Future Casting

Abstract Predicting the future is fraught with danger and in the short term is proportional to the degree of current uncertainty about an issue. This chapter addresses many issues that are important for the future of health care, especially those that provide precise information for individuals. For example, your genome sequence will be determined inexpensively and be included as part of your medical record. With adequate safeguards for privacy, genomics coupled with artificial intelligence (AI) will predict which diseases you will acquire and what risk factors you have for other conditions. AI will become ever more powerful and accurate for making diagnoses, predicting prognoses, and determining therapies. AI will also become the initial and primary means of interpreting medical images. Therapies that are now in formative stages will evolve into routine means of treating disease. Examples are stem cell therapies, chimeric antigen receptor therapies, therapies using messenger RNA, targeted gene therapies, and xenotransplantation. The goal of cancer management will become to intercept its precursors before malignancy occurs. Brain-computer interfaces are currently used to treat selected neurologic disorders, and enabling personal thoughts to direct movement in a paralyzed limb is in development. The risks of monitoring a person’s thoughts or directing them are not just futuristic concerns. Thousands of drugs already purposed for specific conditions can be surveyed to determine for potential effectiveness in other diseases. AI will aid in designing novel proteins for specific purposes. A crucial issue is ensuring that the technologies of precision health care are not misused.