The paradigm of human healthcare could undergo a dramatic transformation in the years and the decades to come. Just a few days ago, Toyota Motor Corporation (Toyota), the world leader in automobiles, unveiled robots and robotic devices that assist elderly and disabled people perform day to day activities. Previously unthinkable tasks such as climbing the stairs by aged people with knee immobility or getting out of bed for bedridden people could be soon a matter of realization rather than hope. Toyota is confident that these new robotic developments are not going to be mere technological showpieces but would actually be smart companions that would be commercially available. This marks a new height scaled by engineering which consistently has been crossing new milestones in diagnostics and minimally invasive and non-invasive surgeries (the latest ones being the ultra-precision scanners, directed radio knife for oncology and ultrasound surgery for uterine fibroids). One may imagine that engineering strides would continue to lead to an unforeseen improvement in the lives of patients and the needy.
At the other end, research into regenerative medicine continues to make steady progress. Regenerative medicine is the process of replacing or regenerating human cells, tissues or organs to restore or establish normal function. This field holds the promise of regenerating damaged tissues and organs in the body by replacing damaged tissue and/or by stimulating the body's own repair mechanisms to heal previously irreparable tissues or organs. Regenerative medicine also empowers scientists to grow tissues and organs in the laboratory and safely implant them when the body cannot heal itself. Because a person’s own (autologous) cord blood stem cells can be safely infused back into that individual without being rejected by the body’s immune system — and because they have unique characteristics compared to other sources of stem cells — they are an increasing focus of regenerative medicine research.
Indian medicine, regenerative potential
India has the doctors’ hands that cure like the best from anywhere else in the world. Indian doctors have also demonstrated the ability to utilize the best of scanning and surgical devices to enhance the efficacy and certainty of surgeries. There is a view that the Indian hospital infrastructure is so grossly inadequate and the availability of doctors and beds is so woefully low that it makes little sense to focus on the futuristic areas of medicine. While there is an element of truth in this, every inflexion of technology offers the opportunity for developing and emerging countries such as India to leapfrog into cutting edge technologies. There are nearly thirty institutes in India such as L V Prasad Eye Institute which are conducting successful research into use of stem cells for various degenerative diseases. Given India’s population spread, disease burden and medical expertise, regenerative medicine could be a great new area of research and application for healthcare in India.
Importantly, regenerative medicine has the potential to solve the problem of the shortage of organs available for donation compared to the number of patients that require life-saving organ transplantation, as well as solve the problem of organ transplant rejection, since the organ's cells will match that of the patient. The use of cord blood stem cells in treating conditions such as brain injury, cardio-vascular ailments, Type 1 Diabetes, stroke, eye repair and hearing restoration would grow in future. As several clinical and pre-clinical studies currently underway demonstrate, cord blood stem cells will likely be an important resource as medicine advances towards harnessing the body’s own cells for treatment. The field of regenerative medicine can be expected to benefit greatly as additional cord blood stem cell applications are researched and more people have access to their own preserved cord blood.
Indian technology, mechanical advantage
At first glance, India could be perceived as a nation that has to be dependent on imported medical technology for perpetuity. However, Indian technology has also its pluses, especially in mechanical, metallurgical, machine tool, automobile, component and aerospace domains. While the machining and casting precision levels have not been up to exacting standards essentially due to lack of precision tooling and die technologies, mastering precision is not an insurmountable goal for the Indian industry. With its Jaipur foot, India has shown that it has the ability to provide low cost solutions for enhancing patient mobility. There is, therefore, significant scope for the Indian industry to participate in the healthcare robotics revolution. What India clearly misses out is on the semiconductor and micro-electronics technologies which it could balance to an extent by the software technology skill sets that would be extensively required in robots and robotic devices.
The Indian private and public sector corporations to date have focused only on basic and consumer industries. The aspiration to engage themselves in newly developing technologies has been somewhat on a low key. This is demonstrated by the reluctance to develop high end products (for example, luxury cars, precision forgings or cold rolled steel) even in the industries where Indian corporations are strong. However, of late there has been a clear glimmer of hope. Tata Motors’ turnaround of Land Rover Jaguar and development of new high end models with Indian components indicates that Indian industry could secure a niche in complex engineering if it sets it heart on the goal. This could, however, require large conglomerates and government corporations to dedicate certain portion of their research and manufacturing expenditure to high technology products.
Artificial intelligence, natural competency
India would have a natural, national advantage in developing products of artificial intelligence, an essential facet of robotics. Robotic devices help patients who have some level of mental ability to understand how to overcome physical disability with robotic assistance. More often than not, seriously ill patients would require caretakers to help them take robotic assistance. Artificial intelligence could be one technology that could help patients comprehend their needs and cope with their disabilities, and also enable doctors, nurses and caretakers fulfill their responsibilities more accurately. Artificial intelligence is more than a computer providing a set of programmed instructions or a series of question and answer sessions. Artificial intelligence that is relevant to the healthcare sector requires real time analysis of the patient’s faculties and comparing them with what should have been a healthy person’s faculties and guiding the patients as well as the robots through the gap bridging.
Artificial intelligence would be helpful to the larger universe of doctors, nurses and caretakers as well. Artificial intelligence could also vary in its scope and application based on the disease state of the patient. A patient affected by Parkinson’s disease would have needs that are different from those of a patient affected by epilepsy, for example. The deficit in faculties varies significantly across disease states. Artificial intelligence could also provide significant reinforcement to devices that are implanted in a patient to regulate his or her physiological state such as a cardiac pace maker or a diabetic insulin pump. Sensory technologies play a major role in developing a patient baseline and a target health line for artificial intelligence. Given the billions of information bytes and logic sets that would need to be captured and codified even in a modest project of artificial intelligence, the Indian information technology industry could play a major role.
Multiple disciplines, singular focus
From complex mathematics and sophisticated engineering to involved psychology and intricate neurology, virtually every discipline is required to develop a viable platform of artificial intelligence. Unlike any other discipline, artificial intelligence has no particular unifying theory. No direct correlations and influences are possible either. Bird biology may not be very relevant to aircraft design but human biology could be quite relevant to healthcare artificial intelligence. Amongst all diverse approaches developed for artificial intelligence, from programmed logic to random simulation, mathematics and statistics with integration of neurological science and human behavioral logic provide a useful approach. Developers are now seized of methodologies and tools that could add even empathy and emotion to artificial intelligence to mimic human intelligence and behavior as much as possible.
A major challenge in artificial intelligence relates to storage and computing power. This has been overcome to a large extent; even otherwise the computing power of computers would continue to grow exponentially. What could limit artificial intelligence is the sheer plurality of behavior of human mind. Even billions of programs could prove unequal to the individual shades of variation in human behavior. It is, therefore, necessary that while deploying as many disciplines as possible to develop viable platforms of artificial intelligence, developers should go deep into specific fields. For example, initial focus could be on disease conditions which have faculty deficit rather than total faculty absence. As the discipline of artificial intelligence proves itself it becomes easier to integrate the learning into newer devices for more complex diseases such as stroke and Alzheimer’s disease.
Indian potential, capable entities
India has probably several advantages to become a centre of global excellence for artificial intelligence. India traditionally has had one of the strongest bases for mathematics and statistics, which is now fortified with multiple disciplines of engineering, especially software engineering. The strategy to become a global power in artificial intelligence has four components for India. The first is the building of supercomputers that can process billions of calculations. The second is the multi-disciplinary programming effort required to create the artificial intelligence. The third is to integrate artificial intelligence with a host of advanced diagnostic and surgical devices to enhance the capabilities of physicians and surgeons. The fourth is to establish an optimal interface and governance between the patient, doctor, nurse, hospital, and caretakers. In each of the four areas India can be take up visionary research and development.
India has demonstrated its capability to build supercomputers such as Param and SAGA with TeraFLOP computing capabilities. As Japan’s latest supercomputer development (K computer doing 10 quadrillion calulations per second) demonstrates, there exist no limits for computing capability. To succeed in the domain of healthcare artificial intelligence, however, India may need to take the supercomputing revolution to the desktop and mobile computer fields, besides networking the central supercomputer to a host of servers. With reference to the multi-disciplinary programming, there are several institutes in India that are dedicated to advanced mathematics, computer sciences, biological sciences and medical engineering as well as medical institutions dedicated to certain disease streams. These institutions can collaborate to develop the thinking and execution for artificial intelligence.
The networking of the above two capabilities with medical diagnostic and surgical hardware would be challenging given the fact that all such equipment is produced only by a few global leaders in medical technologies located in the developed world. That said, GE has been a pioneer in trying to explore the Indian advantage in developing new medical devices in India. India would need to create a value proposition for such equipment majors as the preferred partner for artificial intelligence. Despite the tremendous progress made in imaging of the body, interpretation of the results continues to be a human dominated. In today’s busy medical world, the doctor devotes only very little time to analyze the hundreds of images taken per patient. Artificial intelligence can help the doctors extract the full value of the sophisticated imaging for achieving precision cures. This leads to the next step of limiting cure to the extent required, selectively and precisely, again with the help of artificial intelligence.
Palm reading, body scanning
Several pieces of mythology and fiction have come true in real life over the last several decades and centuries. A dramatically transformed healthcare scenario where science and technology deliver regenerative, reconstructive and reinforcing options for human life would also come true one day. The world over, and across civilizations, palm reading has been popular to understand what the future foretells in terms of health and longevity, among others. In future, hopefully, body scanning backed by artificial intelligence would be, as easy and commonplace as palm reading, and would be a far better predictor of longevity and health. This enhanced predictive capability coupled with robotics and regeneration would make the world a better place to live and enjoy life, for sure.
In terms of developing a total healthcare ecosystem, comprising the patients, doctors, nurses, caretakers and hospitals, based on equipment integrated with artificial intelligence, India can create a model of futuristic healthcare. Today’s poor healthcare services need not deter India from taking a giant leap into this domain. It would be appropriate for the Government of India to develop a nationally networked program of artificial intelligence for specific diseases as a national technology mission. These need to be centrally funded as immediate commercial returns are difficult to envisage. India has some of the best leadership brains that are being utilized in conventional areas such as aerospace, defense, atomic energy and unique individual identification number as well as in various medical, scientific and engineering disciplines. Some of these leaders can be brought together to kick-start the Indian Mission for Artificial Intelligence Networking (IMAIN) for a new era of more assured healthcare.
Posted by Dr CB Rao on November 6, 2011