In order for patients to benefit from progress made in life science and medical research, healthcare has to go through fundamental changes, if not reinvent itself. Today, topics such as artificial intelligence, machine learning, internet of things, big data and digitization are becoming essential to any medical facility. At Basel University Hospital, Switzerland, cardiologist Dr. Jens Eckstein, chief medical information officer, coordinates these aspects for researchers and clinicians alike. Let’s take a fictional tour of his hospital in 2025.
The first thing you’ll notice is that the reception area is missing. Registration, from which patients were sent to remote corridors and floors, is now superfluous. Patients receive their appointment on their smartphones via a text message. At the same time, the hospital’s app provides directions to the facility from the patients’ homes. Patients are guided to the hospital’s parking lot, where free spots are reserved at the time of their arrival. In the hospital, the navigation system leads the way to the waiting room. The app also lets the patient know what electronic files he needs to bring along, and if eating or drinking before certain procedures is allowed.
In the cardiology outpatient clinic, names appear on screens and indicate which patients are currently registered and where they can be found on the hospital’s campus. Five patients are already in the waiting room. Medical records are pulled up automatically and made available to the doctor’s office. Every patient manages his own medical records. For this, cloud-based applications exist. The physician is granted access to this data before every appointment. Data analysis is fully automatic.
After a waiting period of 15 minutes, our patient, whom we’ll call Patient X, is called up. The appointment with the cardiologist was neither requested by the patient nor by the physician. Instead, software for monitoring physiological data found a deviation. Genetic screening in childhood showed Patient X to be at an increased risk of stroke. Since then, corresponding risk factors that indicate the onset of atrial fibrilattion have been continuously monitored at home by the patient. He regularly measures his oxygen saturation, pulse, blood pressure, even records an ECG with the help of a smartphone and smart clothes. Urine and stool are monitored by a remote system installed in the bathroom.
Furthermore, Patient X has agreed to track his vital signs with his personal devices such as sensors and fitness trackers. This information is displayed in real time in the clinic’s data processing center. Algorithms and artificial intelligence evaluate the data according to specific criteria, such as genetic predisposition, pre-existing conditions, current activity and vital signs, as well as medications taken regularly. Hospitals have worked for years so that the data collected in the health system, for example the laboratory values, the findings of the physician, hospital stays, long-term data collections, are comparable and can be evaluated anywhere in the system. This system was a prerequisite for using information gleaned from DNA sequencing.
Patient X’s appointment concerned changes in a blood parameter – for people with his genetic makeup a possible sign of impending atrial fibrillation. Today, doctors try to avoid disease rather than just treat it. Patients are only called in if their data calls for more specific diagnostics. Patient X has gotten to know his physician during their two annual teleconference meetings, where questions about lifestyle, prevention and other options for action are discussed. The hospital provides our patient with insight into current trial results on subjects that concern him.
Arrival at the imaging diagnostics laboratory: Patient X now receives a comprehensive visualization of his cardiac perfusion while resting and under stress. The data is automatically entered into his electronic medical record and compared with existing findings. Patient X will have to spend a night in the clinic.
The chief physician is done with today’s appointments. He now will take care of some telemedical patient talks. This service is used by patients and colleagues independent of their present geographical position.
The doctor dictates his letters and findings. Software automatically creates comprehensive results, sends letters to the patient’s medical team and saves the new data to the patien’ts personal electronical medical record. The entire hospital administration is paperless and digital. The access is controlled by the patients themselves using block chain technology.
Patient X is done with all his tests. The cardiologist presents the findings on two large screens. A computer program suggests options for further treatment with drugs that are particularly effective for people with Patient X’s genetic profile. There is also a voice-controlled digital assistance system in the room, which can be used by both doctors and patients. Patient X orders his dinner, the doctor a new drug for his patient.