Medical Breakthroughs That Will Change Healthcare

In this case, virtual medicine is combined with wireless medicine. When a patient has a biopsy, he or she assumes the worst. The patient doesn't want to wait to hear whether he or she has cancer—not even a day. A telemedicine service can send the scope's images via a secure online network to pathologists for those providers who don't have one on staff or who want a second opinion, allowing physicians to deliver results faster than ever before.

What's Next: Don't invest in any device until you find the right person to use it. An inexperienced technician or diagnostician can do more harm than good. For example, when dermoscopy magnification was new, studies showed that when inexperienced people used it, the results were worse than when a physician did an examination with the naked eye, says Rao, who owns a private practice in Manhattan.

Artificial medicine
Heart, liver, lung, pancreas, bladder, ovary: Scientists continue to pursue advances in artificial organs.

"We think that there are going to be a series of products that will become more and more sophisticated," says Aaron Kowalski, PhD, assistant vice president for glucose control research at the Juvenile Diabetes Research Foundation. He also leads JDRF's artificial pancreas project.

The artificial pancreas would help diabetics control their disease, as it reacts to changing glucose levels and delivers the right amount of insulin at the right time. It builds on two already-approved devices—the insulin pump and the continuous glucose monitor, or CGM. But unlike an open-loop system in which the patient is responsible for testing, reading data, and taking corrective action, the automatic closed-loop pancreas would use a control algorithm to read and interpret the information from the device and respond by dispensing insulin when needed.

The device would be particularly helpful at times when patients are most at risk, such as when they are sleeping and more likely to miss a CGM alarm. In such a case, the system would automatically intervene.

What's Next:Although the ultimate goal is to find a cure for any disease or condition, including diabetes, there are a number of near-term advances that will serve as bridges, Kowalski says. "These intermediary steps are important while we fight to get to the end of the disease—to a cure. When you're living with a condition, you want something now . . . even if it's not perfect."

Costs, benefits, and opportunities
Unlike in other industries, where advances in technology reduce costs (self-check-in kiosks at airports, for example), new devices and treatments typically drive up healthcare costs. A new PET scanner is a big investment, UCLA's Feinberg says. It also results in earlier diagnoses and more people getting treatment—and that drives up healthcare costs, as well. Someday colonoscopies will be performed by a pill you swallow, he says. But that means there will be more diagnoses of colon cancer, that those people will need further treatment, and that costs will go up.

On the other hand, says Sacred Heart's Ronstom, "Technology is going to be part of the answer for healthcare costs, because we're going to get quicker diagnosis, earlier intervention, and better safety."

"We had to justify [investing in the smart OR] in every way—not only to the hospital administrators, but to the board and the hospital owners as well," says Thapar. The benefit to patient care is obvious, but other benefits are demonstrable, too, from financial to quality of care to recruitment to marketing. "When you add it up from an accounting perspective," Ronstrom says, "we've done very well."

There's a fundamental question about the dollar value of preventing an error, an infection, a patient fall, or even a death, says Barry Rabner, president and CEO of the 477-licensed-bed Princeton (NJ) HealthCare System. "Every design solution that reduces or eliminates a problem has a cost, and finite resources make design decisions very challenging."