The practice of medicine has come a long way in a relatively short amount of time. Consider that from the dawn of medicine, or about 400 B.C., the time of Hippocrates, until the American Civil War, the practice of medicine did not change very much. During the Civil War, the basics of infectious disease and dietary insufficiencies were as yet undiscovered. That is why only one third of Civil War deaths were attributable to battlefield injuries. Two thirds of Civil War deaths were from illness and disease, running the gamut from gangrene, dysentery, and cholera to scurvy and beriberi. Today, a scant 170 years later, medical knowledge and diagnostic testing has exploded. Almost daily, new discoveries are being made that make the diagnosis and treatment of human disease better. Yet it must be understood that medicine remains an art, not a science. And that is because of human nature, or the fact that, excepting twins, no two humans are alike and will therefore react differently to treatment regimens.
There are five trends that may shape the future of medical diagnosis. They are:
- Movement from symptom-prompted testing to continuous monitoring and assessment, and from within health settings to everyday living.
- Shift in reliance on individual test results to interpretation of data streams and data patterns.
- Change in the meaning of an “abnormal” test result from a deviation against a population norm to an aberrancy in an individual’s pattern of results over time.
- Increasingly refined and specific diagnostic categories in step with the advent of increasingly differentiated treatment.
- Augmentation of the goals of diagnostic excellence from the detection of disease to the preservation of wellness, and from indicative of present disease to predictive of the future state of health.
Medical records have evolved as well. Once, a medical record consisted of a manila file folder containing doctor’s (usually indecipherable) office notes, test results, and consultant’s notes. Today’s electronic medical records contain much more than that. There is a trend away from periodic blood testing to continuous monitoring. We see it in diabetics with continuous blood sugar monitoring and wearable EKG devices, both usually linked to smartphones. There are also wearable detectors for toxins, air particulates, and radiation. New, miniaturized measurement and monitoring tools, such as those worn, implanted, or swallowed are coming into use. Smart fibers that monitor patterns of breathing, heart rate, chemical composition of sweat, and other uses are under development. The results of all this testing and monitoring go into the patient’s electronic record, as does all genetic testing and information.
All of this means each patient will have a huge electronic file containing highly sensitive and personal information. Healthcare systems must make maintaining the security of these files a top priority. Allowing these files to be obtained by hackers or other unscrupulous parties could be devastating to the patient as well as the provider and healthcare system.
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