In occasion of 25th anniversary of the Nature Medicine, the journal published in January 2019 a series of commissioned articles, perspectives and features with a special focus on digital medicine. The articles highlight new technologies with a potential to transform medicine and healthcare, as well as related regulatory challenges ahead.
Digital medicine refers to the use of digital tools to upgrade the practice of medicine and holds promise in revolutionising healthcare. At the core of this movement is the development of technological solutions to monitor, process and integrate different data at the individual and population levels to help address the health problems and challenges faced by patients, clinicians and health systems.
It is expected that new digital era of medicine democratise access to care and empower patients to engage with their health in a preventive way. It also holds the promise of helping clinicians to navigate the increasing volume and complexity of patients’ data in a cost-efficient and time saving manner.
Artificial intelligence, and in particular deep learning, is among the leading technological tools beginning to be used in the interpretation of medical images and electronic health records. Artificial intelligence tools are speeding up diagnoses, guiding therapeutic choices and optimising patient experience.
The US Food and Drug Administration (FDA) announced its intention to use cost-effective strategies and big data to accelerate the regulatory path of clinical trials, medical product development and innovations in artificial intelligence. On 7 January 2019, FDA Commissioner Dr Scott Gottlieb announced Digital Health Innovation Action Plan. Therefore, it is assuming that medical community will be seeing new devices approved in near future.
One of the perspective articles in the Nature Medicine provides an update on the regulatory environment of artificial intelligence-based technologies across the globe.
A review article entitled ‘High-performance medicine: the convergence of human and artificial intelligence’ underlines that although the benefits of digital revolution are easy to point out, the magnitude of the challenges it creates is harder to predict. Over-the-counter use of medical devices to detect conditions that normally would require assessment by a physician could lead to overdiagnosis in the healthy population, increasing the burden handled by healthcare systems instead of relieving it. Moreover, there is still a paucity of prospective clinical studies assessing whether there is a net benefit of incorporating artificial intelligence algorithms and devices in clinical practice.
Other challenges in digital medicine, discussed in an article entitled ‘Privacy in the age of medical big data’ concern the privacy of health data and establishing proper consent and patient governance in data collection, as well as developing regulation to protect individuals against the use of personal data for discrimination.
It is also worth exploring how the human aspect of medicine, relations between patient and physician, may be affected by the increasing use of technology in medical practice.
An accompanied editorial features that the series represents a collective effort of the journal’s editorial team. When the journal launched 25 years ago, the World Wide Web was only beginning to take off, and medicine had nothing to do with mobile phones and smartwatches.
The celebration of the journal’s anniversary is just at the beginning of their publishing efforts towards digital medicine. Throughout the year the journal will be highlighting young to mid-career researchers, who are changing the medicine’s landscape, as well as featuring on how medicine has changed over the past years. In that regard they highlighted an article entitled ‘Twenty-five ways clinical trials have changed in the last 25 years’.