A review of the new book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care.

Nanosensors patrolling your bloodstream for the first sign of an imminent stroke or heart attack, releasing anticlotting or anti-inflammatory drugs to stop it in its tracks. Cell phones that display your vital signs and take ultrasound images of your heart or abdomen. Genetic scans of malignant cells that match your cancer to the most effective treatment.

In cardiologist Eric Topol’s vision, medicine is on the verge of an overhaul akin to the one that digital technology has brought to everything from how we communicate to how we locate a pizza parlor…There is only one problem: the paucity of evidence that these technologies benefit patients.

via Technological Healing – Technology Review.

The reviewer takes the position that sure all these new fangled digital technologies look good in theory but there is no proof they will be effective. This of course reflects the problem discussed here, on why innovation is so unpredictable.

I will be presenting a half day program at the Yankee Dental Congress January 28, 2012

Everyday dentists are faced with remarkable new high tech products that do everything from finding caries to making a crown. Digital technology is revolutionizing every aspect of dental practice including how we make clinical decisions and how we communicate. A great high tech digital office will never happen just by accident. Planning starts with the essentials for the doctor and the team. That is, knowing what to buy, how to use it, and how to make it all pay off.

via . Yankee Dental

If you are planning to travel for a medical or dental procedure why not travel to a fabulous vacation destination like a Caribbean Island? In the past the answer was, well of course, if given a choice I would rather travel to Barbados than to Cleveland but Cleveland is where the world renowned high quality clinic is located.

The development of some amazing high tech digital systems changes everything. New technology allows high quality services to be delivered almost anywhere in the world. The Internet allows for the global sharing of data. Reliable, relatively inexpensive transportation makes travel more practical.

For example one of the services most sought after by dental tourists are implants. A high tech diagnostic like Cone Beam CT allows dentists to examine and treatment plan implants precisely. The dentist can examine the CBCT anywhere in the world or he/she can send it to an expert for evaluation anywhere in the world. In other words the patient does not need to travel to Cleveland the patient’s digital images can travel there via the Internet instead.

 Online expert technicians can then design a highly accurate surgical guide for implant placement which could be fabricated by laboratory milling machines. The guide insures rapid placement with minimal complications and highly predictable results.

Here is how it might work. A patient from Great Britain is in need of some implants. The patient has a CBCT taken along with a full set of digital photographs. These digital images are sent via the Internet to a dentist in the US. She examines the images and then sends then to a radiologist in Canada and a specialist in New Jersey to evaluate and help with the treatment plan. Once the plan is established she sends the images to a lab in Sweden to design the surgical guide. This is sent as a digital file to Barbados and the guide is milled. The dentist and the patient arrive in Barbados where she places the implants for less than she would need to charge back home in the US because the underlying cost of doing business in Barbados is less.

And by the way the patient and the dentist both get a vacation in Barbados.

Related

 Another hidden provision of the new health care law as reported by AP.

Starting in 2012, the government will charge a new fee to your health insurance plan for research to find out which drugs, medical procedures, tests and treatments work best. But what will Americans do with the answers?

via New fee coming for medical effectiveness research | AP | 12/28/2011.

As with most of these things on the surface research to determine which drugs, treatments and procedures work best seems like a good idea.  Never the less there are some serious areas of concern.

“The government does not have patients it has interest groups.”

Will the “best treatments” be manipulated by payers to force patients to accept the cheapest care as the most effective? Payers are now insurance companies but increasingly the payer will be the government. That means that government will have a direct interest in seeking out the most inexpensive treatment.

On the one hand medical treatments are in serious need of cost control. On the other hand centralized command and control systems have a dismal record of controlling costs. What they are good at is creating shortages. More local control and more doctor patient control allowing the market to function will be more likely to control costs.

What will this mean in terms of research and future innovations in medicine? Will a politicized system kill the profit motive and stymie innovation?

And finally, so what? As the AP article says, “What will Americans do with the answers?” Knowing the best procedures will not mean people will want them. Knowledge does not translate to action. If it did then no one would smoke, we’d all be at our ideal weight and everyone would floss.

WOW!

Scientists have isolated a gene in mice that works to give them “super memories” and reverses the course of several degenerative mental illnesses like Alzheimer’s.

via “Super memory” pill–and possibly an Alzheimer’s cure–could be around the corner | The Sideshow – Yahoo! News.

Follow the link to an article I wrote for the AZ Dental Journal Inscriptions. The article is on paperless or digital specialty referrals.

http://www.azda.org/Inscriptions/2011Dec/index.html#/36/

A link to a new article in Dentalcampare.

What if you could export American quality of care and combine it with a developing world cost platform in a desirable resort destination? You could offer patients a fabulous vacation experience, the opportunity to receive high quality dental care delivered by US trained professionals for less than the treatment would cost in most US cities

via A New High Tech Look at Dental Tourism | Dentalcompare: Top Products. Best Practices..

The first really cool thing I found at the 3D Congress is E4D Compass.

E4D Compass imports data from the leading cone beam systems … and aligns the data with scans of the operative field via an E4D Dentist Scan of hard and soft tissues, models or impressions.

via E4DSky – Dentistry’s Destination – E4D Compass™.

The software is very easy to use; it stitches together a 3D sub gingival hard tissue CBCT with a 3D dental image from the E4D scanner. The operator can then use the combined image for restorative treatment planning that includes both the bone and the teeth.

The best example is implant placement. The user can place a virtual crown in an edentulous space then position the implant to perfectly support the crown and conform to the boney structures underneath.

As we use the software I imagine more creative and advanced uses will follow. E4D Compass is available through Henry Schein.

Update: This relates to the previous post on Augmented Reality. At this time Augmented Reality is experimental and very much a technology of the future. However E4D Compass is a very big step in that direction.

The linked article discusses Augmented Reality in general terms.

The ability to quickly build and track a 3D model of the environment is combined with the ability to display synthetic information onto the real environment. The result? The digital simulation of the world is overlaid on the world, in real time…

via More Mind-Blowing Real-World Kinect Interaction From Microsoft Research | TechCrunch.

This incredible technology has direct and amazing potential for medical dental use. Imagine doing surgery and being able to visualize the bone beneath the surface before you begin. Then as you work pertinent information scrolls by to be accessed when needed.