a complicated and invasive procedure. Finally, advances in smart, implantable pumps will lead to the creation of a closed-loop insulin pump for diabetes in the five to ten year time frame.

RAO: Nanotechnology will have an impact in the clinical setting in three primary areas: Early detection of disease, improved targeting and delivery of drugs, and improved biocompatibility of implants. Specific technologies that we can expect to see in the next fifteen years include point-of-care biomarker diagnostic devices, and targeted, non-invasive ablation of cancerous cells that minimizes damage to surrounding healthy tissue. The emerging field of tissue engineering will also benefit from nanobiological scaffolds in orthopedic and neural tissue regeneration. Also, implantable sensing and monitoring devices, for example in diabetes management, are also expected to have a significant impact in the coming decade.