An interview with Professor Dr. Tobias Preckel (Steinbeis Transfer Center for Medical Engineering & Life Sciences) and Professor Dr. Sascha Seifert (Steinbeis Transfer Center for E-Health Systems and Medical Informatics)
Artificial intelligence, big data, the cloud – digital transformation is now also happening in all areas of medicine. But what will it mean for patients? And what role will data protection play? TRANSFER magazine spoke to Professor Dr. Tobias Preckel and Professor Dr. Sascha Seifert, Steinbeis experts in the digitalization of medicine, and discovered how important it is for medical advancements to gain public acceptance and how all stakeholders have something to gain by linking up technology and data protection.
Hello Professor Preckel, Hello Professor Seifert. Digital transformation and other kinds of technological innovation are accelerating the rate of progress in medicine and medical technology. How exactly does this development impact your work?
In essence, it’s actually what my work is all about as a medical computer scientist and bioinformatic specialist. And digitalization is a given in my work per se, because it’s about digitalizing medicine. On the one hand it’s about helping with diagnosis in the future by using computers, but also smartphones. But on the other hand, it’s also about things like making systems available to hospitals by offering digital solutions – systems that help them with decision-making. The second area is bioinformatics. The current trend in this area is taking us away from time-consuming molecular diagnostic testing, using real samples, and trying instead to work first with models on computers. This is similar to what they do in the automotive industry, where first you create a model and conduct and evaluate it, before you build and test a real car.
That’s also how I see it. Previously, you basically tried to study the biochemistry or development of a disease by examining individual metabolic pathways or specific molecules and their corresponding partners. These days, due to the availability of information and data processing systems, we tend to use a more systematic approach. You try to spot correlations by looking at the data that’s already available from different sources, and draw conclusions that way. We’re moving away from detailed experimentation with individual components, so we’re adopting a systemic approach by trying to develop models in advance – before embarking on elaborate investigations. Coming back to your question regarding the actual impact digital transformation has on my work, I’m more concerned with looking into the possibilities offered by digital solutions in areas such as diagnostics. DNA analysis and investigating the risk of disease based on DNA sequence would be impossible without digital technology. It merges several developments at the same time, especially when it comes to personalized medicine.
Why do you believe it is important to inform society about future technologies in the field of medicine? What kinds of things need to be taken into account?
I think it’s extremely important because medicine will be driven by more technology in the future. The population is aging due to demographic trends. This means the number of people who will need medical support will rise, and this could lead to a drop in medical standards. But we want standards to stay the same. The question is: how? By introducing digital solutions, by avoiding the need to repeat medical examinations, and by ensuring that assessments or diagnostics are conducted more quickly or improve in terms of quality. So that means more and more use will be made of technology to keep the healthcare system on the same level it’s on today, and maybe even improve it and make it less expensive. As things stand now, I see no other way forward.
I also think it’s really important to keep people informed when it comes to new technological developments in medicine so you gain public acceptance. And I think the main focus in this respect will lie in the central storage of patient records. These days there is a trend towards instrument-based diagnosis and our billing systems are set up in such a way that the acquisition and analysis of the patients’ medical history is hardly being paid for, if at all, and it’s the use of diagnostic systems that earns the money. So as a result, doctors are motivated to – whenever possible – use and apply their own diagnostics. But the result of this is that there’s not only too much diagnosing going on, but also for example the diagnostic results of different doctors’ offices are not being pooled. That’s why I think there’s a lot to be gained by storing patient records centrally. It would cut costs and improve the quality of diagnoses. And it could help avoid false diagnoses, because people would simply have access to more information.
And this is where I think things like artificial intelligence come in as a supportive instrument. There are plenty of examples of patients being admitted to hospital with acute symptoms and one of the first things they’re asked is, “Is there a history of any conditions in your family? Is there anything we need to know?” In such a stressful situation patients are prone to forget that there’s an increased tendency of increased blood coagulation in the family. If such conditions aren’t reported and treated prophylactically, in the worst-case scenario you’ll get thrombosis. These are the sorts of risks that can be avoided if you store information centrally.
Turning to you, Professor Seifert, you deal with the internet of medical things, i.e. cloud and big data applications. What opportunities do these technologies offer, and what obstacles do you face?
One of the biggest difficulties at the moment is gaining public acceptance. In Germany, we tend to suffer from techno-fear. This is something we need to tackle – consciously.
In terms of the opportunities, one aspect is that we’re extremely sensitive when it comes to data privacy protection. This is a major advantage for us. The perfect example of this is the coronavirus app. In Germany, we came up with a solution that is marveled at throughout the world because it found an excellent way to implement the technology and data privacy. I think Germany’s extremely strong in both of these areas and it has a good chance of being successful with this internationally.
And you, Professor Preckel: There’s a growing trend toward individualized medicine. What conditions need to be met for this vision to become reality?
There’s one aspect I find particularly important in this area, namely decentralized diagnostics. The way things work at the moment, with lots of indications, samples have to be sent to a big centralized laboratory. What that means is that there may be journeys happening, but also the diagnostic processes are centralized, which certainly offers cost benefits. But I could imagine that if you want to have more individualized healthcare, it would also make sense to carry out certain diagnostic examinations directly in the doctor’s lab. There are already a number of startups and a large number of providers of diagnostic services developing smaller devices capable of analyzing samples automatically using cartridge systems; users don’t need to do much themselves. I could certainly imagine such solutions becoming a growing trend.
Finally then, a more personal question: Which new technologies in the field of health and medicine would you use yourself, or at least accept, and which would you reject in certain areas?
One thing I think would be really useful – and I could imagine using it myself – would be something like an app that uses my personal health risk profile to suggest certain things and help me take prophylactic action.
We could use the problem with increased blood coagulation as an example. If I knew there were certain risks for me, in this case the heightened risk of blood cloting, I could use an app that would regularly remind me to exercise or drink an extra glass of water. Something I’d be skeptical about would be sending a sample of my DNA to a company to create a personal health risk profile for me or work out my genealogy, especially if it were in a country where they don’t have proper data protection regulations.
I feel the same way. I’ll take the example of electronic patient records. I think it’s important that patients are promised more transparency when it comes to their personal information. For example, I can’t remember if I was taking medication five years ago. I think it would be really useful if there were some kind of centralized tool. I’d have no problem with going through past entries with my doctor and looking for connections to see if perhaps an illness I had or a drug I was taking twenty years ago might be affecting my current health. But data must be properly protected.