Monday, December 7, 2009

The Future of Health

Within the next thirty years to 2040, the following scientific and technological trends will be deeply embedded in the global Medical / Health Ecosystem-


Global-Personalised Medicine

Most developed countries will have established comprehensive electronic Health Record Systems to track lifetime patient medical and general health histories including DNA genome sequence and microarray SNP test results.
By 2030 it will also be possible to sequence the human genome at the personal level for less than $200, providing more accurate individual disease prediction and prevention. In addition, an individual’s medical records will provide personalised drug and vaccines protocols based on genetic response variants. Whole-of-Life e-health records will be accessible initially within countries and regions across the developed and much of developing world, eventually allowing the creation of online global networks of personalised records from pre-birth to death.

As well as the information records technologies outlined above, there will be a major trend towards providing expert biomedical advice and services to individuals and populations across the planet, utilising the communication modalities of the Web.
Libraries of medical and hospital patient records including scanned images, will be linked in vast virtual databases by 2030, to provide remote expert support to local medical teams and practitioners. In addition advanced surgical techniques, applied remotely using robotic, virtual and augmented reality technologies will be in widespread use.

Smart mobile phone technologies will also function as personalised helpers, performing real-time monitoring and transmission of patient status data- pulse rate, blood pressure etc, via inexpensive sensor networks, forwarding continuous data to expert hubs for online analysis and intervention.

The Grid/Mesh/Sensor Web will provide ubiquitous communication support for the acquisition and delivery of knowledge on a global basis. It will incorporate virtually limitless bandwidth as well as high levels of redundancy and security to guarantee continuous and fail-safe operation. Sensor webs, collections of wireless processing nodes that can capture local sensor data and transfer it to a processing hub, will play a vital role in customising and updating mobile devices such as smart phones; supporting applications that constrained by a constantly varying environment or context such as the monitoring of patient well being.

These developments will be particularly valuable for developing countries with limited health support resources.


The Intelligent Web 4.0

By 2030, current versions of the Social Web 2.0 and emerging Semantic Web 3.0 will have evolved to the next level of autonomy and intelligence-Web 4.0. The Web’s evolution will have made many important contributions to the biological sciences through the application of new knowledge, network science, logical inference and artificial intelligence.

Web 4.0 will be ubiquitous, powered by a smart computational sensory, computational grid/mesh enveloping and connecting human life and encompassing all facets of social and scientific activity- always on and available. It will connect not only most of the 9 billion individuals existing on the planet by 2050, but also link with other biological and artificial life forms, as well as countless everyday electronically available objects. It will interact with the repository of most available knowledge of human civilisation- including algorithms, protocols and processes, digitally coded and archived for automatic retrieval and analysis.

Through Web 4.0, human intelligence will have co-joined with advanced forms of artificial intelligence, creating a higher or meta-level of knowledge processing. This will be essential for supporting the immensely complex decision-making and problem solving requirements essential for civilisation's future progress, including medical diagnosis and management.


Systems Biology

The power of the web will be supported by a new way of unlocking a deeper understanding of nature and its evolution- Systems Biology. This marks a paradigm shift from traditional reductionism to a more holistic level of understanding of biological phenomena- interpreting organisms in terms of information processing networks at the system rather than component level of genes, proteins, environmental factors etc.
Systems biology also marks the beginning of a more quantitative science, highlighting the causality and dynamics of biological interactions by applying mathematical models and the capability of simulating interactions at all levels- cells, organs and the total organism.
This paradigm will be central to further progress in understanding the patterns of life in terms of biological networks processing digital data.


Genetic-Tissue Engineering

Applying genetic engineering or gene therapy techniques, corrected genes can be inserted into cells including adult stem cells taken from a patient affected by a particular disease. The future treatment of diseases such as heart failure and breast cancer will also be revolutionised by the option of growing new organs and tissue inside the human body using the patient’s own stem cells and biodegradable scaffolds to avoid immune rejection.

Molecular engineers are already beginning to create custom-built proteins with enhanced functions, including the capability to correct disease genes causing haemophilia, muscular dystrophy and sickle cell anaemia.

Stem cell therapies, including both adult and embryonic stem cell differentiation, will be commonly applied by 2030 to the scaffold synthesis and repair of human tissue and organs including—complex skin sheets, cartilage, blood vessels, bone, eyes, spine, pancreas, liver and heart muscle- mimicking their biological counterparts.


Cyber-Human Symbiosis

The linkages between cyber-computer technologies and human biological systems is now well advanced and includes development of the following applications-
Interactions through Virtual and Augmented Realities;
Sensory augmentation implants- such as the Cochlear and early retinal devices;
Prosthetics- such as the recent DARPA funded neurally controlled prosthetic arm –combining technologies of signal processing, electrical and mechanicalengineering and neuroscience.
Brain interfaces-which will enable a paralysed person to pick up a cup and drink, using interpreted brain signals.
Artificial hippocampus- to assist patients with memory deficits;
Brain image extraction- reconstructing and displaying images using fMRI mapping; Building brain functions at the system level- applying evolutionary self organising and learning principles;
Interactive humanoid robots- to provide company and support

Current developments including synthetic biology, cyber-human symbiosis and bioengineering also signal the creation of new and enhanced life forms for the first time in human history. This will open a portal for the explosion of human potential beyond the confines of biological evolution alone.

The impact of cyberspace on the evolution of the brain is also likely to be very significant over the coming decades. Children are constantly being neurally rewired as the interactive Internet becomes a seamless part of their lives for example in the form of video games and social networks.


NeuroEngineering

NeuroEngineering technology will be commonly applied by 2030, involving a greater understanding of brain function and enabling enhancement of human intelligence, memory and creativity. Significant advances are already being made towards simulating and emulating the brain’s capacity for sensation, perception, action, interaction and cognition, using advanced 3D fMRI and Optogenetics. This recent technology combines genetic engineering with optics to study specific cell types, using fluorescent dyes to better visualise the functions of various groups of neurons and their interactions. This allows the location and dynamics of neural circuits controlling behaviour in animals to be studied and controlled, including food seeking, decision-making and stress avoidance. It also reveals new targets for drugs that can regulate neurons and lead to better treatments.

Cognitive enhancement compounds will also be widely used by 2030; applied to Alzheimer’s and other forms of dementia as well as enhancing human decision-making, alertness and memory capability. Two enhancers- methylphenidate and amphetamines, have already been shown to alter the activity of the neurotransmitter dopamine in neural synapses. Enhanced dopamine signalling may improve learning by focusing attention and interest on a task.

Brain simulation is also a nascent field offering huge future potential. IBM has already simulated a brain with a billion neurons and ten trillion synapses- equivalent to a cat’s cortex or 4.5% of a human brain; while a team of European scientists have taken the first steps towards creating a silicon chip designed to function like a the cortex of a human brain. By simulating a fundamental microcircuit, down to the level of individual neurons it can be used to test genetic variations in particular neurotransmitters, mimicking what happens when the molecular environment is altered using drugs.
With research and development converging on all fronts in this field- both at the hardware and software level, it will be only a matter of time until a brain with human-level complexity is scaled up for experimental use.

NanoBioEngineering

Molecular biology has largely been applied as a reductive science but now synthetic biologists are building machines from interchangeable DNA parts that work inside living cells, deriving energy, processing information and reproducing.Flexible reliable fabrication technology, together with standardised methods and design libraries have enabled a new generation of biological engineers to already create new organisms from biological components,from the ground up.

The technologies of the first generation of Medibots is now well progressed. Medibots are tiny robots that only a few millimetres in size that can work internally and are designed to enter our bodies through the mouth, ears, eyes and lungs and swim through the bloodstream. Bby 2030 they will be commonly used to conduct robotic surgery, install medical devices inside the body, including a camera in a capsule small enough to be swallowed, deliver drugs and take tissue samples. remote control is conducted by a surgeon via a computer console, in the same way that a present day astronomer works.

Self-replicating, autonomous nanoscale robots are also being bioengineered and will change the face of healthcare and life enhancement. Nanoscale machines and motors will be inserted inside cells which can then self-assemble and seamlessly integrate with the cell. Smart implants and tiny biological fuel cells are also on the drawing board, capable of producing electricity from glucose and oxygen in the bloodstream.


The Web Takes Control

As previously outlined, the intelligent Web 4.0 will be in full play by 2040 and beyond as a symbiotic extension of life-intelligence on a global scale. It already functions as the central information- processing hub for life on the planet, enabling the successful design and delivery of most complex knowledge generation projects.

The web is evolving, not as an application sitting on top of the Internet, but as a living organism in its own right; because it encapsulates all human as well as artificial intelligence. In addition it already links biological life and artificial life in forms such as software agents and learning machines such as intelligent robots, as well as providing enormous computing power for civilisation’s repository of knowledge.

Most importantly it will have co-joined with human intelligence as an active partner, creating a higher or meta-level of knowledge processing. This will be essential for supporting autonomously the immensely complex decision-making and problem solving essential for civilisation's future progress.


By 2040 the evolutionary trajectory of the Web, within its human and planetary environment, will have necessitated it taking responsibility for most major medical and health management decisions, becoming the senior decision partner in the process with humans.

Major health decisions will require verification and confirmation by the Web’s enormous informational intelligence, encompassing as it will, all medical knowledge, protocols and diagnostic algorithms. In addition, this intelligence capacity will allow it to creatively partner and effectively manage key local and global medical research projects.

The benefits to humanity of autonomous Web intervention in the medical-health decision space will be seen as enormous; allowing far more efficient and rigorous diagnosis and problem-solving, with many lives saved and quality of care improved. For example, real-time, optimal planning will be particularly critical in managing future pandemics, particularly as global warming continues..

On the basis of the current Trendlines this capacity will continue to grow, with human decision input becoming increasingly peripheral; as is the case already in many major engineering, transport, communication, financial and logistical operational areas, where realtime responses are required and optimal algorithms scientifically accepted.

The Web 4.0 and its descendents will then have taken virtual control of the evolution of medical-health science and practice