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Health Care 2037
Distinguished alumni predict a bright, tech-based future
By Kim Franke-Folstad
Americans want to be hopeful about health care. We want to believe the future holds new cures and technologies – but also, maybe, a return to some old-fashioned values. We like to think our nation's entrepreneurial and innovative talents will make it all OK, will make us all OK, and at a price we can afford. And we pray that our grandchildren and grandparents will live even happier and healthier lives than generations past. It's a lot to ask. We asked five distinguished or outstanding alumni from USF's health colleges to look into the future and tell us what they think may be happening in their fields 20 years from now. Their predictions are exciting, challenging, comforting. Here's hoping they come true.
Dr. Peter Embi, the Morsani College of Medicine’s 2017 Distinguished Physician Alumnus, has a job description you can expect to hear about more often in 2037: He’s a physician, researcher and expert in biomedical informatics. Information and technology have already changed the way medicine works, says Embi, MD ’97, president and CEO of the Regenstrief Institute at Indiana University. Advances in big data and analytics will continue to change the role of health care providers and the way people interact with the health care system.
Now, patients go to a doctor or hospital when they're ill, "and we drive care," Embi says. But in the future, he expects to see a more sophisticated approach, with patients taking control of their own health and wellness. "The word patient may even go out of favor," he says. We can already see signs of that change with the ubiquity of devices such as smartphones and wearables that monitor what we eat, how we exercise, our blood pressure, breathing, etc. That data says more about your health than much of what's in the records at your doctor's office, Embi says, and contributes to better preventative care.
Doctors will be able to use that data – along with more specific information about your genetics, environmental exposures, experiences, and other factors – to keep you healthy and tailor your treatment when you're sick. Each individual's information will also go into a database that informs what we know about each disease and how to treat it, Embi predicts, and knowledge will grow globally. "We'll learn from every patient encounter."
The system will be bigger, faster and more efficient, with fewer errors, he says. "So we can take better care of this person, and every generation after that."
Patricia Quigley, 2013 College of Nursing Distinguished Alumna, foresees fewer people suffering life-changing or deadly injuries from falls. A longtime advocate for fall injury prevention and a nationally recognized patient safety expert Quigley, ’75, MS ’82 and MPH ’06, is a fan of customized interventions that protect vulnerable populations, such as people over age 85.
Right now, falls are the leading cause of injury death and non-fatal unintentional injuries, according to the CDC. The World Health Organization reports that in the United States, 20 to 30 percent of older people who fall suffer moderate to severe injuries such as bruises, hip fractures or head traumas. The risk is due in part to physical, sensory and cognitive changes associated with aging – but also because environments are not adapted for an aging population.
Bedside mats, real-time camera surveillance and smart garments that can protect the hips and head are among the products now being developed to prevent serious injuries. Quigley expects more innovations to come. Dangers to the elderly should be given the same level of attention as those for infants and toddlers, says Quigley, who recently retired as associate director of the Veterans Integrated Service Network (VISN) 8 Patient Safety Center of Inquiry. Each at-risk group requires a different approach, she says, but the same level of care.
Versie Johnson-Mallard, a 2011 College of Nursing Outstanding Young Alumna, sees the eradication of human papillomavirus (HPV)-related cancers as a real possibility for the next generation of girls and boys. "My wish would be that every parent vaccinated their 11- to 12-year old boy or girl with the 9 Valent (HPV) cancer prevention vaccine," says Johnson-Mallard, PhD '05 and MS '10.
HPV is the most common sexually transmitted infection in the United States. The Centers for Disease Control and Prevention (CDC) estimates that more than 90 percent of sexually active men and 80 percent of sexually active women will be infected with at least one type of HPV at some point in their lives.
Johnson-Mallard's work in sexual and reproductive health clinics – and the gaps in knowledge she saw in her patients there – inspired her to go back to school to get her doctorate in nursing science at USF. Now a board-certified women's health nurse practitioner and chair of the department of Family, Community and Health System Science at the University of Florida College of Nursing, she predicts health care providers won't pass up opportunities to educate parents about the HPV vaccine and to inoculate children.
"Across our nation and globally, nurses, nurse practitioners, physicians, pharmacists and public health providers will band together and provide factual information to consumers of health about this cancer prevention vaccine," she says.
Dr. Julie Jacobson, the Morsani College of Medicine's 2014 Distinguished Physician Alumna, works every day to make the future brighter – that's her job as a senior program officer for the Bill & Melinda Gates Foundation. It's the foundation's goal to decrease inequity, she says, "and health care is at the leading edge of that."
The United States is going through some "growing pains" right now, but we're in a time ripe for optimism, says Jacobson, '90 and MD '94. The Affordable Care Act is a solid step in the direction of health care as a right, she says, and her hope is that in 20 years we'll have a noncontroversial single payer system. Her work is global, and it's heartening, she says. The new director general of the World Health Organization, Tedros Adhanom Ghebreyesus of Ethiopia, believes access to good health care should be an expectation, and "everything builds from there."
In Jacobson's specialty, neglected tropical diseases (NTDs), the people who suffer most are those who live far from ill-equipped health facilities that have few resources and untrained help. In a world where a child can die from lack of access, the challenge for global care is prevention, she says.
That's the goal for coalitions like Uniting to Combat Neglected Tropical Diseases, of which she is a part. A collaboration between global health and development organizations and industry partners, the organization aims to control, eliminate or eradicate 10 NTDs by 2020. More than 998 million people have been treated through the partnership's efforts, not only improving health in their countries, but also the potential for economic development and political stability, Jacobson says.
"It's been such a success, and it's a sign of what we can do if we work together," she says. "We're on the path, and then it will be up to the next generation. That's the vision."
Philip Amuso, the 2015 College of Public Health Distinguished Alumnus and retired assistant professor at USF, has spent his life in the lab. As director of the Bureau of Laboratories for the Florida Department of Health (now retired), he dealt with the Bacillus anthracis (anthrax) attacks in 2001, the H1N1 influenza virus in 2009, and the Ebola epidemic in 2014.
When it comes to public health and laboratory work, says Amuso, '73, MA '75 and PhD '00, Life Member, "we kind of live from crisis to crisis in terms of financial resources. Generally speaking, there has to be a big perceived threat out there to yield an upgrade in modernization." And it's hard to guess what that big crisis will be two decades from now.
But Amuso, who still consults in clinical laboratory medicine and public health preparedness, does see a paradigm shift coming. Organizations like IBM and Alphabet Inc., Google's parent company, are pouring billions of dollars into artificial intelligence applications, including those related to health care. Remember Watson, the computer that won $1 million playing Jeopardy? Watson has since moved on to more serious challenges. The computer's accuracy in reading mammograms, in tandem with a real-life physician, is astounding. And it's being used to connect data for all kinds of patient care.
"So, here you have this computer that sits with these doctors, and they talk about treatment plans for people," Amuso says. "I see this as the most exciting thing in my lifetime to happen to medicine, and that includes the laboratory – having this huge resource that can take millions and millions and millions of pieces of information and process them in seconds."
While other changes will be incremental, this will be a quantum leap, he predicts. Someday you'll go in for a diagnosis, and instead of a couple of doctors trying to figure out what happened during a clinical trial, they'll have access to information from hundreds of thousands of people who have, or had, your disorder. They'll be able to customize your treatment plan based on your genetic makeup, your age, where you live and what you eat.
"There will be so many factors that can be entered into the equation, it's just mind-boggling," Amuso says. "I think artificial intelligence is going to be a boon to health care. Public health, personal health care, laboratory, imaging – every facet."