Challenging stimuli predicting the future

David Font
 

Photography by Alejandro García (EFE) 

I reread an article published in 2014 in the British Medical Journal, "A Glimpse into the Future: Typical day in the NHS in the year 2050", in which Hannah Wilson, a student at Imperial College, imagines a healthcare system that screens patients admitted to Singapore and New York from London, within the framework of a global hospital, and which operates on patients by remote surgeons using robots. The Euthanasia Department and the Genomics Clinic are, for her, hospital departments in 2050. She describes patients convinced of the suffering of two diseases when they know their genomic sequence and also "digitally addicted" patients in times when a day may end up in an isolation pod due to a virus raised to epidemic levels.

I listen as Eric Topol, cardiologist founding and director of the Scripps Research Translational Institute points out in Eric Topol and the Future Of Medicine that clinical pathways based on means and population studies contain errors, with the example of the amount of sodium in the diet that cardiology routes recommended time ago. He explains how personalized medicine, combining the different diagnostic platforms focused on the individual, will modify –and is already beginning to do so– the diagnostic and therapeutic approach to diseases. Samsung, Google and Apple will integrate the data into their platforms to be accurate health advisors; a daughter diagnosing her mother with heart attack using an electrocardiogram taken by a watch. She also talks about toothbrushes that send information to dentists about whether you brush correctly or forks that tell you if you eat too fast and chew well; devices and platforms for a preventive, predictive and personalized medicine radically different from the traditional one.

I review the project approach of the MIT Operation Research Center and the MIT'S J-Clinic in artificial intelligence (AI) in health, such as optimizing bed management by integrating occupancy data and clinical data to anticipate discharges and propose actions within 5-7 days in advance and with resolution capacity hour by hour. And that of optimizing the location of the patient in the most appropriate resource of the health system; Science fiction projects.

Concerning organizational transformation, I read Jordi Varela's post "Medical services, an anachronism", from September 2021, in which he proposes, inspired by the latest articles by Michael Porter and Thomas Lee and by the reading of Corporate Rebels. Make Work More Fun – a highly recommended book – that the medical services have to stop being management structures and that the functional clinical units have to take the helm. He also argues that scheduled surgery and diagnostic and rehabilitation services must be managed according to factory criteria.

At the Hospital Clínic, we continue to work on the New Clínic Universe with the vision of being a nearby, intelligent, sustainable and pioneering Clínic. We ask professionals for stories about how we will be 10-15 years from now with stories similar to those of Hannah Wilson. In parallel, different projects submitted to the internal innovation awards address AI-based transformations and propose new devices in line with Eric Topol's presentation.

All these stimuli come to me when a commission with representatives from the Department of Health of the Generalitat de Catalunya, the Barcelona City Council and the Barcelona Provincial Council analyzed the demand for a new Clinic and the possible location alternatives in the city of Barcelona. Today we analyze what a new hospital should be like, which should be a reality within 10-15 years and be functional and sustainable for many years. I wonder how, when making its functional plan, we have to consider all the ideas collected in this post. How do other centres do it? It seems obligatory to take them into account, but it is complex and requires courageous visionaries like J. F. Kennedy. It is essential to listen to his speech on September 12, 1962, at Rice University in which he outlined how the Americans would reach the Moon seven years before that happened.