Re-imagining the Doctor & # 39; s Black Bag | Asian Scientist Magazine



AsianScientist (September 3, 2018) – By Jeremy Lim – Two hundred years ago almost everything the medical world had to offer could be found in a doctor's black bag. Patients who could afford it, doctors had come to their home to diagnose and treat ailments; where they would then recover in their own home. As a result, hospitals were few and far between, and usually focused on the poor.

The arrival of medical technology such as X-ray machines, MRI scanners and laboratory diagnostics changed the way health care was delivered. People now had a reason to go to clinics and hospitals, where they could access services that could no longer be delivered to the door.

Today, medicine is undergoing another paradigm shift, again driven by technology. Three technological trends will be jointly transformative: miniaturization, connectivity and machine learning. Through miniaturization, medical devices have shrunk to many more portable (or even portable) sizes; improved connectivity means that data can be transmitted to medical professionals anywhere in the world, enabling remote health care; and algorithms for machine learning assist physicians in diagnosing diseases and recommend treatments more accurately and efficiently. The result is that quality health care now has the potential to reach more people than ever before.

This progress is badly needed. According to a report from the World Bank and the World Health Organization, half of the world's population still has no access to essential health services, with 100 million people experiencing financial catastrophe each year as a result of healthcare costs. In the meantime, developed diseases such as heart disease and diabetes are developing in developed countries such as Singapore. Rapid aging of the population places health care systems under tremendous stress.

Startups: flying lessons for light aircraft (with a lot of fuel!)

Technology-driven transformation opens up unprecedented opportunities for tackling global health challenges, and entrepreneurs play an important role in bringing innovations to the market that will provide more people with access to better healthcare at lower prices.

With their flexibility and speed I think of startups as the light plane of the health care system. They have the potential to fundamentally change the world of medicine. Yet many and many young companies crash before they earn their wings.

I meet many young entrepreneurs who have developed smart new devices or apps, but it is often unclear what problem their technology is meant to solve. To commit themselves to success, startups need to develop solutions to solve problems instead of looking for problems that match their solutions. Doing the first requires closer collaboration between clinical practitioners, who have a laundry list of problems worth dissolving, and technology developers who have the technical know-how to address these problems in new ways that clinical practitioners can not even propose.

Secondly, healthcare startups (and their investors) must plan for a sufficiently long runway to develop not only their technology, but also to identify issues related to regulatory approval and reimbursement. Barriers to access to health care are very high; in my experience, many startups that are based on good ideas often fail because they are too optimistic about how long it would take to get regulatory approval and commercial traction.

No risk, no reward

Startups in the healthcare sector represent a unique paradox. Although medicine is defined by innovation and constant change, it is also very conservative, and rightly so – you would not always want to be a guinea pig for the latest experimental therapy every time you visit your doctor. That said, if medicine wants to take advantage of new technology paradigms, health regulators should also consider themselves industry aficionados, encourage innovation and strike a balance between safety and an acceptable risk level.

If someone can get this balance, it is Singapore. Unlike many countries where the regulatory system often results in binary yes-or-no statements, Singapore – with its small size and ability to collect and analyze data in a robust way – can afford to put many options in between. to take over.

A precedent for this is the regulation of the Viru drug for erectile dysfunction. When Viagra was first approved for use in Singapore at the end of the nineties, it could only be prescribed by urologists and (due to its effect on blood pressure) only to patients who had undergone a cardiac assessment.

After having monitored the situation for some time, the health regulators found that the drug was relatively safe and they dropped the need for cardiac assessments. Finally, the provision was also lifted that Viagra could only be prescribed by urologists; today you can buy the small blue pills from general practitioners. This example, although perhaps somewhat erratic, illustrates the continuum of policy options that regulators may consider to enable innovation.

The new doctors barefoot

The journey from the couch to the bed is usually long and difficult. Given the potential impact of technology on global health problems, medical entrepreneurs, investors, healthcare professionals and regulators must work together to create sufficient room for technological innovation within the health care ecosystem.

During the Cultural Revolution of China in the sixties, Mao Zedong started a program in which village representatives were trained in the basic health care system, provided with rudimentary equipment and sent back to their villages to practice medicine. In spite of the simplicity and the low cost of the program, these doctors turned out to be barefoot & # 39; remarkably effective in improving health in rural China.

Consider how much more effective these healthcare workers today would be if we arm them with smartphones, portable diagnostic devices, and access to cloud-based, AI-controlled guidance systems. Even in the most remote areas, the barefoot 2.0 doctor has a super power: the ability to tap a wealth of medical expertise from all over the world. For the 3.5 billion people who still do not have access to primary health care, the black bag of this doctor really makes a difference.

Asian Scientist Magazine is a content partner of SGInnovate.

Copyright: SGInnovate. Read the original article here; Photo: Cyril Ng / SGInnovate.
Disclaimer: this article does not necessarily reflect the opinion of AsianScientist or its staff.


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