This article on modern medical technology is part of the Science in Sci-fi, Fact in Fantasy blog series. Each week, we tackle one of the scientific or technological concepts pervasive in sci-fi (space travel, genetic engineering, artificial intelligence, etc.) with input from an expert. Please join the mailing list to be notified every time new content is posted.
The Expert: Rachel Berros
Rachel Berros is an emergency physician assistant who works closely with a virtual visit development team for her healthcare organization. During her spare time she writes speculative thrillers that mix the laws of science with magic, or just skirt the edge of possibility. You can check out her website, or follow her on Twitter for more information. She’d love to connect.
The Near Future of Medical Technology
Science Fiction is always known for its ability to push the limits of what’s available, and then to predict what’s to come. As a voracious reader, I’ve yet to see too many uses of medical technology in fiction. Though I’m sure one of you fine readers could point me toward a few examples. While I’d love that, I’d request you write some new ones for me (then include me in your acknowledgments 😉).
The most prevalent images of fictional med tech are from Star Trek. “He gave me a pill and I grew a new kidney” was my all-time favorite line, for years. And while that’s still quite far in our future, the fictional universe’s hand-held scanners are not. As with all technology, medical tech is advancing rapidly. The problem though, is that most of it is proprietary, and unless you or a family member is unfortunately in need of such services, you’re not likely to ever see what’s available. I’m not a futurist, I’m not even a SciFi gal who dreams up new tech, thus, without further ado, please let me introduce what is currently available so you can improve upon it in your work.
Video Calls/Virtual Visits
This is the most common, quickly accepted, and rapidly spreading technology. In my personal practice, and many facilities/practices/networks around the US, Australia, and several European nations, patients are able to contact their provider via their phone, computer, or other internet capable device. They allow:
- Patients to come with common complaints, speak with their provider, have a minor visual exam through video software and the home device’s camera
- Orders and prescriptions to be sent electronically to laboratories or pharmacies.
- Patients who’ve called for emergency services to speak directly with an emergency physician who can then route the patient to an appropriate facility, which is not always an emergency department (ED) (we don’t call it an ER despite that still common practice).
- Patients to remain home for simple check-ups, post-operative evaluations, and many other visits that do not require a physical exam for diagnosis.
One day we may even have a holographic doctor pop up from our computers and triage or treat us based on a computerized algorithm, but to my knowledge, that’s not yet available or in process.
Telemedical devices are a step up from virtual visits because they allow for a physical exam. However, that requires a knowledgeable person on either end, such as nurses, physicians, or techs to operate the device. Most of these are computers mounted on a rolling cart with varying levels of autonomy and attachments. With these:
- Neurosurgeons can evaluate a stroke victim and determine a care plan from hours away. Allowing the local providers to initiate appropriate care prior to placing the patient on a transport vehicle.
- Specialists such as cardiologists (heart), ophthalmologists (eye), or otolaryngologists (ear, nose, throat), dermatologists, and many others, can evaluate a patient from a distance. This allows them to place orders, decide if they should see the patient in person, or set up close follow-up.
- Psychologists can speak remotely with mentally ill patients, and conduct any level of exam they deem necessary.
- Allow neonatologists to give real time orders for a dying newborn, that the specialist can see, from hundreds of miles away.
Basically, these allow rural, remote, and underfunded/underserved communities access to specialists they otherwise could only reach by phone, if at all.
Wi-fi and Bluetooth Devices
Our phones don’t need to plug in to charge, our watches synch with our computers, and our cell phones can get verification codes from pills we swallow (this last according to Effie Seiberg’s Your Sci-fi Cell Phone Isn’t Cool Enough). Medicine isn’t any different. Current uses include:
- Bluetooth heart monitors that relay to the physician’s office whenever an “event” occurs.
- Cardiac pacemakers/defibrillators that can send and receive data for treatment protocols.
- Insulin pumps that keep track of a patient’s sugar levels, sends a log to the doctor, calculates and provides insulin doses, and sends a distress signal to EMS if glucose levels reach a dangerous level.
- Camera pills able to send real-time images of intestines to search for sites of masses or bleeding.
- I’m yet unaware of devices that can mark or transmit the exact location within the bowel, but I’m sure that’s not far away, if not already in testing/limited use.
- Smart ambulances that transmit a patient’s real-time data, including ECG tracings and vital signs to the receiving facility.
- Scales can sense body-fat content or fluid weight, and send the data to a provider.
With clothing companies allowing you to get scanned through our computer’s camera for a “perfect fit” while shopping online, I imagine something similar for healthcare is also on the way. Soon it will be a full vital sign reading, general health assessment with blood testing for things such as glucose and medication level testing, all from the comfort of your couch.
Phone Apps and Portable Equipment
This tech is the most exciting to me because it brings us closest to Star Trek’s scanners. I’ve held each of these in my own hands:
Medical Devices for Phones:
- An ultrasound wand—check for internal bleeding or broken bones while hiking (etc.) to determine the need for a helicopter evac vs. suck-it-up-buttercup (such triage is best performed by rescue personnel)
- ECG leads—three leads offer a mini EGC similar to an ambulance’s
- Microscope lenses—can’t bring the item inside, look through your phone and snap some pictures
- A stethoscope—listen to and record heart/lung sounds for triage, or use at home to listen to a fetal heartbeat.
With the increased, and almost exclusive use of digital x-rays, hand-held x-ray packages are not far off. But, I have yet to see a prototype or advertisement for them. This may be due more to the dangers of such devices than the lack of tech. The other listed devices would cause no harm if used by untrained or too-young hands (except for the untrained triage results 😉), but even digital x-ray use some level of radioactive components and thus have a whole set of complications unto themselves. (I am not an X-ray tech, please do not ask for more details on this.)
- Hand-held ultrasound devices—they have longer battery life than phones especially when turned off between uses, and can be added to expedition medical kits for similar triage needs as listed above
- Health watches—wrist bound devices the size of watches that measure a patient’s vital signs and heart rhythm, perfect for medical rescues/evacuations or triage in a mass casualty situation. Would pair well with Bluetooth/WiFi tech for receiving facilities to have real-time data of patient volumes and acuity levels for better disaster management.
The medical technology world is improving as rapidly as every other area of tech, and this is only the electronic versions of medical advancements. Things like growing a human ear on the back of a rat, or experimental bandages capable of closing surgical wounds without sutures, are medical advancements best discussed by experts of those fields.
With the increasing use of virtual reality, phones, cloud space, electronic health records, and swallow-able sensors, I’m sure you will be able to come up with amazing new or futurist health systems. Or, with the latest cyber-attack on electronic health records, and a certain Vice-President’s concerns over terrorists hacking his pace-maker a few years back, a kick-ass cyber villain could do some incredibly scary stuff.
Have fun everyone, and please let me know if you see any of these amazing items in practice. I’ll be sure to announce when medicine makes a kidney-growing pill. Cheers!
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