Hi there, I am Jon Herries, I work at the Ministry of Health and I am here to talk about how we keep people healthy.
Hi I'm Darian and I work at the Australian Digital Health Agency. We're going to talk for the next 7 minutes about what healthcare may look like in 50 years' time. The context we were given for this talk was an optimistic future, and after spending a lot of time thinking about all the potentially disastrous futures, we had a clever idea about an optimistic future.
The picture you can see is from Star Trek Discovery a new iteration on the original Star Trek series which is now showing on Netflix. Gene Rodenberry's original series inspired a number of technologies just over 50 years ago, some of which are becoming a reality in the health space now. An example is The tricorder a portable device for sensing, computing and recording.
Sound familiar? Just check out your phone....
We thought it would be interesting to consider how health will look again in 50 years in the context of a genre spawning tv series. One that is well known for exploring and confronting social issues.
Food served on the Discovery is an example of where preventative and precision medicine may go. The meals are customised to individual's physiological needs, ensuring that they receive all the nutrition they require. An interesting comment in the show is that what you need, still isn't necessarily what you want.
Medicines in the show are also tuned for use by an individual - with the captain of Discovery receiving targeted medicines for his "light sensitivity".
We see personalised medicine as a key opportunity coming soon through the field of genomics. In the show, this is based on the easy collection and analysis of DNA. Our ability to use this information will help us ensure that rare diseases are better understood and treated. An example of how genomics could help is happening in Ireland right now with a plan to sequence the genomes of children with epilepsy. This will provide a great test case as epilepsy has a number of different treatments, and finding links between treatments and genomic markers could help provide the right treatment first time.
The transporter in Star Trek Discovery gets a heavy workout, but also in common use were 3D holograms and the ubiquitous warp drive.
Our ability to transport patients in these ways would eliminate transport issues for those living rurally. This would provide a massive improvement in access for Australia and New Zealand citizens who currently have large numbers of the population living a long way from hospitals.
Also our ability to provide a full virtual presence able to interact with the environment and people in the environment means virtual consultations could offer more personalised care than is currently on offer.
Perhaps also in the future we will be able to provide instantaneous transport via a spore drive around which the plot twists but maybe that is a little bit far-fetched.
The show has a sick bay with doctors and nurses. This shows that despite advances in healthcare there is a continued need for the human touch and empathy.
In the future we see machines increasingly being able to offer an end to end healthcare service, for example, scanning patients using combination EEG, MR and CT examining the results and presenting the patient and health professional with a summary and potential options for treatment, just like it does in the show.
The health professional's role in this context is much more of a healthcare navigator working for the patient to ensure the machines provide the services that the patient needs. A prototypical version of a health navigator is appearing in our system now. They are often critical to patients from minority groups and for those who report a fear of hospitals and health services. They offer support and empathy at times of high stress and emotion. Currently they are using their own experience and understanding of a complex system to help navigate patients safely.
In the show, one of the engineers ends up with a series of technological implants connected to his nervous system. Despite this, presumably due to genetic compatibility matching, he appears to be healthy, with these modifications forming a permanent part of his body. There are also a number of crew members with varying self-adopted and maintained technological adaptations. Currently non-communicable diseases put increasing pressure on our health system and responses when these diseases reach their end stages. We are already seeing experiments in 3D printing of organs and body parts. Our expectation is that for those people requiring amputation due to vascular disease, or people dying from renal failure or heart failure could have in the future new 3d printed organs and technology implanted into their bodies to support their health without the need for donors or anti-rejection medicines.
The last big problem which we know will impact on the environment and more widely is how the population will change in the future. New Zealand's population density had never been an issue, with our fertility rate likely to reach a low but sustainable equilibrium in the early 2020s.
However in the future we need to consider that people could choose to live forever. In the context of Discovery, the only people to die have been at the hand of others. It would seem that this ability to extend peoples lifespan perhaps indefinitely - is likely to destabilise the population creating a consequent impact on the environment.
This consideration is perhaps the most interesting unstated premise of the Star Trek universe. Perhaps the plan to boldly go where no one has gone before is a mechanism that serves to ensure both the ongoing survival of humanity but also to help manage the growth of the population in the future.
To close, I want to say that the federation in Star Trek is founded on equity. In this show, an african american woman with a currently male name, is respected, cast down and then redeems herself over 15 episodes. She falls from grace by forgetting this principle and saves the federation when she remembers it at the end.
From our own information that we publish, we know that Maori and Pacific Island people have poorer outcomes than other ethnicities in New Zealand. It would be great to think that maybe some of these advancements and technologies will bring this type of optimistic future into our grasp.