What We Learnt in Digital Health in 2016
In order to successfully move into 2017, it is crucial to draw the lessons of the past year in terms of successes, failures, remaining challenges and impenetrable obstacles in the field of digital health. Food for thought!
An impulsive year in science and healthcare
2016 was a bold, busy and impulsive year in science and healthcare. Elon Musk, CEO of Tesla, founder of SpaceX and great visionary raised the stakes in astronautics again for the greatest pleasure of the fans of space flights. He promised no less than to take humanity to Mars as soon as possible (I explored the medical challenges of the project here). In July, NASA’s Juno spacecraft entered Jupiter’s orbit, a great milestone in a five-year-long journey on a $1.1 billion mission. In October, the Nobel Prize in chemistry was awarded to three brilliant scientists very simply for having developed molecules with controllable movements, acknowledging the immense potential in nanotechnology.
Uber’s driverless cars appeared on the street of Pittsburgh, and I mapped the potential medical application of automated cars as new points-of-care. The developers of Hyperloop Transportation Technologies announced that travelling in the futuristic hyperloop pods shooting through a tube above the ground will be possible in four years. The amazing genome editing tool, CRISPR got a green light from the US National Institutes of Health for clinical trials. In March, HoloLens, Microsoft’s augmented reality (AR) viewer went on sale for developers eager to take risks by investing in new technologies. It is exciting news taken into account how augmented (and for that matter, also virtual) reality might transform whole areas in medicine.
The list is certainly not exhaustive, but I believe it shows the great scientific and medical progress we experienced in 2016. Of course, I do not want to sound overoptimistic: many unsuccessful attempts, impenetrable obstacles and unsolved challenges characterized 2016. These experiences are the most important in terms of our ability for successfully moving forward. We have to draw the right lessons – and we have to learn from them.
Here are a few thoughts to consider before we dive into 2017.
1) Regulations are slow
Bureaucratic machines and mammoth-like systems are slow. They cannot keep up with the pace of innovation, especially the technological innovation of the 21st century. It sounds evident, but I cannot stress its importance enough. It is the number one reason why the application of amazing medical technologies is in delay for so many areas.
Look at the example of the artificial pancreas. It basically replicates what a healthy version of the organ does on its own; and it enables diabetes patients to live an easier life in a sustainable way. As there was no single device on the medical market, which was able to monitor blood sugar and supply insulin automatically, creative persons invented a DIY version from existing technologies. A grass-root (social media) movement called #wearenotwaiting grew out of the initiative, who campaigned for the introduction of such artificial pancreas on the market for years persistently. One of the leading figures of the movement, Dana Lewis told me how an artificial pancreas eases everyday life. She has been using the device for almost two years by the time the US Food and Drug Administration finally approved it.
2) The rise and fall of Theranos
One drop of blood – and patients will know more about their illnesses than ever before in their whole lives. That was the promise of Theranos, founded by Stanford-graduate Elizabeth Holmes in 2003. It was the disruptive dream: to make blood-testing cheap, flexible, easily portable and above all – reliable. Everyone believed it is one of the greatest medical inventions of the century. By 2014, Theranos had raised more than $400 million in funding with an estimated value of $9 billion.
But after one decade of blind expectations, The Wall Street Journal dropped the bomb. In October 2015 it raised serious concerns about the viability of the project. At the beginning of 2016, I described how the fate of Theranos would have a huge impact on the future of medical innovation, and that 2016 is going to be a decisive year for the company.
As a reaction to the extensive coverage about the company, a comprehensive investigation was launched. In July, regulators decided to revoke its license to operate a lab in California because of unsafe practices. They also banned Holmes from the blood-testing business for at least two years. Theranos announced it would close its laboratory operations and wellness centres to work on miniature medical testing machines in October 2016. That’s a major backlash to the once $9 billion worth company. There is not even proof or evidence that truly did what they claim they did.
3) Amazing new technologies are still too expensive
Although Microsoft’s HoloLens went on sale for developers in March, we still have to wait for its everyday use for a while – not least due to its exorbitant price. You can order the Development Edition for $3000 and the Commercial Suite for $5000. Oculus Rift, one of the greatest VR devices promising the magic of presence, costs $600-$800. These prices are definitely not for mainstream users. Although Google Cardboard offers an easily accessible and cheaper solution with its price range between $10 and $20, it is definitely not enough. As the saying goes, one swallow does not make a summer.
And Magic Leap, the VR-company located in Florida has not even showed a prototype about its product yet. It calls mixed reality (MR), namely the mixture of AR and VR solutions, and has amazing marketing videos, but there is no proof that Magic Leap would work in practice.
4) Precision medicine has to fight for its place
Too many are still skeptical about precision medicine, the compilation of medical practices aiming at healing patients with the fewest possible side effects and negative impacts by applying personalized treatments. I generally believe precision medicine is the only viable future for healthcare. Although I know its limitations. Currently, it is too expensive and it is difficult to gather enough data in such a short amount of time. I also try to be cautious with innovation and to identify overhyped technologies.
Still, I think nanotechnology, genetics and surgery all hold great promise for precision medicine in many areas. Look at cancer treatment. Today, one of the most common practice is chemotherapy. In spite of the fact that it does not only destroy cancerous cells, but also healthy ones. In the future, with the help of nanotechnology, drugs might be delivered precisely to the cells to be healed. Another possibility would include medical professionals using surgical robots such as da Vinci Surgical System. Such devices are capable of performing operations with previously unachievable precision. The future also holds targeted treatments. Companies such as Foundation Medicine are creating customized treatment plans based on the genetic makeup of the patient’s tumor. They sequence DNA from the tumor, and try to match the key mutations to drugs on the market or clinical trials already on the way. Over time, this might become the standard for assigning cancer treatment regimes.
5) No access to our DNA
I have had four genetic tests in my life so far, and I received valuable information about my health and body each time. Patients had been able to order such tests online with 23andme, Navigenics or Pathway Genomics since 2005, 2006 and 2007 for a while; then regulators stepped in and started to roll obstacles into their ways. Their basic idea is that anyone should be able to order a test from home, learn about their risks for certain medical conditions, and what lifestyle choices they should make to avoid them.
The US Food and Drug Administration (FDA) forced 23andMe to stop marketing the health reports in its spit kits in 2013. Although it approved to offer its tests directly to consumers (DTC) two years later, patients still do not have access to enough information to truly understand their results. Tests are still too expensive and 23andMe can only run tests that have been approved by the FDA. Generally speaking, DTC genetic companies still cannot provide services for patients they are truly designed for, and they are only allowed to send raw data without the analysis. In 2016, I still have no access to the underlying information in my DNA.
6) People are afraid of bionic/cyborg technologies
I feel you. The world is huge, full of imbalances and incertitude. No one knows what the future brings, which is pretty scary. It especially rings a bell concerning new technologies. Not that surprisingly, the most popular articles on TMF are the ones focusing on how scary technologies might be or how bioterrorism might get a boost in the future.
People have been afraid of the unknown since the dawn of times. Thus, my mission is to get you familiarized with new technologies to be able to enter the new era of healthcare with confidence and knowledge. I already listed 10 reasons why people should not fear digital technologies, but I’m going to continue. Talking about our dreads and fears in connection with novelties in science and health has never been more timely, so keep following me!
7) People acknowledge AI if they start using it
Do you remember the feeling when you first tried to ride a bicycle or went swimming into deep water? For me, it was a combination of fear and excitement. Later on, fear disappeared completely. It is the same with new technologies such as artificial intelligence. People will acknowledge its benefits when they start using it. IBM Watson, the company’s advanced artificial intelligence program was recently made available widely at US Clinics. The so-called Watson for Genomics helps advance precision medicine by combining cognitive computing with genomic tumor sequencing. I also presented how physicians use Watson on a daily basis. When physicians get a chance to see it in action, they stop being reluctant to adapting them.
8) No smart algorithms analyzing wearable data
Around a hundred million wearable units to measure health parameters were sold in 2015. It is predicted that 245 million wearable devices will be sold in 2019. There are already tens of millions of wearable sensors and healthcare gadgets in the pockets of people worldwide. But where are the smart algorithms? Where are the artificial intelligence programs being able to analyze people’s own Big Data?
Unfortunately, the development is in delay due to various reasons. The result? I still need to analyze my own data and draw conclusions about lifestyle choices myself.
9) No food scanners
Currently, we have absolutely no idea, what we are eating – not to speak about what we should. Food scanners promised they will be able to tell how many grams of sugar a piece of fruit contains, or what the alcohol percentage of a drink is. Canadian TellSpec had a successful crowdfunding campaign in 2013 and raised more than $380,000. It announced its aim is to develop a hand–held food scanner that can inform users as about specific ingredients and macronutrients. They sent out the first devices to beta testers in mid-2015. However, the market launch is in serious delay jeopardizing the company’s reputation.
The Israeli company SCiO raised over $2.7 million on Kickstarter in 2014. It uses a technology similar to TellSpec’s but is designed to identify the molecular content of foods, medicines, and even plants. The company promises that in milliseconds the ingredients and molecular make–up of the foodstuff will appear on the user’s smartphone. The device was scheduled for shipment in 2015, but disappointed backers, as it still hasn’t shipped. On top of the delays, experts in applied science criticized both SCiO and TellSpec for overstating what their inventions can do.
10) The relationship between Boston Dynamics and Google is over?
Boston Dynamics, the engineering and robotics design company meant the future when it came to robotics in 1992. It was so promising that Google X bought it for hundreds of millions in 2013. They produced mind-blowing videos and even more inspiring robotics developments. However, in March, Google announced that it is ready to sell it since BD was rather reluctant to work with Google’s other robot engineers, and the unit reportedly failed to come up with marketable products in the near term. Toyota and Amazon was aired as potential buyers. In May, Tech Times reported “the ink was almost dry” on the purchase of the company to Toyota. But since then, no news about the business being sealed.
11) 3D bioprinting has a future
Organovo is going to prove to be a true success story! It has been in the spotlight because of 3D printing biomaterials for years. They announced successfully bioprinted liver tissues in 2014 and they seemed to be 4-6 years away from printing liver parts for transplantation. But these bioprinted livers could also be used in the pharmaceutical industry to replace animal models for analyzing the toxicity of new drugs.
A few months ago, Organovo launched its second commercial product, bioprinted human kidney tissue. In December, Keith Murphy, CEO announced that the company expects triple-digit percentages in growth for years to come by driving the adoption of bioprinting, by expanding their products and offerings. I am hopeful to see Organovo’s growth in the next year!
2017 will be an even more exciting year in digital health and we have a lot to do not to make the same mistakes, to overcome the obstacles and to rise up to the challenges. Let’s learn from things that took place in 2016 and check the predictions for 2017.
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