What’s the problem with healthcare? Ask a dozen people and you’ll get probably more than a dozen different answers. But one theme that crops up time and again is the ageing of our population. When I first qualified as a doctor, it was remarkable to have a 90-year-old patient. Now, I regularly do house visits with 90-year-old patients, doing their best to cope at home with multiple long-term conditions. We should certainly celebrate this as a modern medical success story, but it also has huge consequences for how we organise and fund our healthcare systems in the future.
One regrettable side effect of surviving to an older age is greater potential to develop cancer. Cancer is becoming an increasing focal point in medicine given the effective diagnosis & treatments for early mortality conditions like infection, heart attack, or stroke. Alongside the higher incidence of cancer, we are also getting better at diagnosing it at an earlier stage. Recently in the UK, the guidance to family doctors has been to lower the threshold for urgent referral from a positive predictive value (PPV) of 5% to 3%. This inevitably means that more people will be referred for investigations, typically involving a biopsy, placing additional strain on an already over-stretched pathology service.
We are very familiar with digital photography – who uses film anymore? And likewise, the transformation of film-based X-rays to digital systems is virtually complete. Now, we are seeing the same process starting to happen with pathology. The transformation is happening on two levels: digitising an image makes it easier to store, retrieve and examine. But building on that new-found freedom, pathologists can do things previously unthinkable. They can instruct computers to screen out the more obvious normal biopsies, saving them time to concentrate on the abnormal samples. Even better, manual and automated analysis of digital images can yield new insights into disease while even helping distinguish and define new conditions. These new imaging techniques enable greatly improved targeting of therapy in mainstream practice.
Intel has been working with Coventry & Warwick NHS Hospitals and Warwick University, to optimise technologies supporting the movement of digital pathology from a research environment towards mainstream usage in a real provider environment. Early progress has been impressive with recent results discussed here: https://phys.org/news/2017-05-cancer-cells-accurately-hospital-artificial.html.
In the pathology practice, we are seeing significant improvement in patient benefits by creating a digital transformation in the way we diagnose, treat, and cure diseases in the 21st century. It’s a great time to grow old.