Medicine of the future: how technology will extend our lives

October, a warm evening. Mr. Rossi is walking the streets of his city with his dog when an ambulance approaches him. He comes down a paramedic and invites him to come up because he is about to have a heart attack and it is necessary to take him to the hospital. It seems dystopian but, in reality, it is a scenario (for the moment imaginary) of the medicine of the future.

The situation becomes more complicated and Mr. Rossi has cardiogenic shock, the urgency of a surgical operation becomes clear and – thanks to various situations and parallel emergencies – all the surgeons are busy. A British surgeon is then hired who, from London, manages a robot to operate in Milan, in the hospital where Mr. Rossi is hospitalized.

The medicine of the future, more than a hypothesis

Is the scenario above plausible? The answer is yes, because the future must first be imagined and Mr. Rossi’s medical vicissitudes are at the center of medical-medical technology which has three goals: precise and early diagnoses, quicker and more targeted treatments, leaner and faster courses and hospitalizations . All of this translates into the to live better and longer with positive effects on mistakes doctors and health care costs.

It can be objected – not entirely wrongly – that better prevention can avoid hospitalizations and this is unquestionable: however, noticing the formation of a tumor as it arises does not exclude cycles of chemotherapy, if anything it reduces the number and intensity. Similarly, a heart problem diagnosed before it presents itself with all its violence does not exclude surgery, if anything it requires a less urgent one with a shorter post-operative course.

Where are we?

The question must be divided into two aspects: the first purely technological, the other organizational and procedural.

Of interventions a distance they have already been doing it for 15 years and also on hospitalized patients in Italy. In 2006 Dr. Carlo Pappone operated from Boston to San Raffaele from Milan. A not very complex operation useful for demonstrating in the field that the precision of the operation was such as to reduce the post-operative risks.

In Milan they are underway dozens of experiments from telemedicine, made possible by 5G connectivity which is necessary for both transmission speed and low latency. If a surgeon moves a robotic arm a thousand kilometers away, this must imitate the movements in real time, if there was too much time lag the movements of the doctor and the robot would not be coordinated.

Current medical technologies allow remote control of people with chronic diseases. An aspect of primary importance because the continuous monitoring of the parameters allows to intervene before the clinical situation worsens. Which means going to the hospital before hospitalization becomes urgent and therefore staying there less time, perhaps avoiding drastic measures such as operations or long hospitalizations.

Who is on the other side?

Doctors in the flesh and artificial intelligence (TO THE). To go back to the hypothetical Mr. Rossi who wears sensors, which monitor his heart, the data collected is sent to a central unit – normally a hospital or a specialized clinic – and examined by an AI which, finding anomalies in vital parameters, activates a procedure which will then be followed by a doctor.

AIs in the medical field are used above all to make diagnoses because they are able to consult millions of medical records and reach conclusions autonomously. It goes without saying that the diagnosis goes confirmed by humans and therefore to fear that one day we will be cured by an algorithm is premature and, as things stand right now, we cannot be sure that will happen. But the double reading of the man-machine data makes it possible to reduce errors because, if the doctor has the last word, it is also true that the Ai offer him precise support, based on the analysis of a number of data that a man it would take years to read.

Not just prevention

Technology not only allows for more precise diagnoses and treatments, it also allows for rehabilitations that were unimaginable until a few years ago. One proof among many is Hannesone of the most advanced robotic hands in the world built in Budrio (Bologna) with the contribution ofInail and which restores maximum mobility to the man who has lost his natural limb.

Likewise a Trent (but we could mention many other similar projects) with Trec a digital healthcare is being created made up of data, instant interaction between doctor and patient and remote care, administered when necessary in the useful quantity, and this thanks to sensors worn by patients. At times perhaps annoying – progress will deliver us smaller and more discreet ones – but capable of improving people’s lives.

The cultural and organizational question

Cultural, ethical, regulatory, organizational and logistical issues are holding back the adoption of these technologies.

The age-old question remains privacy and that of responsibility: is a wrong diagnosis the fault of the doctor, of the AI, of those who created the algorithms, of those who installed them, and so on along the entire supply chain? It is difficult to establish responsibilities just as it seems difficult to create rules that help technological medicine models to take hold definitively.

Last but not least, the question logistics And organizationalwhich goes beyond the technologies themselves: there is a technology that can save Mr. Rossi’s life, but whoever takes care of monitoring his state of health (which hospital, which doctor, …) and the effects of all this can be soothed if there are no men and means to intervene very quickly, if not even in real time.

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