2016 saw an increase in the adoption of medical technology innovations aimed at tackling some of the most intractable healthcare challenges. Our first blog of 2017 shares the Centre’s view of the top 12 innovations (in alphabetical order) that we believe will have the greatest impact on the continued transformation of healthcare.

1. 3D Printing is poised to make a big impact in 2017 - and is expected to be worth $1.2 billion by 2020. The first 3D-printed prescription drug received FDA approval in 2015 and medical devices made from 3D printing now include instruments used for surgery or devices implanted into patients. End-use parts, like surgical tools and device implants will become more common in 2017 as sophisticated metal materials for 3D printing are refined and gain approval for human contact. By 2019, 3D printing is expected to be a central tool in roughly one-third of surgical procedures involving prosthetic and implanted devices.ⁱ

2. Increased use of 3D visualisation and augmented reality for surgery - In 2016, two of the most intricate surgical practices, ophthalmology and neurology, began experimenting with 3D visual representations of their patients enabling them to operate more effectively and efficiently while also giving medical trainees a clear picture of what they're doing. Augmented reality glasses that display holographic images of human anatomy could also bring the end of cadaver labs at medical schools. Meanwhile virtual reality is also being used to accelerate behaviour change in patients in a way that is safer, more convenient, and more accessible.ⁱⁱ

3. Artificial intelligence (AI), predictive analysis and machine learning are developing in new areas - AI is starting to demonstrate the kind of impact it can have in medicine from accurately interpreting patient records including pathology slides, x-rays, skin lesions and scientific literature. These highly advanced AI systems are capable of employing deep learning algorithms to sort through massive amounts of structured and unstructured data to automatically detect, diagnose and suggest treatments regimes for medical conditions. There are numerous start-up companies working on AI applications in healthcare, with the engagement of the major technology companies who have all made major investments in this the space. A recent 60 Minutes US news segment suggested that AI could find an evidence-based therapy for 30 per cent of patients with cancer that was not identified by their oncologists.ⁱⁱⁱ

4. Blockchain is starting to transform healthcare - blockchain can help organisations bridge traditional data silos, dramatically increase IT and organisational efficiencies, keep business and medical data secure, and streamline patients’ access to medical data. Blockchain offers "long data" as opposed to big data, capturing a full history of a patient's health. A 2016 IBM survey of 200 healthcare executives in 16 countries found that 16 per cent expect to have a commercial blockchain solution at scale in 2017. These companies expect the greatest blockchain benefits in three areas: clinical trial records, regulatory compliance, and medical/health records. They also anticipate widespread business model innovation but believe that regulatory constraints will keep new competitors and models in check.

5. Diabetes drugs and advanced monitoring technology will reduce complications and improve the management of diabetes - Experts predict 2017 could bring a shift in the medicines prescribed and ways of managing type 2 diabetes. Glucose sensing technology is advancing, moving away from low-tech finger pricks of the past to continuous glucose monitoring where a sensor is placed beneath the diabetic’s skin in the abdomen region and could dramatically reduce spikes in glucose levels. These monitoring technologies then link to medication administration devices, and often utilise mobile apps for sharing readings with physician as well as caregivers.^iv

6. Drones, will play an increasingly important role in bringing medical care to people in emergencies - helping to link remote communities with distant clinics, and delivering blood, vaccines and other medical products and patient samples to and from regional hospitals.^v For example a drone could transport an emergency medical kit along with say smart ‘glasses’ to people stranded in hard to reach places. A person attending the injured individual can then connect to a remote physician who can see the scene and guide treatment until paramedics get there. Another example is a drone that can transport patient samples or medical supplies over distances, using a drone that is fully automated, taking off, flying to its destination, and landing all on its own. This is already happening in Madagascar^vi, but regulatory restrictions in many parts of the world don’t yet permit autonomous flying devices.

7. Gamification will come into its own as a healthcare tool - The 2016 worldwide phenomenon, Pokemon Go, showed how a game could be used to encourage people to get outside and become more active. This success is likely to lead to new ‘video games’ being used in 2017 to impact on people’s behaviors and actions. For example, creating healthcare-facing games that feel like, actual video games, can make rehabilitation exercises fun or simulate surgery functions.

8. Liquid biopsies will improve cancer detection and measurement of treatment responses - Analysing tumor genetics is enabling the development of targeted cancer drugs and ushering in the era of less toxic “precision” medicine. More specifically "liquid biopsies” are blood tests that uncover signs of highly abundant cell-free circulating tumor DNA which is shed from a tumor into the bloodstream.^vii Several companies are developing testing kits expected to hit the market in 2017. Liquid biopsies are also hailed as a flagship technology of the Cancer Moonshot Initiative, a national effort across the US aimed at ending cancer.^viii It remains to be seen whether a liquid biopsy will provide accurate detection, but the benefits over solid tissue biopsy include being less expensive and risky.

9. The microbiome will be used to prevent, diagnose and treat disease - the human microbiome is a community of trillions of bacteria, archaea, viruses and other microbes that are an integral for human physiology, including supporting vitamin production and helping provide an efficient immune response. However, unlike their fixed genome, people’s microbiome changes constantly, in response to changes in their environment. Scientific advances during the past fifteen years, among them the Human Microbiome Project, increased our understanding of the interaction between people and their microbiome. Biotech companies are increasingly looking at the microbiome's potential to develop new diagnostics or therapies and probiotic products to prevent microbe imbalances. Over the next 12 months the microbiome is likely to establish itself as one of the health care industry's most promising markets.^ix

10. Use of Point-of-care (POC) diagnostics will accelerate - The growth of boundary-less hospitals and community care is increasing the need for rapid results outside of the clinical setting. Key factors include the increasing prevalence of lifestyle and infectious diseases and a move towards home healthcare. 70 per cent of POC testing takes place in provider locations and experts predict this will grow at an average of 15.5 per cent each year.^x POC testing delivers precision medicine that will both improve quality and affordability of care at a time when outcomes-based medicine is the new model for healthcare. Providing faster access to test results expedites speed of diagnosis and treatment and can reduce unnecessary hospital associated costs. The ability of POC to rapidly and inexpensively diagnose a significant number of infectious diseases is increasing, with the list now including HIV, human papillomavirus and influenza , to name but a few.

11. Demand for surgical, rehabilitation, and hospital robots will continue to rise - Driven by declining costs, labour shortages, and successful pilot projects; healthcare robots deployed in the years ahead will be involved in surgery, hospital logistics, disinfection, nursing, exoskeletal rehabilitation and prosthetic limbs. Forecasts suggest that healthcare robot shipments will increase from approximately 3,400 units sold annually in 2016, to more than 10,500 units per year by 2021, representing an increase in revenues from $1.7 billion to £2.1 billion over the same time period.^xi

12. The adoption of telemedicine will be mainstreamed - with an explosion in easy-to-use, clinical grade, consumer-facing devices that allow patients to administer readings on themselves and which can then be used (and trusted) by care providers. These advances in consumer-facing medical devices will increase the quality of care that is able to be delivered via these remote systems. Telemedicine also allows those who are homebound and/or geographically isolated, to obtain access to the medical attention they need.

While predicting the future is by its nature challenging, one thing all the above predictions have in common is that the developments are made possible by the advances in technology and the emergence of new collaborations and partnerships. I believe that 2017 is truly at a tipping point with new opportunities to deliver solutions that diagnose needs and inform care decisions, improve care delivery and enable more comprehensive care management. The Centre will continue to monitor these innovations and plans to revisit them in more detailed blog posts over the course of the year.

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ⁱ http://medcitynews.com/2016/12/3d-printing-impact-healthcare/
ⁱⁱ https://www.youtube.com/watch?v=irs453Tf-2s
ⁱⁱⁱ http://www.cbsnews.com/news/artificial-intelligence-making-a-difference-in-cancer-care/
^iv http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/treatment/txc-20169988
^v http://insideunmannedsystems.com/drones-deliver-healthcare/ and http://medcitynews.com/2016/12/emergencies-drones-can-help-deliver-medical-supplies-even-google-glass/
^vi http://www.digitaltrends.com/cool-tech/drones-healthcare-madagascar/
^vii https://www.cancer.gov/news-events/cancer-currents-blog/2016/asco-liquid-biopsy
^viii https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative
^ix https://techcrunch.com/2016/08/03/how-the-microbiome-will-lead-a-revolution-in-the-consumerization-of-personalized-medicine-and-diet/
^x https://www.researchgate.net/publication/6758161_Poised_for_growth_Point-of-care_testing
^xi https://www.tractica.com/newsroom/press-releases/healthcare-robot-shipments-to-surpass-10000-units-annually-by-2021/