Dr. Bertalan Meskó talks about some the most exciting developments in medical technology that has the potential to change the future of healthcare. He also shares his opinion on how the doctor-patient relationship has changed over the years through technology advancements. Dr. Meskó sees healthcare professionals as guides to patients in this era of medical and digital information, where patients can go online to search about their disease and look for possible treatments.
Dr. Bertalan Meskó, PhD is the Director of The Medical Futurist Institute analyzing how science fiction technologies can become a reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is also an Amazon Top 100 author. He is a Private Professor at Semmelweis Medical School, Budapest, Hungary. Dr. Meskó has over 500 presentations, including courses at Harvard, Stanford and Yale Universities, Singularity University’s Futuremed course at NASA Ames campus and organizations including the 10 biggest pharmaceutical companies. He has been featured in dozens of top publications, including CNN, the World Health Organization, National Geographic, Forbes, TIME magazine, BBC and The New York Times.
Wayne Bucklar: You’re listening to Health Professional Radio. My name is Wayne Bucklar and today I’m joined by a special guest, I’m joined by Dr. Bertalan Meskó PhD. Dr. Meskó is a medical futurist and a director at The Medical Futurist Institute and his passion has been about analyzing how science fiction technologies can become a reality in medicine and healthcare. Now I have to admit this as an interviewer I’ve been looking forward to doing for some time. As a geek physician with a PhD in Genomics, he is also an Amazon Top 100 author. He is also a private professor at Semmelweis Medical School, Budapest in Hungary and my apologies to everyone in Hungary if I’ve got that pronunciation awfully wrong. He has over 500 presentations, including courses at Harvard, Stanford and Yale Universities, Singularity University’s Futuremed course at NASA Ames campus and organizations including the 10 biggest pharmaceutical companies. This is one of the top voices globally on healthcare technology and we’re delighted to have him with us today. Dr. Meskó has been featured in dozens of top publications, including CNN, the World Health Organization, National Geographic, Forbes, TIME magazine, BBC and The New York Times. He has a resume that I can only be jealous of and he regularly publishes his analysis at his own podcast on medicalfuturist.com. Dr. Bertalan Meskó, welcome to the show.
Dr. Bertalan Meskó: Thank you for having me.
Wayne: It’s absolutely our pleasure. Now every day, you surround yourself with some of the latest medical technology that has the potential to change the future of healthcare, what do you think are the most exciting developments happening at the moment?
Dr. Meskó: As a geek physician, I would love to give you a list of destructive technologies that will heavily impact how we practice medicine but the most important change in the coming years is the patient empowerment movement. The fact that now without the ivory tower of Medicine, patients have access to information, data, the best technologies and they want to be equal partners with their caregivers. That’s I think, it can be the most important milestone in the history of medicine altogether, not just an exciting change in the coming years. And I’m not saying that this is already happening everywhere, of course it’s not true but in many countries, in many regions we see patient empowerment getting mainstream and we see technology is helping them to get engaged in their care, to provide good questions for their medical professionals and in general to participate in their care. So that’s I think that’s the point I’m the most excited about.
Wayne: Now maybe ten years ago, my colleagues who are physicians were disparaging of Doctor Google and they were hating the idea that their patients had been googling their symptoms and googling their illnesses before they came for a consultation. Do you think that’s changed today?
Dr Meskó: It has changed but I think we have to make a clear distinction between patients who just go online to find something and empowered patients or e-patients because e-patients have a strategic perspective about using technologies including search engines online or health sensors at home. So they they have some sort of technical skills that help them get the most out of these it’s jungle of healthcare and digital information. What needs to change to support this from the medical professionals’ perspective is that for thousands of years, we have been trained to become no semi-gods of patients. Knowing everything, of course is not true, but now I think we are more like we are transforming into a new role which is something like a guide in this jungle of medical and digital information. So before, I think even now, medical professionals are but concerned about patients we just google something and they demand treatments from that point because they found something online. I think that’s still the case but what’s different with e-patients is that they want to help. They want professionals to spend less time with them but in a more focused way because they can help. They bring quality and data to the table that they can discuss together and altogether, this whole attack or philosophy is called patient design, which basically means that whatever product, process, treatment we develop for patients, we have to include them in the decision making process. For example, in the Netherlands there was a new hospital facility that they designed and before designing it, they invited their chronic patients to have their voices heard and now the facility has doctor-patient examination rooms that look exactly like what patients and physicians wanted. So both of them love working in those facilities, it can lead to reduce stress, it can lead to less burnout and in general a better feeling of participation and partnership between patients and caregivers. That’s what I try to work for every day.
Wayne: Now for this interview, we’re kind of living the technology dream. I’m based in the Philippines talking to you, you’re currently in Europe for the interview. Do you think there will be a big impact on the gap between the first and the third world based on what is happening in medicine and technology today? Or do you think it will exacerbate problems?
Dr Meskó: I think there’s going to be a gap but not in the way that you would think first. I think, if I can give you examples about that, in those countries where there are major gaps in resources, there are doctor shortages, there’s a lack of trust towards the healthcare system and financial issue in the background – I think those countries have a better chance to leap into digital health rather than just taking a few steps to keep on improving their IT infrastructure. Just a few examples in the country Rwanda in the heart of Africa, the government realized that they can’t provide healthcare to the 12 million people they have in the country because of the road conditions, the infrastructure and all these so they turned to innovators coming from abroad and they opened up their healthcare system to those with very good regulations and guidelines. And now they can provide telehealth services, telemedicine basically, into most of the rural parts of the country. I think that’s exactly what we they in third world countries, but again they choose a leap toward digital health instead of just taking a few minor steps into health IT.
Wayne: It is fascinating to me going back in my career into the 90s when again in Africa, villages which had no handsets at all, not even old bakelite dial mobile phone handset, never went through the progression of technology that we in Australia did. They never went step by step by step to a current mobile phone, it was just giant leap from a bakelite handset at a rotary dial to what was then state-of-the-art 3G technology. Is healthcare doing the same thing? Is it leapfrogging all the intervening step?
Dr Meskó: In certain regions but not in the entire world because again, in some places regulations are just not advanced enough to welcome innovation. So if I told you that there’s a country where medical drones can deliver supplies and equipment or there is artificial intelligence based algorithms in the medical record system there is telehealth solution for almost everyone in the country, you would not come up with Rwanda as the first guess. It would come up with the United States, United Kingdom, Germany but it’s not true for any of these countries. So what what we see now is when technology started playing a much more important role in practicing medicine in 1980s then e-health emerged, then converse could be connected, then telemedicine appeared. Later when social media became mainstream, we saw the birth of Health 2.0 and Medicine 2.0. And then when smartphones and mobile phones became quite a commodity for everyone, then mobile health emerged. But what’s next now is not based on a new technology, but it’s based on the cultural transformation that we need to see in healthcare to make sure that we keep on using advanced technologies that provide objective and transparent data but we also want to create an equal partnership between patients and caregivers, sharing responsibilities, sharing the medical decision making process and that’s what we call digital health. And the reason why I’m telling you this now is that digital health gives a chance to everyone – not depending on where they live or what language they speak or how much money they’ve got – to get access to care so what we believe in at The Medical Futurist Institute is that patients need to become the point of care. It’s not acceptable that in 2018 I have to go to a point of care to get my heart rate or blood pressure measured. I’m not even mentioning any advanced biomarkers or vital sign, just the basic ones – it’s just unacceptable. I want to be the point of care wherever I am, I want to get diagnostics and treatments based on my personalized customized features.
Wayne: Bertalan I might be I threatening to your tribe here, but general practitioners have made an enormous amount of money over the last 70 years by being the people who take your blood pressure, by being the people in some cases supported by legislation, who are the only people who can do some of these things. Is it doctors themselves who are standing in the way of some of this adoption?
Dr Meskó: No way and I’m not saying this to defend my own tribe. As the medical professional, I think that three major reasons why you don’t see these advanced technologies everywhere – the first is health care systems as a whole are just not open to innovation. Whether you go to a country with private insurance companies or to a country with socialized medicine for different reasons and due to doctor shortages, these systems are not open to innovations. Even if they were, I think people are not by this I mean stakeholders of healthcare not just medical professionals, they can’t easily adopt these new innovations and technologies. They are we are slow at this because that’s how we have been trained. When the first telescope was introduced, it to the guy who came up with the idea 30 years to get the message across because no Medical Association wanted use the gadget while practicing the art of medicine. So before, we had 30 years for one technology, now 30 new technologies come out every week and no medical curriculum prepares us for that. And the third reason is even if the systems were open to innovation and we could adopt to them to a much faster way, I think we are still afraid of the unknown. If you read about artificial intelligence and how those algorithms can perform better and better diagnosing at certain conditions, if you read about how robots can replace certain jobs in healthcare, personalized genomics and all these – obviously, we feel like this is a threat to what we have been doing and we might get replaced. I think these are the three major reasons why we don’t see the science fiction-like technologies in practice today.
Wayne: You’re listening to Health Professional Radio. My name is Wayne Bucklar and today I’m in a fascinating conversation with Dr. Bertalan Meskó. Bertalan is a PhD and a medical futurist and director at The Medical Futurist Institute and he also has his own website at medicalfuturist.com. And now at the risk of asking some questions that you’ve already answered on your own channels Bertalan, I’d like to take you into a bit of a look at the not too distant future but I guess the exciting future – augmented reality. Now I know it’s been used in surgery and for explaining diagnosis to patients, what do you see is the future fragmented reality in healthcare?
Dr Meskó: Well besides virtual and augmented reality, robotics, artificial intelligence – I’m more than happy to provide a few practical examples about how these can help transform medicine.
Wayne: Please, I ‘d love to hear them
Dr Meskó: One example is the one I sawo in studies because that’s you know how digital have needs to work, we still need evidence based studies to see whether they work in action or not. I saw a study about how virtual reality application helped patients to reduce pain in an objectively quantifiable way. In a US hospital, they tried to help patients we need to the hospital for long. They wanted to help them to feel better so they gave them virtual reality headsets with virtual fantasy worlds developed inside those so patients felt like they were on Iceland, they were in the middle of the sea just looking around them in a very quiet and peaceful way and they could measure objectively again that they’re pain score got reduced. I know about artificial intelligence based, but not artificial intelligence algorithms yet, that is going to help physicians diagnose better because it’s not about whether an algorithm can be better at diagnosing for example breast cancer on pathological issues compared to pathologists but my favorite study pointed out that when pathologists were allowed to use the algorithms to support they own decision-making, their success score was about 99.5% almost a hundred percent. It’s not about which one is better, it’s about how we can use them to make our capabilities or skills much better. We’ve seen examples when robots can look and go around in hospitals and they can disinfect the hospital room in about 12 minutes with UV light just by themselves. I’ve seen robots working in in the background of pharmacies to sort out medications and deal with the whole supply chain so the pharmacists don’t have to spend an hour or so every afternoon looking through the whole supply to make sure that they know exactly what’s missing – the robot just took care of that. I always try to advocate for the notion that it’s all about disruptive technologies replacing us or getting better at us it’s about ‘which repetitive parts of my job could be replaced by these technologies so I only do things that require me as a human being, that need my human skills from empathy and creativity to problem-solving and all these.’ The parts that makes somebody want to become a medical professional because I’m sure no physician who works today wanted to become a medical professional to do Administration in sixty percent of their time, no person in the world would like to do that. But we become physicians to help to care for people, who have eye contact have time to discuss the important issues when someone is vulnerable it’s even more important than other times. But now, we just don’t have time for that. We don’t have energy and effort to make sure that we can create that kind of real-life connection with patients. What I believe in is that good technologies, digital health technologies will help us remove the parts of our jobs that’s where we are not required so we only do what we are the best at – caring for people.
Wayne: That’s a lovely point and I’m so pleased that you made it. I was reading through my producer’s cheat sheet, when I get to do an interview I get a bio on people and I was struck by two things I didn’t understand – they were digital tattoos and nutrigenomics. So I’d like to invite you to educate me please on both digital tattoos and nutrigenomics.
Dr Meskó: I’m more than happy to do that. Let me look at it from that perspective, if you have a car and the engine light is on that you know that you have to take your car to the service or the shop and most of us do that early because we are afraid that it would just stop working at some point. We have no sensors, even if we do we have no idea that in our bodies, there is a warning sign and we should take care of that unless you have a symptom. But if we want to prevent diseases from happening, we have to be much more effective than that so what happens with digital tattoos is that these are very tiny, very flexible sensors that you can put on your skin. You don’t even feel that it’s on your skin and it can stay there for weeks and in the meantime, it measures Vital signs and health parameters. It measures your physical activity, your sleep patterns, basic vital signs from heart rate and even ECG – all the things that can help someone with an artificial intelligence algorithm in mind to try to draw conclusions from the big amount of data. If you could do that, I mean the physician-patient relationship you still do that but you have to meet the patient and measure things on-site at the point of care and then draw conclusions but personally I would love it to be a seamless and constant process. Whenever there is something wrong or about to get wrong in my body, let me know. Send a notification on my smartphone so I know I have to go to see a doctor because I think that’s always going to be a part of the process. Digital tattoos can make healthcare invisible, so you’re being taken care of even if you don’t even realize but it’s going on. The second topic you mentioned is one of my favorite ones because I have a hard time finding out what’s the best kind of food and nutritions that I have to eat every day. It’s a struggle I think for most of us but not because it’s so hard, but because we have no idea what we should eat. I had to test myself so I know which what kind of food or I metabolize differently or how much cocaine I can get a day make sure I feel okay. I know these tiny changes and details compared to for example yours, but most of us have no idea about this. So Nutrigenomics is using the fact that there are many genetic differences even between two persons and based on these those differences, our metabolism becomes different. So Nutrigenomics aims at telling people what kind of food, what kind of meals, what kind of nutrients will be the best for them and it tries to give them recommendations about what kind of diet they should follow. Actually it sounds like something from the future but if you think about that, I think we will tell our kids in 10 or 20 years that … in the early 21st century. we had no idea what we ate because we had no food scanners back then. We just thought we knew but we didn’t, we had no idea what we should eat based on our personalized metabolic differences and we had no idea when we should eat those things so it was a very barbaric era in the early 21st Century.
Wayne: Dr. Bertalan Meskó, it’s extraordinary here you explain some of these things and I do thank you for making yourself available to be with us today. Thank you very much for joining us on Health Professional Radio.
Dr Meskó: Thank you so much for having me on the show.
Wayne: Now if you just missed my chat with Dr. Bertalan Meskó, then you’ve just missed my chat with a fascinating man, the medical futurist who has been explaining some of the things
that are just going to have a huge impact on us both now and in the future. But the good news is, all is not lost because on our website you can find a transcript of the whole interview if you’re a reader. But given that this is health professional radio you probably don’t read all that much, so we have also an audio archive on iTunes, SoundCloud and YouTube that you can treat like a little mini podcast, well that’s because it is a little mini podcast and you can download and listen to it again at your leisure. Bertalan thank you very much for joining with us, I can’t say enough. I have really enjoyed having you with us and for people who want to reach out to Bertalan, the website is medicalfuturist.com and there you can find all sorts of fascinating insights from Dr. Bertalan Meskó about the future of Medicine and what it’s like to be a medical futurist. This is Health Professional Radio, my name is Wayne Bucklar and you’re listening to www.hpr.fm