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The Technology Contribution to the Future of Preventive Medicine Richard M. Satava, MD FACS Professor of Surgery Yale University School of Medicine New Haven, CT 06510 [email protected] Technologies that Change Healthcare Devices for diagnosis and treatment Pharmacological for prevention and treatment agents Information tools for coordination, analysis and dissemination of preventive health information The 5 P’s of the Future of Medicine Predictive - Genetics, allergies, specific medications Preventive - Acting proactively with preventive medicine Point of care - Mobile communications & ubiquitous computing Parametric - Multiple parameters, over time, referenced to patient’s own baseline, compared to standard model Personalized -Individual treatment for each patient SATAVA 7 July, 1999 DARPA The 5 P’s of the Future of Medicine Predictive With genetic screening, epidemiology and population analysis it will be possible to focus preventive health efforts on those most highly at risk The 5 P’s of the Future of Medicine Preventive By identifying those populations and individuals who are at risk, medical education, screening and treatments can become more proactive. The 5 P’s of the Future of Medicine Parametric Collecting multiple parameters over time determining the change over time (which is more critical than isolated measurements) Comparing that change to the person’s own baseline in the past Final interpretation of these changes relative to a population standard for age, sex, race, etc. The 5 P’s of the Future of Medicine Point-of-care Continually monitoring all relevant parameters in an unobtrusive manner wherever it is most convenient, including the home and work place The 5 P’s of the Future of Medicine Personalized Customizing healthcare by time, dose and method of application so that each individual has the SPECIFIC treatment for their needs Genetic Chips DNA based genetic screening devices will permit the accurate genetic profiling of susceptibilities Figure 1 - Gene Chip (Affymetrix, Inc, Santa Clara, CA) Genetic Engineering Direct the cells to fight disease rather than proscribe drugs Extend potential life span beyond 120 - 130 years Micro-sensors and nanotechnology Brings the ability to detect and monitor disease down to the practical and point-of-care level Figure 2. Micro-chip embedded into watches (Polar, Inc. Australia) Figure 3 Non-invasive blood glucose sensor (MiniMed, Inc, Northridge, CA) Hand-held imaging Provides point-of-care diagnosis of anatomic and structural abnormalities with the capability of remote transmission of images Figure 4 Hand-held ultrasound (SonoSite, Inc, Bothwell, WA) Medical Informatics Powerful information tools will permit data acquisition decision support information distribution/storage ubiquitous access distant education CONCLUSION Technology will shift healthcare from acute, emergent care to proactive preventive health