Experts Explore Future of Medicine
Emma Ross,
Associated Press Writer

8:10 PM EST; November 11, 1999; London, UK (AP) -- Picture a world where wheelchairs can climb stairs and insulin sacs implanted in diabetics automatically release just the right amount at the right time. Such breakthroughs are on the horizon as medicine looks likely to change more in the next 20 years than it has in the last 2000 -- mostly because of new technology, the Editor of the British Medical Journal said Thursday. The prestigious publication is one of 42 worldwide devoting editions this month to exploring how technology is changing medicine in the new millennium.

"Cures aren't really our final destination," said Dr. Thomas Reardon, president of the American Medical Association, in London to launch the themed issues of the British Medical Journal and the Journal of the American Medical Association. Predicting and preventing diseases, mostly through technologies that allow us to better understand our genes, will be more of a focus than trying to diagnose and treat them, Reardon said. One paper in the British Medical Journal predicted that drugs and lifestyle changes would be the preferred prescription for people genetically predisposed to a given disease, rather than trying to manipulate the genes themselves.

Many of the advances highlighted in the journals also promise to make life better or easier for people grappling with common ailments. Sensors, used widely in industry, will transform health care in the next decade, according to a paper by Charles Wilson of the California-based Institute for the Future, published in the British Medical Journal.

Sufferers of irritable bowel syndrome will be able to detect imminent diarrhea with gut sensors and forestall it by pressing a drug-filled pouch under the skin, the paper said. Japanese engineers have designed a toilet that weighs whoever sits on it and tests the urine for bacteria and sugar levels. It then transmits the results directly to the doctor. In fact, most of the tests performed by laboratories will be done automatically by sensors either worn by or implanted in patients, or built into hospital beds, Wilson said. He said hospital beds and operating tables will be replaced by multipurpose units equipped with sensors that can provide suction and ventilation during surgery and monitor vital signs and release intravenous fluids during recovery -- signaling the end of traditional intensive care units and the risk of spreading infections that they pose. In addition, ceiling vents installed in hospital lobbies will monitor the air to detect and report any visitors who might spread airborne infections to patients, he said. An under-skin sensor for diabetics that regularly monitors blood sugar levels and a "wristwatch" device that does the same by producing tiny electric shocks to open pores enough to extract fluid are under development. Those technologies will replace the frequent finger-prick blood tests that diabetics now must perform.

Diabetics also can look forward to implanted insulin reservoirs that will automatically release the right amount of insulin at the right time, eliminating the need for daily injections. Those advances will not only make life more pleasant for diabetics, but will also save them from the sometimes fatal complications of their disease, doctors note. In addition, robotics technology being introduced into electric-powered wheelchairs will allow users to balance on two wheels, drive through sand and gravel, or climb curbs and stairs. At the same time, technology already in limited use will become less expensive and more widespread. This includes cochlear implants which help the deaf by bypassing the parts of the ear that don't work and sending messages directly to the brain. More than 20,000 people worldwide already benefit from them, Wilson said.

"These advances will not only be for the rich. They will become more simplified and will get less expensive. Home monitoring will be a huge saving," he said. "The affluent will always have things the rest don't, but the gap will not be extreme when it comes to fundamental new technologies," he said. "When it comes to saving lives, new vaccines for everything from cancer to diabetes will be the technology to have the biggest impact," he said.