Attendees of the Virtual Engineering Week keynote, “Mayo Clinic 2030: Hospital of the Future,” got a glimpse of healthcare’s future. Mark Wehde, chair, Mayo Clinic Division of Engineering, explored the increasing digitalization of healthcare and how it could lead to more patient-centric care. Mayo Clinic’s 2030 Bold Forward plan is one such effort. “The plan recognizes that digital transformation is the key to our future, and digital platforms will be crucial to enable us to provide better care to more patients. We are well into the beginning of the fourth industrial revolution—this is the digital platform revolution. Healthcare is shifting from a traditional hospital-centric care model to a more virtual distributed care model that heavily leverages the latest technologies around artificial intelligence, deep learning, data analytics, genomics, home-based healthcare, robotics, and 3D printing of tissues and implants.”
This digital transformation will depend in part on data. Wehde said that data analytics in its simplest form is analyzing data to identify trends and answer questions. “If you think about all the data in a typical electronic medical record, data analytics is going allow us to present this information in a way that is useful to the care provider. And of course we going to be using wearables to track health status and predict future health states. And one of the huge applications of AI leverages the strength of AI in traditional pattern recognition systems to analyze CT and MR images, and this will be a huge support system for radiologists.”
Looking at “longitudinal patient data sets—data across time—will allow us to integrate medical data, financial data, and data from home and self-monitoring sources, and we will be able to do this over a patient’s entire life,” Wehde said. “We’re going to have data from home monitoring so we can make changes on the fly, and the explosion of wearable consumer devices will lead to development of wearable medical devices over the next decade.”
The Internet of Medical Things (IoMT) has been enabled by the development of wireless sensors, nanotechnology, and the continuous miniaturization of electronics, Wehde said. “It is now possible to connect to these personal digital devices, medical devices, implants, and other sensors all together. Patients can upload data to the cloud, and telehealth will enable patients to send all this data to physicians to remotely diagnose disease, he said.
Driving the growth of data analytics is the reduced cost of storing data and unlimited storage, he said.
Healthcare has already amassed a considerable amount of data—well over 2 zettabytes worth of health data, Wehde said. There is so much data that “doctors are drowning in information, and they cannot find the information they need,” he said. “Healthcare hasn’t done well in managing data, but we are catching up.” He said that it has taken healthcare a lot longer to take advantage of big data partly because of complexities, regulations, privacy, and fragmented and highly invested incumbents such as major healthcare systems, insurers, EMR providers, and government agencies.
Artificial intelligence assistance could help with data analysis. “People are always going to be involved in providing oversight and review, but AI systems most likely will be adjuncts helping make the physicians’ and healthcare providers’ jobs easier.”
In addition, “we need to figure out who owns data—is it you, is it your healthcare provider, is it your insurance company, or is it the government—to really make use of the power of data we are going to have to figure that out.”
Additive manufacturing could help deliver personalized medicine. Mayo Clinic’s history in 3D printing is deep—in 2006 a Mayo team developed 3D-printed models to help surgeons successfully separate conjoined twins. The lead surgeon had asked if the clinic could provide 3D-printed models of the organs that needed to be separated. The models helped surgeons visualize the internal structures of the organs.
In 2013 Mayo created a dedicated anatomical modeling lab using 3D printing and polymers and metals and is now making 3000 models per year. These models can be used to make custom cutting guides for surgeons as well as help orthopedic surgeons design new implants.
Mayo Engineering is planning “our next adventure in 3D printing with a titanium printer,” Wehde said. “We are hoping to be printing custom implants for animal trials and human clinical trials over the next couple years.”
Advances over the last few years have really made custom implants a viable possibility. “We plan on working with FDA to address some of the regulatory challenges," he said. "Mayo Clinic is poised to be on the forefront of moving personalized medicine into custom implants.”
The global 3D printing medical device market is expected to generate over $2 Billion in revenue by the end of 2024, he said. “Manufacturers use 3D printers to make inexpensive medical devices like spine cages or cranial implants. We also use these printers to create patient-specific implants utilizing CT or MR scans for use in complicated surgical procedures,” he explained.
Currently, 3D printing of patient-specific implants is expensive and time consuming, he said. “Putting an additive manufacturing facility at the point of care will save time and money and will drive innovation by putting technologists and engineers and clinicians all together in a collaborative environment.”
“Robotic surgery as it exists today is primarily an assistive technology for the surgeon,” said Wehde. “In the future these systems will be a lot more autonomous. We are likely to see a surgeon in a healthcare epicenter monitoring and directing surgeries around the world.”
Changes in healthcare will be driven by technology and to some extent by our changing demographics, said Wehde. By 2050, there will be 10 billion people on the planet, 2 billion of whom will be age 60 and older, with 500 million over the age of 80, he noted.
We are also seeing a dramatic shortage of healthcare providers. “The physician shortage is expected to reach 85,000 in the United States by 2032 due to the complexities of training, the aging population, and the associated retirements,” he said. “We really need to rethink how we train physicians and caregivers and how we provide care because this simply isn’t a sustainable model.”
Wehde said that the hospital of the future will be in patients’ homes and in their communities, providing care based on continuous healing relationships—"providing care whenever and wherever it is needed, not just in face to face visits,” he said. “Healthcare is going to be delivered as a seamless continuum of care, away from the clinic-centered point of care model with a greater focus on prevention and early intervention,” he added.
Change will be a challenge. Healthcare “is a complicated system with unnecessary duplication, long waits, and disorganized knowledge, and it is designed for episodic care, whereas most disease is chronic,” he noted.