3 Questions – 3 Answers: Bioviva

A new format starts here on the blog: The 2b AHEAD expert network in dialogue. Health experts regularly raise relevant questions on the future of health. Other experts from our network comment on this – and in turn ask new questions that will go to new experts. In this way, an inspiring dialogue grows and we will continue to expand it. Would you like to become a part of it? Just send me a short mail or comment here.

In the focus today: Liz Parish and Avi Roy from Bioviva

The expert questions today go to Liz Parrish, founder and CEO of Bioviva, and Avi Roy, CTO of Bioviva. Bioviva is one of the pioneers of telomerase – or to describe the result: Bioviva is working to prolong human life by intervening in the genetic code. Significantly prolonging it. Bioviva’s research focuses on the ageing processes of individual cells. Parrish, Roy & Team are among the most important drivers of the longevity movement.

Success-based medicine

Peter Ohnemus, DacadooPeter Ohnemus, Founder and CEO of dacadoo: With digital health, the proof of positive outcomes of drugs can be fully documented. When do we want to start designing a 100% outcome-based healthcare system?

 

Liz Parrish, BiovivaLiz Parrish, Founder and CEO of Bioviva: We do not have any evidence to support the claim the ‘digital health’ can absolutely prove positive (or negative) outcomes for drug trials. Most molecular and physiological biomarkers are hard to measure digitally without having an advanced molecular pathology lab. But regardless, your question regarding the outcome-based healthcare system is a valid one. Currently, in the UK the National Institute for Health and Care Excellence (NICE) balances the choices of medicines available to patients based on a multifactorial assessment of cost-effectiveness, opportunity costs associated with decisions, and the impact of treatment option on quality-adjusted life years (QALY). QALY’s and disability-adjusted life years (DALY) are the main outcome-based method to test the efficacy of a treatment in a healthcare system. Although flawed this is currently considered the gold standard by health economists and politicians. In conclusion, all countries that can afford to have a functioning health care system try to assess the efficacy of treatments based on outcomes, but the biomedical science community need to provide them with better biomarkers than QALY and DALY’s.

Who do we trust?

Arkadiusz Miernik, Universität FreiburgProfessor Arkadiusz Miernik, Freiburg University:  Should we trust the big pharmaceutical companies or rather biohackers in the future?

 

 

Liz Parrish 2, BiovivaLiz Parrish: We think that it is foolish to blindly trust any organisation or system. At BioViva we really like the Russian proverb, which was used by President Ronald Reagan on many occasions, “Trust but verify.” To elaborate, we are building a standardized bioinformatics testing platform which will test the efficacy of anti-ageing treatments regardless of them being produced by big pharmaceutical companies, or small biotech startups, or indeed biohackers.

Consequences for the immune system

Florina Speth, 2b AHEADFlorina Speth, Senior Researcher, 2b AHEAD ThinkTank: How does our immune system react when we continuously and permanently prevent diseases?

 

Avi Roy, BiovivaAvi Roy, CTO, Bioviva: Dr Speth, I am not quite sure that I understand your question, but I’ll try to answer it. In biogerontological research, and at bioviva we are trying to rejuvenate the human body and its organs and tissues at a cellular level. Our research and therapeutics target the hallmarks of cellular ageing which includes genomic instability, telomere attrition, epigenetic alteration, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication.  these processes happen in every cell type in the human body. when we think about treating a disease we are not necessarily thinking about cardiovascular disease or dementia instead we are targeting these fundamental cellular processes that go awry overtime. Therefore immune system cells will be beneficially affected by these anti-ageing treatments and would produce favourable outcomes. We imagine a future where we can rejuvenate long live cells, kill cells that are senescent or cancerous, and create new functional cells from stem cells.

The immature patient has had his day

The roles of doctor and patient in the future: What was the immature patient yesterday has long since changed. The one who just had to wait patiently and yield to the judgement of the only competent expert in white is no longer satisfied with this role. Or at least should not do it anymore. See below for counter-examples.

Steven Joffe from the University of Pennsylvania has just described in a pleasingly differentiated and clear article how the three factors of patient rights, available knowledge and direct-to-consumer tests have lastingly changed the doctor-patient relationship. He outlines how the immature patient comes to eye level. Joffe’s article deserves an urgent reading recommendation. It is hereby pronounced.

Three factors
  • Factor 1: Patient rights. For the first time ever, their formulation has led to the claim of patients to have their own opinion, their own decision and the corresponding information provided by the physician.
  • Factor 2: The Internet as a constantly growing source of medical knowledge.
  • Factor 3: The increasing availability of medical tests with scientific requirements directly for patients. We have already discussed this new role for laboratories with the associated business models on various occasions here and here. Joffe clearly emphasizes the impact of this development on the entire healthcare system.

For the sake of precision, we are talking here exclusively about the doctor-patient relationship between practicing physicians. The immature patient of the hospital is a similar but more complex subject. I will take up this point at a later date.

A contemporary role of the doctor

Joffe shows how, on the one hand, our traditional image of roles in health care is still very much alive. Here is the expert whose judgement is to be followed. There the receiving patient. On the other hand, Joffe demonstrates how these roles already lose their justification.

The contemporary and forward-looking role of doctors is therefore threefold:

  • The doctor as the patient’s advisor and health coach,
  • the gatekeeper for advanced medical knowledge and special testing, and
  • Finally, access to optimal follow-up services. That is, the medically necessary, although perhaps not directly required of the patient. Here, the doctor is the one who has an overview of the consequences of an illness and treatment. Who, on his own initiative, is committed to what is medically necessary – and in this way creates added value.

So much for the present.

Second opinion at Yahoo?

However, this present also includes this picture from a doctor’s office, which has been circulating on Twitter these days and has received thousands of approvals within a very short time:

 

The immature patient - Dr. Google must stay outside
The sign reads: “Patients who have already received their diagnosis via google are asked to obtain a second opinion not from us, but from yahoo.”

 

The reaction: several thousand likes, hundreds of comments along a line “Patients can be so annoying if they don’t trust the doctor’s diagnosis”. Yes, they are, at least for perceived half- and three-quarter gods in white. Is a doctor afraid of patients who want to take responsibility for themselves? In any case, he has difficulties with setting commas in the4 German language. But there is always something.

Those who hang up such signs in their practice deny their patients much more than just the ability to search the Internet for specific health information. With the reference to Yahoo, the poster looks like it did in the year 2000. The mentality behind it is much older; it goes back deep to the last century.

Counter-question: Who seriously wanted to recommend to a patient to rely exclusively on the knowledge that a single expert reproduces from his memory within a few minutes? With an effort of research, limited by the time that the health care system is currently paying.

A future-oriented role for the physician

Even more important from the point of view of futurology is the question of how to continue the series of trends and drivers:

Patient rights, available high-quality knowledge and B2C test procedures are followed at least by

  • Artificial intelligence in everyday use by doctor and patient,
  • an exponentially growing database in type and quantity,
  • large international players who are entering the healthcare market and claim a competent role here,
  • more and more: an interpretation of biology and medicine as information technology.

On this basis we then negotiate the roles between health seeker (ex-patient) and competent companion, supporter and initiator (ex-physician). The immature patient has had his day.

 

The healthy pace: Alexa vs. card

Two messages that @medinfode pointed out this week: Alexa learns diagnostics and the German Handelsblatt reports a breakthrough in electronic patient records. In their random juxtaposition, they form a lesson about the importance of speed: the healthy pace makes the healthcare of the future.

Doctor Alexa

Message one: Amazon is working on Alexa recognizing possible diseases by the human voice. I have already reported on similar approaches in connection with Beyond Verbal. And Amazon is already in the spotlight here in the blog as one of the key players in healthcare. As early as 2017, Amazon applied for the corresponding patent on the algorithm. Now this has been granted. In a nutshell: It is well known that Alexa constantly listens to what happens in the environment of the smart loudspeakers. With this development step at stake, Amazon is moving on to scanning the voices of the environment for diseases: Coughs and sniffles, but apparently also depressions. We futurologists have long predicted this: emotion becomes a natural part of data collection and analysis.

The benefits for Amazon are obvious. Anyone who knows the physical sensation of a person can address him personally at a decisive point. If you hear coughing, you can play out personalized advertising. And what’s more, they can also suggest orders and sell healing products. And, by the way, this creates an almost perfect usecase for models with ultra-short delivery times. DocMorris is currently advertising its online services nationwide with the slogan “Those who should stay in bed should not have to go to the pharmacy”. This logic is already outdated here: If you have the right smart speaker, you don’t even have to go to your online pharmacy.

Doctor with card

The other success message – and yes, it is a success message: The most important players in self-administration in the health care system of Germany have agreed on a policy paper that should provide us with a first form of the electronic health card for everyday use by 2021. This is a) more than has been achieved in the past 15 years. But that’s b) just exactly what it is: a paper. We have agreed on what the doctor´s associations should process and what the Gematik should process.

The key data sound promising: the patient retains sovereignty over the data. We at 2b AHEAD predicted in a large study as early as 2015 that this is where the future lies. Uniform standards should ensure broad application. And at least the Federal Minister of Health can already be quoted with the statement that the card is after all only one of potentially many access routes. The network structure in the background is decisive. And the health insurances publicly agree: A deviation is no longer possible without loss of face. On the other hand, who hasn’t actually lost face in the years since 2004? No one has been disturbed yet.

The healthy pace

And here is the connection: The one factor that is repeatedly underestimated in prognoses on artificial intelligence is its learning speed. Once in the world, the growth of performance continues to accelerate. Prerequisite: A sufficient amount of data is generated in the system. The fact that this is the case is unlikely to be seriously debated with Alexas’ market penetration. The forecast is characterized by a healthy pace. Some people program network standards, while others use algorithms to evaluate large amounts of data. Some are imposing sanctions on doctors to purchase suitable reading devices, others are having algorithms evaluate large amounts of data. Some hope for Gematik’s first successfully completed project, others have algorithms evaluate large amounts of data.

Who wins? Exactly.

No cyborgs! Amazon positions itself

Andrew Bosworth, head of VR at Amazon, has made his view of the future of mankind transparent: “We don’t have any projects involving implants. We don’t build cyborgs.” Superpowers yes, but no cyborgs.

 

Like all major tech companies, Amazon is also working intensively on projects for the future of healthcare. Andrew Bosworth emphasizes the importance he attaches to expanding human vision. The priority of VR and AR technology is correspondingly high. In the current interview, Bosworth announces a pair of glasses that we can wear every day, using additional third party information. Amazon is committed to expanding human capabilities. But this expansion takes place outside the body. Amazon is thus positioning itself among those who are striving for a non-invasive human evolution.

GAFA goes Healthcare

No cyborgs, or just yet – the big tech groups are clearly working on their role in the healthcare of the future. The focal points are quite different. At Microsoft, health boss Simon Kos is driving the development in the direction of networking medicine and care. The company is striving for a central role in the classic medical sector and beyond. Simon Kos outlined the key points during his keynote speech at the 2b AHEAD Future Congress in Wolfsburg in June 2018. The video is available here.

Simon Kos, Microsoft, and Michael Carl, 2b AHEAD
© www.AndreasLander.de

Apple is focusing more on the development of its own technology. Cupertino is upgrading its staff and has just strengthened the functionalities of its own devices, above all the Apple Watch. Here, the already hermetically closed ecosystem is being expanded step by step, with a focus on the collection of vital data. The diagnosis being the expansion stage.

 

Google, on the other hand, has long since set an accent in medical-scientific research. The video with Andrew Conrad is legendary; targeted acquisitions expand the portfolio.

 

Elon Musk, who, strictly speaking, is not a member of the GAFA family, plays a remarkable role here. He obviously has nothing to do with a “no cyborgs”-claim. On the contrary, his impulses point strongly in the direction of digital armament for humans. He stresses at every opportunity that this is our only protection against the ever more powerful artificial intelligence. Only the intentional expansion of the human body will prevent us from becoming the cute domestic cat of artificial intelligence. I described the details and the state of development in detail in a trend analysis published here by 2b AHEAD last summer.

 

Healthcare of the Future (2/2)

In the summer of 2018, I gave the keynote speech at the Roche Days “Diagnostics in Dialogue”. I then noted a few very basic thoughts on the healthcare of the future. They have just been published by Roche. The first part is here; this is the second part of the slightly shortened text.

From patients to healthcare customers

Data-based knowledge of people’s sensitivities will also blur the boundaries between illness and health. The fact that people are not either 100 percent healthy or ill is not a new idea for the healthcare of the future. However, the broad data basis makes it possible not only to discover existing diseases. In the future, healthy people will also know a lot about the risks of potential diseases. This in turn raises the question of where the line between healthy and sick lies. The WHO defines health as a state of physical, emotional, mental and social well-being that goes far beyond the absence of illness or complaints. A forward-looking understanding.

Today’s patients depend on the data collection, evaluation and interpretation of their attending physician. In their perception, they are dependent on him. Patients of the future have the largest amount of data on their own health status and have access to their evaluation and interpretation. While classical patients look towards illness, symptoms and deficits, future customers focus on health. Patients become health customers.

Customers look for suitable service providers

Health customers are changing the health market with their attitude. They choose the right health service provider to optimize their state of health. Its attractiveness will depend on the added value it can deliver. It will be crucial for the successful service providers of the healthcare of the future to know exactly what the needs of potential customers are. They will analyse how each of their healthcare customers “ticks”, what their needs and expectations are and how best to communicate.

In the sense of “optimized” health, technologies could also be used in the world of tomorrow to expand or fully maintain bodily functions: The contact lens displays necessary information when needed. New organs are created in the 3D printer from the patient’s stem cells. Perhaps it will also be completely normal to order organ replacement from the doctor long before the first organ resigns.

Healthcare of the Future Michael Carl

Human – Machine Organisms

In the future, personal interaction will lose its central role today. People will increasingly experience that a machine simply understands them better. Communication with machines can be superior precisely because it follows clear structures and takes into account a multitude of data and parameters. If we continue to consistently think ahead, computers could become personal assistance systems that make calls on behalf of their owners, obtain information and offers at a frequency and perseverance that people would not be able to. Service providers in the healthcare of the future will have to adapt to this.

As a result, the way work is done will change completely. Where today we are talking about interfaces between man and machine, in the future we will look at man-machine organisms. In learning systems, algorithms will emancipate themselves as human tools. They will become de facto fully-fledged team members and will even take on management tasks.

New way of thinking

All these changes require a fundamentally new way of thinking and thus a change in corporate culture. In order to do justice to the possibilities and progress of digitalisation in the healthcare of the future, we must fundamentally rethink our ideas of values, quality and dealing with mistakes. Our way of thinking so far does not allow us to keep pace with the exponential pace of change. We must not just wait and see. We must act, even if we exceed our competencies and avoid good intentions. In the world of tomorrow, the maxim applies: Better to apologize afterwards than to ask for permission beforehand.

The Future of Healthcare (1/2)

In the summer, I gave a keynote speech at the Roche Days “Diagnostics in Dialogue”. Afterwards, I wrote down some very basic considerations about the future of healthcare. They just appeared in a Roche publication. This is the first part of the slightly shortened text.

The feeling that the world is turning faster and faster is not deceptive. The familiar linear and controlled pace of development is increasingly becoming a thing of the past. Our environment is changing exponentially – one could actually say that our world will never again develop as slowly as it does today. This development will be driven by the large amount of data available – also in the future of healthcare.

Internet of Everything

Today’s idea of data composition and data quality is generally too narrow. Technology experts confirm: By 2020 at the latest, thoughts and sensations will also be part of everyday data. Even today, electrodes can read brain waves used by paraplegic people to steer their wheelchairs. In a few years’ time, electrodes will no longer be attached directly to the patient’s head, but sensors will read our thoughts from a meter away.

Every object of everyday use will potentially be connected to the Internet and networked – the chair on which we sit, our refrigerator or our car. In the so-called Internet of Everything, not only computers, laptops, tablets and smartphones are connected to each other, but also intelligent machines that generate additional data. For tomorrow’s children, the phrase “I’m going online” is incomprehensible, since it would mean that they were offline before.

Networking large amounts of data leads to highly adaptive products that can adapt to the individual, changing needs of people. This especially applies to the future of healthcare: Recorded data from smartphone apps, sensors from smart homes and wearables open up new possibilities for individually adapting health services to each patient.

Personal health networks

This form of personalized medicine is therefore data-centered medicine. Data about a patient is already numerous today, and continues to increase exponentially. Where yesterday perhaps a laboratory value and an X-ray image were the basis of a medical decision, in the future a multiparametric overall picture will be created for the medical recommendation of action. This will also change structures and processes in the context of patient management. Patient data assume the leading role in the entire treatment chain. The data-based knowledge of a patient’s condition and the potential diagnoses, therapies or preventive measures derived from it are also driving the increasing specialization of professions in the future of healthcare.

New health providers

Dynamic healthcare networks will emerge around the individual, whose nodes will be both the traditional players in the healthcare industry and new providers: companies in the food industry, sports and fitness, medical technology or the IT sector. The pace of decision-making for preventive measures or therapies is increasing, as is that of new developments for products and health services. In addition, this form of personalized medicine offers the opportunity to find new places for health and to place health topics flexibly, for example at home, in the car, in a restaurant or at work.

Future of Healthcare Michael Carl

Data Interpretation and Data Sovereignty in the Future of Healthcare

When patients have more and more information, this does not mean more knowledge or understanding at the same time. This is why the explanation and interpretation of data and the communication of risks, for example, are becoming increasingly important. Patients need experts to advise them. However, this role will no longer automatically fall to the family doctor in the future. On the contrary, different players in the healthcare industry are competing for this function, which is usually limited in time. These can be contact persons for certain clinical pictures – for the cancer patient the oncologist, for the woman who wishes to have children the gynaecologist – or contact persons who are important in a certain phase of life, e.g. a caregiver for an elderly person. There will be competition for the control function. Because whoever plays this role will have a decisive influence on the other players in the network and their care tasks.

Blockchain as key

Of course, all these predictions only occur when people release their personal data for medical analysis. Data protection of the future must therefore mean that the patient has sovereignty over his or her data. He determines how they are dealt with. They must be able to rely on the fact that their data is available at all times. At the same time, he must be protected against access by unauthorized third parties.

Blockchain technology plays a decisive role in this context. The best-known and oldest blockchain application is the digital currency Bitcoin. In the blockchain, information is not stored on a single server, but rather decentrally on different computers in a network. In order to falsify information, it is no longer sufficient to hack a single server, but every single computer in the blockchain. This makes the technology particularly secure. It is thus also suitable for the exchange of sensitive health or disease data in the future of healthcare.

Read in part two of the text how data-centric medicine leads to a new picture of disease and health. Digital communication is fundamentally changing the future of healthcare.

SITiG and bitkom call for a federal agency for digital medicine

There are good reasons to think that the development towards a digitalised health economy in Germany is too slow. Unfortunately, there are even many good reasons for this. Anyone who can once again watch how medical specialists manually transfer patient data into the hospital database, including depreciation errors, has no more questions here. The device is out of order, again. This happened to me ten days ago. Bitkom and SITiG have now proposed setting up a federal agency for digital medicine to speed things up.

A motor for health communication?

This federal agency for digital medicine  is to develop standards, so the publications of the initiators in short and long, in order to make safe health communication possible. In the language of bitkom: “A Federal Agency for Digitised Medicine can create framework conditions for technical and semantic interoperability and for the implementation of data protection and data security requirements”. That´s Achim Berg, bitkom President. This agency shall have a catalytic effect, unites all players and will make Germany the “number one technology and research location” for medicine in Europe. The only thing still missing is the German government’s eHealth strategy, on which all of this could be built. A rogue who thinks of the Federal Government’s AI strategy and its almost comically formulated goal of establishing artificial intelligence as an “export hit”.

The Ärztezeitung sums up the initiative of SITiG and bitkom (involuntarily?): At its core both associations are concerned with control. With this federal agency for digital medicine they want to create a new instance of central supervision.

More Power to the Patient

The initiative fits in with the picture of future healthcare that has long been demanded by the associations. The result of these demands is known. The initiative also fits in with the tenor of the “Digital Health” conference organised by bitkom last week in Berlin: “More Power to the Patient”, the title of the conference, summarized here very succinctly.  Core results of the keynotes and contributions: It needs the electronic patient file. And again: lots of solutions for the object “patient”. But only little power for the user of the system, only little decision-making authority for the customer of the health economy. People are always turned into patients. And a “patient” obviously always needs others who know what is good for him. Others who decide for him and others who improve his care. Others who turn him into an object and others who set up federal agencies for this purpose.

The future of healthcare

Once again to take notes: Those who equip their field staff with iPads have not yet digitized their sales. Anyone who supplies a school class with laptops has not yet made a contribution to digital education. And anyone who demands an agency that will develop standards for the interoperability of data in the course of the introduction of the electronic health card in a long process and at great expense has neither digitized the health industry nor made a significant contribution to the future of healthcare.

The healthcare of the future will enable people to measure, change and raise their state of health and well-being – ideally beyond a 100% natural or God-given threshold. People will use technology to do this: Data of the most diverse kind and quality, algorithms for their evaluation, databases, genetic engineering, 3D printing and the like more. This is the scope of the digitalisation of health. Anyone wishing to support this through a federal agency should set up an agency that – analogous to the newly established digital agency of the German federal government – promotes leap innovations financially and structurally. There is plenty of room for this – see above. A federal agency for digital medicine, which ultimately springs from the spirit of controlling a complex system, will achieve exactly the opposite.

Beyond Verbal: The Voice Leads to Diagnosis

When the voice becomes an early warning system for serious diseases: A pointer to a technology that may not be entirely unique, but which is exceptional in any case. Yuval Mor developed it with his team at Beyond Verbal. This is where voice control takes on a whole new meaning in the healthcare of the future.

This is the approach: Beyond Verbal can show that specific severe diseases lead to characteristic patterns in the human voice. These include severe heart diseases, but also neurological diseases such as Alzheimer’s and Parkinson’s disease. These patterns cannot be identified by human ears. Beyond Verbal has developed an algorithm that can detect these subtle changes with amazing precision. The special thing: The algorithm is able to hear these changes before the heart fails, before Alzheimer’s can be diagnosed in the conventional way. Voice analysis therefore allows a much earlier intervention, permitting action instead of reaction. Which language someone speaks is, by the way, completely irrelevant for the analysis. The characteristic patterns occur in Mongolian as well as in Swiss German.

Yuval Mor was a speaker at the 2b AHEAD Future Congress 2018 with his topic and presented his project for discussion. The colleagues at 2b AHEAD have already put the video of his impulse online. It is available here.

Beyond Verbal - Yuval Mor

A matter of course, but always worth remembering: Beyond Verbal introduces one of the technologies into the healthcare of the future, which very concretely lead to a fundamental shift of knowledge. This is an effect that we are seeing again and again. It is particularly easy to show here: The algorithm generates knowledge that can lead to a considerable increase in well-being and well-being. The traditional players in the healthcare industry can only distinguish themselves by how well integrated and self-evidently they deal with this knowledge.

Please test it for yourself!

And to make it even more concrete: Beyond Verbal has made the app “Moodies” freely available in the app stores as a kind of by-product. It accesses the same algorithm and analyses the emotional state of the speaker within a few seconds. I now use this app regularly on keynotes, both to demonstrate the power of Artificial Intelligence, and as feedback of my own effect, simply to improve myself. I can only encourage you to try “Moodies” for yourself.

Digital diagnostics: Disruption does not start in harmlessness

Today, two tweets have rushing through my timeline. Both touch on the subject of digital diagnostics and they show an idiosyncratic, seemingly contradictory picture. Does digital diagnosis lead to better results – or a diagnosis by a human doctor? And from whom do we want to receive such a diagnosis?

Digital diagnosis as a life saver?

The Intelligent Health AI from Basel is bringing positive news, enthusiastic about the feasibility.

Digital diagnosis: AI can do

One could object: Where is the news? The fact that the diagnostic capability of halfway modern systems of artificial intelligence is superior to human expert knowledge should come as no surprise. This imbalance is well documented. Every oncologist, radiologist and probably almost every laboratory doctor will confirm this. Even if the ideas of the consequences probably differ considerably: The fact is indisputable.

Analog students at MIT?

Futurist Andrew McAfee paints a different but remarkable picture of his practice at the university:

Digital Diagnostics

Contrary to all reason, it seems that the next digital elite – nothing else is being trained here at MIT – is actually putting up with disadvantages. They opt for human diagnostics and not for digital diagnostics. He does not comment on the motives. Even if he did, this would hardly lead to a statistically reliable picture.

Three models of interpretation

Let us place the two impressions next to each other and interpret them together. Three patterns of interpretation seem plausible:

Interpretation 1: In case of doubt, technological fascination is always the solution for the others. Autonomous driving is as inspiring as it perfectly makes sense, if only one’s own steering wheel does remain. I call this the deficit model of technological disruption. The guiding principle is the fear of losing familiar solutions, services and features, despite all the technological fascination.

Interpretation 2: The time lag shows an apparent contradiction. This is the model of harmonization over time. Today, students reject what they will get used to over the coming years. At first glance, this is an obvious idea. At second glance deceptive: Those who allow themselves to be guided by this interpretation are in danger of covering up the disruptive character of innovation with harmony sauce.

Interpretation 3: In this juxtaposition we clearly see how one of the most important innovations in health care will take place. The model of the creation of meaning through innovation. A conventional diagnosis that does not involve life and death will – with good reason – be made and communicated by a human doctor in the foreseeable future. Even if an AI would actually be better, there is no real risk. However, when it comes to the threat of fatal diseases, AI offers a leap in quality; those who want to overcome this threat are less choosy when it comes to choosing the means. The main thing is: something works, even if it´s digital diagnostics.

Disruption does not begin with harmlessness

If this third approach prevails, we will see AI in use very soon. The triumph of digital diagnostics, however, will not begin in the harmless and risk-free, but – on the contrary – where it really counts: In the fight against life-threatening diseases. Ebola, malaria, rapid cancer will bring AI into the everyday life of healthcare before it also devotes itself to the fight against colds and lice infestation. Sometime later.

I tend, you will suspect, to the third interpretation. The most important innovation of healthcare of the future will begin with questions of life and death. But please, judge for yourself.

3D Printing of Organs: State of the Art and Prognosis (2)

The future technology 3D printing of organs. The first part focused on Dr. Anthony Atala and his work at the Wake Forest Institute for Regenerative Medicine in Winston-Salem, North Carolina. He will probably be the first to receive formal approval for 3D printed implants. Dr. Gabor Forgacs has a different focus. While Dr. Atala strives to replace organs 1:1 with printed implants, Dr. Forgacs sees greater potential in the field of pharmacology. He is interested in printing individual biomaterials on which doctors can test the effectiveness and mode of action of pharmaceuticals. A test on the individual body, but before prescribing the drugs to the individual patient. The advantages are obvious: risks are reduced, intolerances become apparent in advance, and dosages can be tested. As a result, patients can be treated more efficiently: cheaper, gentler, more effective.

With Organovo, Dr. Forgacs can claim to have founded the first commercial company in the field of 3D printing of organs. He was already a guest at the 2b AHEAD ThinkTank in 2012. With his focus on samples for toxicological tests, he also avoids most hurdles to approval. In addition, he expects an application of 3D printing, especially in the area of prostheses, which has long since become reality in many areas. Hearing aids have long been in use in the double-digit millions. However, the actual potential of Forgacs’ approach seems to lie in the area of pharmaceutical development anyway. Every day that technology can shorten the enormous development cycles of new drugs is enormously valuable in monetary terms alone.

3D printing of organs Gabor Forgacs

Use cases as drivers for 3D printing of organs

It’s worth taking a look at TeVido BioDevices, a company based in Austin, Texas. In contrast to Atala and Forgacs, founder Laura Bosworth does not start on the technology side, but from a relevant problem. In this case: the reconstruction of the breast after cancer. More precisely: The medically correct, but often visually unsatisfactory reconstruction. TeVido manufactures artificial nipples using 3D printing technology with natural optics thanks to natural substances.

3D printing of organs is therefore a safe candidate for a promising future: technology with experience and potential for scaling, decentralized know-how, relevant use cases.