007Pervasive self-diagnosis and self-treatment

Blue sky Policy Alert 007

FP7 themes health agro ict nano energy environment transport ssh space security
ERA goals mobility infrastucture rtd institutions knowledge sharing  joint programming  cooperation 
Author(s)Anthony Walker, Joe Ravetz, Rafael Popper, Thordis Sveinsdottir
Contributor(s)Anna Kononiuk, Denis Loveridge, Andrej Magruk, Dorota Pawlak, Sally Randles, Ozcan Saritas, Phil Shapira, Alexander Sokolov
ManifestationGradual development
Potential impacts in Europe
infrastructures
Critical
people's lives
Critical
legislation & regulation
Major
economy & business
Moderate
defence & security
Minor
government & politics
Moderate
environment & ecosystems
Negligible
science & technology
Critical
Importance for EUMajor
Strategic attentionby 2030 Minor  by 2050 Major
Type of impactExtremely positive
Inspired byBrainstorming session and group discussions in the iKNOW Workshop in Manchester (February 2010)
Related to
Keywords, , , , , ,
 

 

Wild card

This wild card assumes that nano-enabled self-diagnosis and self-treatment becomes pervasive. This would allow the general public to diagnose, monitor and treat illness themselves having their own ‘Doc in a Box’. Doctors may become redundant and the ageing population could increase. Although this occurrence is considered ‘wild’, it is very interesting as there are a number of ongoing research projects based around this technology, which if exploited could trigger this wild card. This would have a huge impact on people’s lives, drastically changing the way that we diagnose and treat illness and disease.

 

Surprises ("wild" scenario features)

Treating illness is clearly of huge importance globally, and this wild card would not only dramatically alter the way in which aliments are treated, but also change the way in which we monitor and diagnose illness. Imagine the scenario whereby everybody has a small microchip which gives a morning report on the state of heath of an individual, for example, specific actions are proposed over breakfast such as ‘take the pill’. It is feasible that high throughput scanners could be achieved by 2030 thus providing cheap personal genome at €10 overnight and giving automatic interpretations/diagnosis. The potential is high for the knock-on effect of early diagnosis and treatment available to all increasing the ageing population – significant increases of having ‘too many healthy people’ would be highly likely. Further societal effects would include the expansion of health communities as the centralised medicine system is redundant and dissolves.

 

Possible interpretations

It is considered that there is certainly a need for technical progress in this field, and one way of interpreting this wild card is to consider it as an aid to enhancing the quality of life (which is clearly high on the global agenda). Equally, this technology would be available cheaply and as such has the potential to be accessible by the global population. However, as much as this could be considered as a great benefit, it is apparent that with these developments, there would be a rise in the ageing population. There would also be ‘opportunities’ in other sectors as there would be a need for proper databases to be developed to ensure the accuracy of such technology.

 

Key actors

Key actors related to this wild card, include:
  • Scanners or "early warners" such as public and private organisations involved with patient safety and medical malpractice, health incurrence and legal services providers as well as health and safety agencies.
  • Shapers (i.e. enablers/inhibitors) : regulators and the global society, especially the ageing population who are more reliant on diagnose and monitoring of treatments.
  • Stakeholders positively or negatively impacted include several actors of the health care system. Clearly, the effects of such a wild card would be of significance and concern to doctors, pharmaceutical employees and other health care workers who could be rendered redundant (or at least the reliance on them for diagnosis would be drastically reduced). In parallel to this, health care systems would be altered, for instance, far less people would require hospital attention, and perhaps there will be less people inclined to become involved in health care (and if the technology ‘collapsed’, there could be a global lack of qualified pharmaceutical and health workers).

 

Potential impacts

This wild card could bring about a number of different impacts, and it is uncertain as to whether this would be primarily beneficial or unwanted. With the development of this advanced technology and the realisation that it is available to the global population, what would happen if this was rejected by society? For instance, what if people still preferred the personal relationship and comfort that can be afforded by visiting the doctor? With the technology rejected, will there still be enough qualified health care specialists? This would have a dramatic global impact. Similarly, if the ‘doc-in-a-box’ patents were controlled by Russian-Chinese conglomerates, there could be a US boycott of the world intellectual property system. A further impact could be that big Pharmaceutical organisations can no longer be sustainable and they disappear. Of course, there is the possibility of people living longer and having a greater quality of life, but again this will lead to a rise in the ageing population. Careful considerations would need to be maintained with regard to disposing of the units – millions of doc-in-a-box may end up in landfill. There is the impact on social well being to consider as social isolation could lead to large bouts of depression. Regarding actual technological impacts, complicated diagnostic systems could become unpredictable for outlaying cases and may lead to death of users of prescriptions; this means that regulation is needed.

 

Potential actions

There are a number of actions that should be considered with regard to this wild card, for example, there may be a need for Nano Education from primary school or the Development of databases for self diagnosis and problems to diagnose leading to something like www.doctorgoogle.com. For As such, a number of early actions (pre-wild card) and early reactions (if the wild card occurs) should be considered:

  • Policy actions

    Early actions: Stakeholder and public debate; New infrastructure; Educational system; New legislation – specific legislation; International dimension (negotiation).

    Early reactions: Monitoring systems and regulations at policy level.

  • Business actions

    Early actions: Public- private partnerships; Business planning – forecasting of market entry; Technological improvements; Development of databases of medical conditions on blood, urine and other tests; Development of programs for analysis of the tests available online www.docgoogle.com; Disruptive technology for pharmaceutical; Positioning new business for new product.

    Early reactions: Commercialising, Cooperation with R&D groups (this post it was placed on the before/after border); Technological advancement.

  • Research actions

    Early actions: Development of algorithmic descriptions of diseases; Developing self-diagnosis technology roadmaps; Identification key technologies; Research on standardised analysis of medical data (blood results, urine results) by deduction from many possibilities to the one which someone is ill; Public perception – acceptance of technology.

    Early reactions: State-of-art analysis, technology analysis (this post it was placed on the before/after border); Risk analysis (this post it was placed on the before/after border).

 

Weak signals

As discussed, this wild card is very relevant and interesting due to their being a number of research projects on going with the potential to influence, impact and advance the current technology. As such there are several signals or observables that either individually or in combination with others may be warning us about the probability of occurrence of such a wild card. Such signals include: (1) Existing self diagnosis via the internet – everybody can almost diagnose themselves due to the overwhelming amount of information available in the internet; (2) Numerous patents are being taken out (or applied for) on multiple aspects of core technology – Some patents have been contested with likely long delays on commercialisation; (3) Herbs (enhanced by nano) are being used with the potential to fight cancer; (4) Much research is ongoing into ‘intelligent’ materials to release antibiotics into wounds; (5) Nanotubes are being used to ‘heal’ cancer directly in the cell without damaging other cells or tissues; (6) Everybody wants to be happy and live longer - Social disturbances on the rise, changes in family structures (people grow/get mature later); (7) Funding programmes that are directed towards health; and (8) Targeted nano-antibacterial agents developed to kill bacteria.

There are also a number of growing trends that could be an indication leading up to this wild card including: the generation gap increasing with the potential for having 5-10 generations all living at the same time; the increase in the ageing population; and the changing and evolving definition of what it is to be ill.

Disclaimer: The wild card presented in this brief may not happen at all or in the near future. iKNOW is a new EU funded research project aimed to explore surprising events (wild cards) and emerging issues (weak signals) potentially shaping or shaking the future of Europe and the world.