Future Health Care Systems and the Needs of Patients

• In Event: The GPS of Medical Knowledge for the 21st Century

Abstract

We are currently at the start of the fourth industrial revolution in which digital technologies are completely integrated into our everyday life (1). Over half the world’s population have access to the power of the internet and those who currently do not are expected to catch up in the ensuing decade. Owning a smart device which is internet enabled allows its owner to access all the knowledge developed since human civilisation began. Consequently, the patient and the public can access medical information about their condition directly and not have that information passaged through a healthcare professional.

Conversely citizens are able to share information about themselves with whomsoever they choose and often a good number of people they don’t choose. Wearing a smart watch or fit-bit like device allows people to check their activities and increasingly their mental and physical health.

In the future it is predicted that it will become routine that citizens will all choose to be tagged in some way either using a wearable or an implantable device and vast amounts of data on their everyday lives and functioning will be collected to be used by their healthcare attendants. Doctors then will need to exchanged their stethoscope for a ‘datascope’ and a consultation whether in person or on line is like to include analysis of this data and understanding what it means in the context of that individual patient. The potential of the way technology will change healthcare delivery was explored in a recent review of the impact of digital technologies on the UK NHS led by Dr Eric Topol (2) Not only will this change interaction between doctors and patients but it will also alter how healthcare systems response to and deliver healthcare to whole populations.

This seismic change in care delivery will need a new type of healthcare professional. Doctors will not be able to hold in their heads all the knowledge they require to provide high
quality healthcare. However, some critical knowledge will have to be retrieved very rapidly still, for example the treatment of life-threatening situations where seconds count, such as anaphylaxis. Other knowledge which is required less immediately and which is subject to regular change for example guidelines for the treatment of chronic conditions such as asthma would need to be known about and easily assessible but not memorised.

We need to identify what knowledge will be required to practice medicine in the next two decades and where will that knowledge will reside – beneath skull and skill or in the cloud or a combination of both. These ideas have major implications for how we teach, how students learn and how we assess a physician’s knowledge.

Author

• Trudie Elizabeth Roberts, University of Leeds