We are getting used to hear that all sorts of technological innovations will help men and women live almost eternally without suffering: magic seeds, like the beans in the fairy tale, that grow without water and with therapeutic properties; colour pills that will extend our lives beyond 200 years; gene therapies that will eliminate cancer; brain implants allowing us to transcend for thousands of years, so we will never die and our conscience will remain not in a celestial cloud, but in some virtual servers. We expect to live in a kind of chapter from the dystopian series Black Mirror (any self-respecting wannabe visionary has watched every single season), but produced by sweet and benign Disney and starring Mickey Mouse.
However, sometimes that ideal chapter shows us a rather less genteel side. For example, there is the entrepreneur in San Francisco dreaming about getting blood test results without extracting blood, who ended up being a con artist (the Theranos case). An example proving that Silicon Valley saying “Fake it till you make it” cannot and must not be used in healthcare situations. Regulations are severe, and a biotechnology company must not be set up without biotechnology experts, regardless of whether its founders are graduates from Stanford or MIT.
Another less visible story was MIT cutting ties with Nectome, a company that intends to download terminally ill patients’ minds onto a computer terminal. The main reason was the excessively hopeful message advertised that claimed it could maintain the individual’s conscience. Once again, it was this excessive level of expectation the project generated on something as delicate as someone’s life and their loved ones that alerted the scientists.
Despite these incursions in the dark side of Black Mirror, we all hope that technology will allow us to do more (and better) with fewer resources, particularly in health related issues. Many of the WHO’s most important challenges rely exclusively on technology improvements to change things in the short term on a universal scale.
Expanding universal healthcare using a public system undoubtedly calls for measures that only technology can provide. Measures such as a virtual triage using Artificial Intelligence from home could create a more efficient patient flow towards the existing healthcare resources, as they would get appointments online in an orderly way and without having to wait on the phone. The NHS is taking its first steps with Babylon Health in this sense. Also, to follow patients with chronic diseases or for preventive measures (including mental health), both sensorisation and teleassistance have a lot to offer. The elderly population will certainly have digital assistants and caregivers that will never get tired and will learn to be empathetic, in a true Disney Hero style.
Often, Black Mirror examples are also used to discourage innovation in healthcare. There are talks about cybersabotage when problems are caused by a bad maintenance of software versions due to greedy and lazy companies. There’s talk about data protection, when in fact, as citizens, the processing of all our data belongs to us and we should therefore be able to decide if we want to engage in clinical studies and new therapies. There’s also talk about a lack of clinical evidence supporting eHealth, hindering large scale digital healthcare instead of getting down to testing. It’s cheap and easy to make up excuses to avoid change. Everyone says they want change, but deep down few people really want to change. However, that long-awaited benign change will come, because we all know Disney stories end well.
