Caring about Time

Time to Care. This could also be interpreted as ‘Caring about Time’.

Whatever man’s data collection prowess, we risk being diminished as human beings if we do not ensure that the data human intelligence has allowed us to put together are used for the benefit of all.

Although the wealth of data now available does not in itself solve the issue of the time available for care faced by doctors and patients, the fact remains that today we have complex integrated data collection and processing systems at the service of doctors, scientific research and complex healthcare organizations.

The problem today is rather to link all this with the time to care by simplifying and enhancing the way we provide healthcare. To do this, the whole healthcare system must be involved, especially health system management.

These are exciting times for research institutions and the people who work in them, with milestones being reached in incredibly short timeframes. However, this should not make us forget that for many professional operators and ordinary men and women, the time to provide and receive care is often still very lengthy and risks becoming even longer while in other cases in other contexts that time is all too short.

I allude rather to those cases where time to care is a reality, providing all-embracing care within expanding timeframes. Although still only for the lucky few, in these instances the future is already here.

Today’s tireless targeted research will lead to the development of full-fledged treatment regimes in less than ten years, achieving previously unthinkable goals and bringing the prospect of being able to extend treatment to all those in need.

Big Data allow previously unimaginable synergies and swift changes. The problem now is twofold: to ensure these changes become opportunities for pharmaceutical companies to produce successfully, but at the same time, are not rejected but actively embraced by healthcare systems – especially the public healthcare service – with the introduction of organizational innovation.

This requires the full commitment of all healthcare operators, especially medical doctors, along with the full backing of institutions as part of their public service duty.

Indeed, institutional commitment to a public service duty is a way of avoiding phenomena like the formation of groups that take it upon themselves to spread anti-vaccination propaganda.

The enormous quantity of information released every day on the web as a result of biomedical innovation – which thanks to ICT and financial backing currently has more than 7 thousand new drugs in the pipeline – has to be correctly interpreted and put to use quickly and appropriately.

Connected to a gigantic data collection system, machines are producing a
continuous flow of bits. Man is able to collect these flows and literally ‘shoot’
them into our digital system.

(From the presentation by Professor Enrico Bucci and Professor Andreas Hoeft at the third edition of the Festival della Scienza Medica[1])

These data are a major outcome and will impact our society in a way still to be assessed and quantified. Assumptions abound. As a consequence, the future is full of unknowns.

Research data double every six months. No one can read them all.

The expression used is the ‘semantic analysis of unstructured data’.

Digital technologies re-design the doctor-patient relationship. Smart, across-the-board processing of Big Data paves the way for personalized medicine.

Healthcare professionals are developing new ways of working. Robotics and its attendant workers, biomedical engineering and physics have all in recent years profoundly impacted the most innovative sectors of the pharmaceutical industry and today dictate the ‘time to care’.

The electronic processing of all healthcare data, from hospitals to individual patients, means that broadly trained operators are confronted with a mass of molecular data whose management requires the involvement of the medical community, from researchers to healthcare management. All players must be made aware of the importance of being part of the on-going experimentation and its relevance for patient treatment.

Yet the time issue, especially the question of time to care at the individual level, remains decisive and often neglected.

The Festival has on several occasions looked at the question of the delicate relationship between doctor and patient. This year, it will also consider the psychology of medical decisions and their effect on patients.

From the considerations given above it is evident that tools like Big Data and the technological platforms able to put this wealth of information to good use have the ability to produce rapid analyses and action. As a result, the question of the doctor-patient relationship comes to the fore once more, taking on a much greater significance than even a few years ago.

From the United States we hear of doctors’ visits lasting 15 to 18 minutes – less than the time spent at the barber’s, despite the fact that the doctor-patient relationship must be built on continuity and trust.

The Festival looks at these questions in a constructive way since the Italian healthcare system, albeit not always and not everywhere, today deserves our applause.

There are, admittedly, issues of fragmentation, but these are being dealt with successfully in many areas.

Research and development in the field of artificial intelligence and telemedicine will also be on the Festival’s agenda, looking at how best to use data to improve healthcare delivery.

How can the values of empathy and a sense of trust be restored to doctor-patient relations, allowing the doctor to once again be a mediator between patients and their illness?

What does including the Medical Humanities once more into medical practice actually mean? How does this play out in a context where the doctor-patient relationship is superficial and often without any plausible follow-through, and where suspicion on the part of patients and their families – often supported by the legal profession – further undermines the relationship?

Fabio Roversi Monaco

President, Genus Bononiae. Musei nella Città

 

[1] L’era dei Big Data. Intelligenza artificiale e medicina (Bologna, 22 April 2017)