The GP and television presenter says sharing our medical information globally could lay the groundwork for the next healthcare revolution
A few years ago I undertook a genetic screening for a television show. The tests, which analysed aspects of my DNA from a swab of my cheek cells, revealed I was genetically prone to raised levels of an amino acid called homocysteine, and that I was slightly more likely than others to develop blood clots.
It wasn’t a big surprise – my father had suffered from deep-vein thrombosis (DVT) – but far more remarkable was the related drug-sensitivity profiling: the go-to anti-clotting drug at most hospitals wouldn’t work for me.
This revelation was very worrying. I would have turned up at hospital with my DVT, received the standard treatment and assumed all was fine, until I had another clot and dropped dead from a heart attack or stroke.
Genetic screening is one of many examples of how healthcare could benefit from advances in technology.
It’s expensive at scale, but think of the money that could be saved if we were all screened from birth: prescribing would be individually tailored, doses accurate and many adverse drug reactions could be avoided. The cost of wasted unusable drugs alone would cover the cost of genetic testing.
The chief medical officer only recently announced that genomic testing, which has been around for years and can help tell how your body will react to cancer, should be standard for the NHS care of cancer patients.
The medical profession can be frustratingly slow to embrace new technologies, because we are the ones who give drugs to patients and feel a great sense of responsibility. However, we can be slow on the uptake, and our reticence harms people.
There’s wisdom in the crowd
Here in Britain, for example, we fail to share medical data enough. The NHS fears IT breaches, but any UK doctor should be able to gain swift access to your medical history. A much improved, secure intranet would be a good starting point.
For better clinical trials, better individual diagnoses, faster treatment and more, data needs to be shared, but we’re held back by bureaucracy and an irrational suspicion of sharing data, even within the profession.
But we already have what we call “grand rounds” in hospitals, where a group of doctors, students and others will discuss a difficult or complicated case.
In other countries, technology has enabled a similar mass-pooling of expertise online, for instance crowd-sourcing diagnoses from a scan of an anonymous patient’s cells from a smear test.
Instead of one pathologist analysing the cells, tens of thousands of them can give their opinion, and with it a statistically much more reliable answer, without affecting patient confidentiality.
This is an example of really interesting medicine, linking brains around the world just as the internet does with computers. I don’t know why we do not do this more widely in the UK.
VR in the ER
Of course, there are many tremendous opportunities for technology in medicine. Virtual reality, for example, could dramatically improve teaching, removing the need to operate on pigs or cadavers, allowing the introduction of anatomical variations, or scenarios of things going wrong mid-surgery.
Even more exciting are the Da Vinci robots, currently used for some surgeries, including prostate removal. They can be operated remotely by the very best surgeons thousands of miles away from a theatre.
Of course, the systems behind such surgery must be robust and safe as we become more reliant on them – and they surely will.
These are exciting times to be a doctor, but the medical profession needs to be more open and forward-thinking in how it considers these and other changes if we are to have a healthcare revolution. The constant, shrill cry for evidence has stifled truly innovative thinking and held us back.
The safe management of data will be essential if we are to maintain a duty of care to our patients, but we mustn’t let concerns around a more open world in medicine prevent better care for all.
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