Editor's Corner | The pace of development for new stuff that affects our lives is accelerating rapidly. Much of the innovation springs from improved electronics that are becoming miniaturized to the point where that, when they are in use, we aren’t even aware of the presence of an electronic device watching over us.
Case in point: exercise and fitness trackers can be found everywhere. Elevator conversations now focus on how many steps, who had relaxed sleep, and number of calories burned. Today’s gizmos record heart rate, acceleration, distance traveled, even muscle motion to decide if fitness is being achieved. Alternatively, microsensors placed in medication capsules to record when a patient takes a medication, and sports equipment like footballs are being instrumented with sensors to measure speed, spin, arc, and other measures that make a quarterback more efficient.
But while the gadgets are getting smaller and more capable of gathering our personal information and sending it to our smart phones, the needs of the next generation of monitoring and communication involve the use of artificial intelligence and other intelligent systems to aid in daily decision making about functions designed to improve quality of life. The next generation of innovation will incorporate not only the newest miniature sensors, but will connect them to intelligent systems that will aid in making day-to-day decisions on a variety of questions.
"The next generation of innovation will incorporate not only the newest miniature sensors, but will connect them to intelligent systems that will aid in making day-to-day decisions on a variety of questions."
One of my favorite intelligent systems has always been Watson®, the IBM system that can win at world-class chess, diagnose illness, and develop care plans for patients. Watson is being used for medical education and its intelligent systems can be applied to almost any problem where decision-making is based on input from surrounding community databases. Using these concepts, an intelligent medical record system would identify your next patient, open their record, display the prior progress note, list medications, suggest recent studies, look at the appropriate performance record, and inform you if a key performance measure was neglected.
Helpful, for sure, but a more intelligent system would review the patient encounters coming up on your clinic day, review the chart for problems and diagnoses, and query the patient using text messaging about new symptoms. The same system would program your car radio to provide a series of short discussions on topics related to the cases you will see later that day. When your clinic session is completed, the system would review your quality measures and create a dataset that would calculate your quality score. As the administrative requirements expand in all of our practices, this type of intelligent system serving our communication, clinical, and administrative needs will be the next goal for innovative information technology. Besides medical application of such intelligent systems, the same type of system could arrange your grocery shopping, your car maintenance schedule, your vacation, and business travel.
Finally, innovations in medicine will involve the combination of new gadgets, and the information from the gadgets being incorporated into complex, automatic clinical decision-making systems that will relieve the physician of much of the routine burden of stable, chronic disease management. An important task will be to educate the next generation of physicians on use of these systems to improve medical practice.
Given all of that, we are left with one issue: who is going to innovate all this? We need to look close to home. In our cover story, the experts tell us what goes into innovation, how it works (and how to work it), and how everything must change from academia to day-to-day practice in order to innovate the future.
The good news is that some doctors-in-training today already have a background that will make them the innovators of tomorrow. This new breed of physicians, dubbed ‘clinician innovators,’ can teach us all the importance of thinking and acting in a more innovative manner.
Innovation is no longer a luxury, nor even an option; rather, it is a demand of every aspect of medicine, patient care, and research. How well we serve patients tomorrow will be determined in no small part in how good we are today at thinking—and being—innovative.
Alfred A. Bove, MD, PhD, MACC, is professor emeritus of medicine at Temple University School of Medicine in Philadelphia, and former president of the ACC.
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