research papers about medical technology

• Research article
• Open access
• Published: 26 February 2018

The use of advanced medical technologies at home: a systematic review of the literature

• Ingrid ten Haken 1 ,
• Somaya Ben Allouch 1 &
• Wim H. van Harten 2 , 3  

BMC Public Health volume  18 , Article number:  284 ( 2018 ) Cite this article

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The number of medical technologies used in home settings has increased substantially over the last 10–15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important. This paper presents a literature review on types, trends and experiences with the use of advanced medical technologies at home.

The study focused on advanced medical technologies that are part of the technical nursing process and ‘hands on’ processes by nurses, excluding information technology such as domotica. The systematic review of literature was performed by searching the databases MEDLINE, Scopus and Cinahl. We included papers from 2000 to 2015 and selected articles containing empirical material.

The review identified 87 relevant articles, 62% was published in the period 2011–2015. Of the included studies, 45% considered devices for respiratory support, 39% devices for dialysis and 29% devices for oxygen therapy. Most research has been conducted on the topic ‘user experiences’ (36%), mainly regarding patients or informal caregivers. Results show that nurses have a key role in supporting patients and family caregivers in the process of homecare with advanced medical technologies and in providing information for, and as a member of multi-disciplinary teams. However, relatively low numbers of articles were found studying nurses perspective.

Conclusions

Research on medical technologies used at home has increased considerably until 2015. Much is already known on topics, such as user experiences; safety, risks, incidents and complications; and design and technological development. We also identified a lack of research exploring the views of nurses with regard to medical technologies for homecare, such as user experiences of nurses with different technologies, training, instruction and education of nurses and human factors by nurses in risk management and patient safety.

Peer Review reports

As a result of demographic changes and the rapidly increasing number of older patients, there is a need for cost savings and health reforms, which include an increased move from inpatient to outpatient care in most industrialized countries over the last 10–15 years [ 1 , 2 ]. As a consequence, the transfer of advanced medical devices into home settings was considerable and it is expected that there will be a further increase in the near future [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ].

When ‘an increase’ in the number of medical technologies used at home is mentioned, it is not clear which and how many technologies are involved. Today, there are an estimated 500,000 different kinds and types of medical devices available on the world market [ 8 , 9 ]. The European Commission (EC) publishes data regarding legislation and regulations for medical devices, but the actual figures for medical technologies in outpatient practice are not available [ 10 ]. The U.S. National Center for Health Statistics (NCHS) stated that technologies have shifted from hospitals into the home, but it too does not illustrate its findings with statistics [ 11 ]. We searched for data with regard to the actual number of medical technologies used in home settings and it proved difficult to find any systematic data sets available throughout the international landscape.

An important condition for the application of medical technology in the home setting is that quality of care and patient safety must be guaranteed [ 6 ]. From a historical perspective medical technologies were designed for hospital settings [ 12 , 13 ]. This means that specific factors regarding the implementation and use at home now need to be taken into account [ 7 , 14 , 15 ]. In general, risks with medical technologies can be classified regarding (a) environmental factors; (b) human factors and (c) technological factors [ 16 ]. Human factors, however, are very important in patient safety in both hospital and in home settings [ 1 , 6 , 12 ]. For example, a major risk factor is the number of users and handovers in the chain of care. In home settings, a sometimes impressive number of different users of medical technology, often with various levels of training, instruction or education, are involved. Although patient empowerment moves control to the patient and/or relatives, an important user group is that of professional nurses. Understanding user experiences and information about adverse events and near incidents are important aspects for developing knowledge regarding implementation and use in home care setting. Sharing this knowledge can support patients and caregivers, and especially nurses in their professional work and will also contribute to patient safety and quality of care.

Therefore, there is a need to address the question first, which types of technologies are used at home; second, how frequently are they used and third, what trends can be distinguished. Additional research questions are whether there are any scientific data regarding particular user experiences; training, instruction and education; safety and risks, and finally, what can be concluded about the role of nurses in using medical technologies in the home environment. The objective of this paper therefore is to present a systematic literature search on the international state of art concerning various aspects of the use of advanced medical technologies at home.

Definitions

First, we want to clarify some definitions. In general, ‘health technology’ refers to the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of life [ 17 ]. The World Health Organization [ 8 ] uses the definition of ‘medical device’ as ‘An article, instrument, apparatus or machine that is used in the prevention, diagnosis or treatment of illness or disease, or for detecting, measuring, restoring, correcting or modifying the structure or function of the body for some health purpose …….’. A specification for a home use medical device is: ‘A medical device intended for users in any environment outside of a professional healthcare facility. This includes devices intended for use in both professional healthcare facilities and homes’ [ 18 ].

The landscape of medical devices is diverse with technologies varying from relatively simple to very complex devices. Wagner et al. [ 19 ] stated that ‘high-tech dependency’ (for children) matches with ‘technology-dependency’ if it concerns ‘a medical device to compensate for the loss of a vital bodily function and substantial and ongoing nursing care to avert death or further disability’. ‘The needs of these patients may vary from the continuous assistance of a device and highly trained caretaker to less frequent treatment and intermittent nursing care’ [ 20 ]. Although patients dependent of advanced medical technologies at home are often medically stable, they sometimes have high technical needs and may be expected to need long-term recovery. They also require skilled nursing [ 21 ] and a considerable degree of advanced decision making, planning, training and oversight [ 22 ]. An overall definition of ‘advanced medical technology’ is: ‘Medical devices and software systems that are complex, provide critical patient data, or that directly implement pharmacologic or life-support processes whereby inadvertent misuse or use error could present a known probability of patient harm’ [ 23 ]. Examples of advanced medical technologies used at home include ventilators for respiratory support, systems for haemo- or peritoneal dialysis and infusion pumps to provide nutrition or medication.

In the Netherlands, the National Institute for Public Health and the Environment (RIVM) [ 24 ] uses the following definition:

Advanced medical technology or high-tech technology in the home setting is defined as technology that is part of the technical skills in nursing and meets the following conditions:

technology that is advanced or high-tech, for example equipment with a plug, an on/off switch, an alarm button and a pause button;

technology that had been applied formerly only in hospital care, but that is now also often applied in home settings;

technology that can be categorized as ‘supporting physiological functions’, ‘administration’ or ‘monitoring’.

Within the Dutch classification of advanced medical technologies 19 different devices are identified (see Table  1 ), which will be used in this review as a basis to categorize the technologies. It is a classification format in which specific advanced technologies are defined. Terms as ‘advanced medical technology’ (from now on abbreviated as AMT) will be used consistently as synonyms for ‘complex medical technology’ and ‘high-tech medical technology’. The term ‘technology’ will be used in the meaning of ‘device’ or ‘equipment’. The target is on technologies that are instrumental and ‘hands on’ use by nurses in the care for patients. This means that information technology (IT) based technologies as domotica (automation for a home) are not part of the study.

Eligibility and search strategy

The systematic review of the literature was conducted early 2016. Key concepts for the review were ‘medical technologies’ or ‘medical devices’, and ‘home settings’. The concept of ‘home settings’ is related to the terms ‘home nursing’ and ‘home care service’, of which the stem is ‘home’. Combining the key concepts provided the search string: (‘medical technology’ OR ‘medical device’). As domotica is not part of the study, the search string was extended with: AND NOT (eHealth OR telecare OR telemedicine). The exact search string is (“medical technology” OR “medical devices”) AND home AND NOT (ehealth OR telecare OR telemedicine). Online databases MEDLINE, Scopus and Cinahl were searched electronically using the search string to obtain data.

Inclusion and exclusion criteria

Criteria for selection were defined prior to the search process. General criteria for inclusion were:

Year of publication: 2000–2015.

An abstract or an article (with or without abstract) has to be available, containing reference to AMT information.

The article is published in English, German, French or Dutch/Flemish language.

If medical technology is cited, it has to conform to the definition of ‘advanced medical technology’ [ 24 ].

The abstract or the article has to contain empirical material. For the purpose of this review, ‘empirical material’ has been defined as: AMT which is designed for the home setting, or where the design or choices took into account the setting of the home, or where the medical technology has been tested for the home or if the medical technology is already on the market and being used in the home setting.

For further selection, inclusion criteria related to the key concepts for title and abstract were applied, such as ‘advanced medical technology’, ‘high-tech medical technology’, ‘home-centred health-enabling technology’ and ‘care at home’. The classification of the RIVM (see Table 1 ) has been taken as a basis to categorize technologies in this review. Domotica and telemonitoring technologies scored under ‘monitoring’, such as fetal cardiotocography, and respiratory and circulatory monitoring, were left out. If the abstract or article was about electronic health records, ‘smart home’, ambient intelligence, pervasive computing, software of devices, smartphone or surgical robots, the article was also removed from selection. Technologies as ‘VAD (ventricular assist device)’, ‘dental devices’ and ‘AED (automatic external defibrillator)’ were not seen as part of the technical nursing process and these records were left out as well. Studies conducted in the hospital, hospice or nursing home settings were also excluded. An overview of all inclusion and exclusion criteria can be found in Table  2 .

Screening process

The search in the online databases using the search string, identified a total of 1287 references. After checking for duplicates, 1070 articles remained. Those articles were reviewed by a reviewer for titles and abstracts on basis of the inclusion and exclusion criteria. A double check was performed by two reviewers, who independently screened random samples of 20% of the articles. There was an initial agreement of 88%. In case of disagreement about the inclusion of an article, the decision was based on a joint discussion by all three reviewers to an agreement of 100% and the resulting screening policy was applied to the rest of the abstracts. Based on the selected titles and/or abstracts, articles were retrieved or requested in full text and assessed for eligibility. Some articles were excluded from further study, for reasons of ‘full text not available’ or the article contained no empirical material. Finally, 87 studies remained which were included in the analysis (see Table  3 ). A graphical representation of the screening process has been included in Fig.  1 .

PRISMA flowchart

Appraisal of selected studies

To conduct the systematic literature search on the international state of art concerning various aspects of the use of advanced medical technologies at home, several sources are consulted. To guarantee a scientific standard, only articles were retrieved from academic databases. MEDLINE refers to journals for biomedical literature from around the world; Cinahl contains an index of nursing and research journals covering nursing, biomedicine, health sciences librarianship, alternative medicine, allied health and more. These databases related to discipline have been supplemented with Scopus, which is considered to be the largest abstract and citation database of peer-reviewed literature. Grey literature, such as national and international reports on regulations and safety of medical technologies, is also used to illustrate the background of the problem statement and describe definitions. The Classification of advanced medical technologies in the Netherlands according to the National Institute for Public Health and the Environment (RIVM) has been used as a framework to categorise the medical technologies in the selected articles. No methodological conditions of selected studies were applied in advance and the quality criterion we applied was that of the article had to contain empirical material, as we wanted to obtain an comprehensive overview of published studies of any design and to get insight in a variety of contents.

Categorization of included articles

The characteristics of the included articles are outlined in Table  3 . All included articles were categorized by year of publication and the type of research, like the designs, methods and used instruments in the studies. Research features were synthesized where possible into overarching categories. For example, ‘systematic review’ and ‘narrative review’ were scored as ‘review’ and instruments as ‘semi-structured interview’ and ‘in-depth individual interview’ were both assigned to the category ‘interview’.

For each study, the medical technology or technologies on which the study was based was scored. The categorization was in accordance with the classification of AMTs (see Table 1 ). For example, the devices ‘continuous positive airway pressure (CPAP)’ and ‘negative pressure ventilation (NPV) have both been categorized as ‘respiratory support’; and the devices ‘jejeunostomy tube’ and ‘gastronomy tube’ as ‘enteral nutrition’. With regard to the category ‘dialysis’, further subdivision was made by using ‘haemo dialysis’ and ‘peritoneal dialysis’. If in an article a medical technology was mentioned as an example, but was no subject of study, then the technology was not scored.

‘Medical diagnosis (or diagnoses)’ as mentioned in the studies, was included in the analysis only if it was related to the medical technology as the subject of study, not if it has been mentioned as an example. In some cases, an underlying cause of diagnosis was indicated. For example, ‘chronic respiratory failure due to congenital myopathy’, in itself a neurological disorder, has been scored as ‘neurological disorder’. Diseases or disorders have been classified as much as possible under the overarching name. For example ‘pneumonia’ and ‘cystic fibrosis’ are categorized under ‘respiratory failure’, and ‘gastroparesis’ and ‘Crohns disease’ under ‘gastrointestinal disorder’. The category ‘other’ contains diagnoses which occur only once, such as ‘chromosomal anomaly’, or which are not yet determined, like ‘chronic diseases’ or ‘congenital abnormalities’.

In relation to the research questions, articles were classified regarding one of the following categories and, where appropriate, into subcategories:

User experiences

Training, instruction and education, safety, risks, incidents and complications.

From an analysis of the articles, additional categories of content emerged:

Design and technological development

Application with regard to certain diseases or disorders, indication for and extent of use

Policy and management

Types of medical technologies used, frequency of use and trends.

In four of the 87 articles (5%) there were no specific medical technologies mentioned as a subject of study (see Table  4 ). Almost half of the studies (45%) considered medical technologies for respiratory support and 39% devices for dialysis, either haemo- ( n  = 18), peritoneal- ( n  = 15) or dialysis not specified ( n  = 1). Of the studies, 29% reported on devices for oxygen therapy. In addition, there has been relatively more research conducted on equipment for ‘infusion therapy’ ( n  = 19; 22%), parenteral nutrition and enteral nutrition with a score of 20% each ( n  = 17). Relatively little research has been carried out on suction devices (8%), external electrostimulation (5%), nebulizer (5%), insulin pump therapy (3%), sleep apnea treatment (2%), patient lifting hoists (2%), vacuum assisted wound closure (1%) and continuous passive motion (1%). None of de studies considered medical technologies with regard to decubitus treatment, skeletal traction or UV (ultraviolet) therapy.

Table 4 shows that on the years 2000 and 2001 no relevant articles on the subject were found. Over the period 2000–2005, 17 articles were published, the same number over 2006–2010, and there has been a substantial increase in the number of publications to 54 over the years 2011–2015. In general, it can be concluded that more frequent investigated technologies show a fairly even distribution of publications over the years 2000–2015. Technologies, on which little research had been done, except for nebulizers, have been mainly investigated since 2010. An increase of published articles over the years 2000–2015 is apparent particularly for haemo dialysis and to a lesser extent, for devices for enteral- and parenteral nutrition. As mentioned before, several studies reported on the increase of the number of medical technologies used in home settings, but concrete data are not available. However, the number of studies and the visible trends may be indicative of the frequency of use.

In 63% of the cases ( n  = 55), a medical diagnosis (or diagnoses) was mentioned in the article. Where a diagnosis has been mentioned, in almost half of the studies ( n  = 26; 47%) it concerned diagnoses in the field of respiratory failure (see Fig.  2 ). This is not surprising, since ‘respiratory support’ is the medical technology most commonly found in the articles, similarly ‘oxygen therapy’ has also been considered relatively often. Diagnoses with regard to neurological disorders occurred in 42% of the studies ( n  = 23). Just over a quarter of the studies (27%) considered diagnoses ‘other’, such as ‘sepsis’, ‘chromosomal anomaly’ or other not specified medical disorders, nearly a quarter (24%) considered ‘cancer’ and 22% kidney disorders ( n =  12).

Number of medical diagnoses mentioned in articles on AMTs ( n  = 87, multiple answers possible)

An analysis of the used research designs identified that 64% ( n  = 56) of the studies used an observational (non-experimental) design and only a small part of the studies ( n  = 5; 6%) used an experimental design, such as a Randomized Control Trial (RCT). Of the included studies 19 were reviews and 8 were essays. A quantitative design ( n  = 37) was used more frequently than a qualitative design ( n  = 25); and only one study applied ‘mixed methods’ (quantitative and qualitative). Just over one-third of the studies (35%) used a descriptive design, and a similar number used a cross-sectional study (36%). Case series were used in 12% of the articles and a cohort-study in 9%. A phenomenological approach was applied in 16% of the records. Research instruments most frequently used were interviews (33%) and survey/questionnaires (21%). In 10% of the cases other instruments were used, including different types of assessments or tests.

With regard to the categories of content, most research has been carried out on ‘user experiences’ (see Fig.  3 ): just over one-third of the articles ( n  = 31; 36%) focused on this topic. Of these articles almost all studies focused on experiences of patients or informal caregivers ( n  = 29) and only a small number ( n  = 2) considered the user experiences of nurses or other professionals (see Table  5 ). More than half of the studies ( n  = 19) used a qualitative research design; of these 13 used a phenomenological approach. The goal of these studies was to elicit the essence of human phenomena as experienced by the users. Seven studies used a quantitative design and one an integrated mixed method. Three of the studies applied a grounded theory approach and two an experimental design (randomized controlled trial). The research instruments in this content category to collect data were interviews, either semi-structured or in-depth, and a survey. About two-thirds of the articles regarding ‘user experiences’ were published in the period 2011–2015, with an accent on the psychosocial impact of patients or informal caregivers.

Number of articles on AMTs with main content categories ( n  = 87)

Relatively little research was found on ‘training, instruction, education’ ( n  = 7), for the use of AMTs in home settings. It was remarkable that all the studies identified as focusing on this topic, concentrated on one category of AMT. Respiratory support was the subject of study in four instances and in the other three, the focus was on technologies for enteral nutrition, haemo dialysis and external electro-stimulation. Four of the seven articles utilized quantitative methods, among which three of them used an observational non-experimental design and one was an experimental randomized double-blind clinical trial. Another study within the initial seven articles used a qualitative observational non-experimental design, one was a review and another was in essay format.

In total, 22% of the articles discussed topics on safety, risks, incidents and complications ( n  = 19). In the majority of cases ( n  = 13) general aspects about the subject, for instance safe use, factors affecting safety, a safe transfer of the equipment and monitoring of assessing safety were considered. One article described technological factors with regard to safety, three articles reported on environmental factors and two explored human factors. Safety aspects were explored over a wide range of medical technologies. Five articles were reviews and one an essay. Quantitative methods were used in ten of the cases, particularly for monitoring, evaluating and assessing safety, technological and environmental factors. Only three studies used a qualitative design. Retrospective chart reviews or case series were used to collect data in some cases of unforeseen events. Table 5 shows about a doubling of published articles in the period 2011–2015 regarding this content category, compared to the previous period 2000–2010.

Approximately 20% of the selected articles considered the content category ‘design and technological development of the medical device’ ( n  = 17). The studies each focused on only one type of AMT and treated a relative wide range of eight different categories, such as ‘respiratory support’, ‘oxygen therapy’, ‘haemo dialysis’, ‘infusion therapy’, ‘insulin pump therapy’ and ‘enteral nutrition’, but also ‘external electrostimulation’ and ‘patient lifting hoists’. Interestingly, in this group of articles, relatively often ( n  = 6) no medical diagnosis was mentioned. Around half of the studies ( n  = 8) referring to this topic were in review or essay format. All other studies used a quantitative research design and throughout the search no application of qualitative designs were found. Two studies used an experimental study design (randomized crossover trial) to obtain data and two described a prospective cohort study. The majority of papers ( n  = 11) were published in the period 2011–2015 and six in the preceding period up to and including 2010.

Seven articles concerned the application of AMTs, all of them devices with regard to at least respiratory support and/or nutritional support. Five studies used a non-experimental quantitative design including the analysis of clinical data, such as record reviews or cohort studies, and two articles were reviews. Most articles on this subject ( n  = 5) were published in the period 2012–2015.

Six articles described policy or management systems in different countries regarding the use of AMTs at home. The majority of the articles ( n = 4 ) were in essay or review format. The other papers concerned a qualitative cross-sectional case study analysis and an observational quantitative study in which data are collected prospectively using a database. The categories of content will now be discussed in greater detail.

Content description and trends to secondary research questions

In this category, 22 articles described the psychosocial impact on patients or informal caregivers from the use of medical technologies at home. Living at home with the assistance of medical technology needs a range of adjustments. Fex et al. [ 25 , 26 ] state that self-care is more than mastering the technology, in terms of the health-illness transition, it requires ‘…. an active learning process of accepting, managing, adjusting and improving technology’. When it comes to children, they have to learn to incorporate disability, illness and technology actively within their process of growing up [ 27 ]. It seems that the use of medical technologies in the home can have both a positive and a negative psychosocial impact on patients and their families, which in turn causes ambivalence in experiences [ 27 , 28 ]. On the one hand, patients in general gain more independence, an enhanced overall health and a better quality of life [ 29 , 30 , 31 , 32 , 33 , 34 ]. On the other hand, for some patients the experience is one of dependency on others for executing daily activities, and these circumstances, to some extent, a social restricted live and perceived stigmatization [ 29 , 30 ]. The situation in which patients need to use medical technology at home also affects family functioning and requires next of kin responsibilities [ 35 , 36 , 37 ]. As a result, next of kin caregivers are frequently faced with poor sleep quality and quantity, and/−or other significant psychosocial effects [ 38 , 39 , 40 , 41 ]. Nevertheless, family members had a positive attitude to the concept of bringing the technology into the home [ 42 ]. Knowledge of how to use the technology and permanent access to support from healthcare professionals and significant others, enabled next of kin caregivers to take responsibility for providing necessary care and to facilitate patients learning to provide self-care [ 25 , 36 , 42 , 43 , 44 ]. Bezruczko et al. [ 45 , 46 ] developed a measure of mothers’ confidence to care for children assisted with medical technologies in their homes. To provide high quality sustainable care, nurses have to recognize and understand the psychosocial dimensions for both patients and family members which arise as a result of changing role and providing care for the patients. The need to provide emotional support and support with appropriate coping strategies is a key professional role [ 25 , 26 , 47 ]. Insight into the psychosocial effects on those involved can be used to assist designers of medical devices to find strategies to better facilitate the integration of these technologies into the home [ 28 ].

Seven articles reported on the usability, barriers and accessibility experienced by patients or informal caregivers. Findings in these studies showed that several technologies were rarely perceived as user-friendly and that home medical devices inadequately met the needs of individuals with physical or sensory deficits [ 48 , 49 ]. An accessible design which meets the diversity of individual user needs, characteristics and features would be better able to help patients manage their own treatment and so could contribute to the quality of care and safety of patients and lay users [ 50 , 51 ]. Munck et al. [ 52 ] stated that restricted patients were reminded daily of the medical technology and were more dependent on assistance from healthcare professionals than masterful patients.

In contrast to the group of patients or informal caregivers, only two papers in this content category focused on the user experiences of nurses or other professional caregivers. The review demonstrates that to maintain patient safety, more education on application of medical devices for users is needed together with improved awareness and understanding of how to use the medical technology correctly in a patient-safe way [ 53 , 54 ]. More collaboration between all involved ‘actors’ in the process of care is also requisite. Continuity among carers, trust between patient and carers and supportive communication between informal and professional caregivers are important factors for the successful implementation of medical technologies in the home environment while maintaining patient safety [ 44 , 51 , 53 , 54 , 55 ].

Three articles regarding this topic focused on nurses or other professionals and four on the patients or informal caregivers. The results showed that successful use of advanced medical technologies at home requires adequate staff education and training programmes. Although many topics in educational programmes are suitable for different types of professionals in care provision, the focus for the level and application of information can vary for Registered Nurses and unregistered care staff. In addition, for overall learning experiences to be of maximum benefit there is a need for a clear focus on the specific client groups [ 56 ]. According to Sunwoo et al. [ 57 ], in the case of home non-invasive ventilation the degree of clinical support needed is extremely variable given the mixed indications for this respiratory support. A relatively simple procedure, such as the replacement of a feeding tube, can be performed by nurses, the patient and informal caregivers, provided they are trained well [ 58 ]. However, several studies revealed the complexity of the education needed by patients and informal caregivers for the use of advanced medical technologies at home [ 59 , 60 ]. Nevertheless, the studies revealed that a structured education programme, specific training, or the support of a dedicated discharge coordinator has several advantages [ 59 , 61 , 62 ]. It was evident that good preparation by patients or informal caregivers may result in a shorter length of stay in hospital, a better performance with regard to the use of the equipment or less requests by patients and/or families for assistance.

Most articles regarding this topic ( n  = 13) reported on safety in general, like aspects of safe use, factors affecting safety, complications and prevention of incidents in the home. Some identified the risk factors and the complications that may arise [ 63 , 64 , 65 ], where Stieglitz et al. [ 66 ] also emphasize that human error is the main reason for critical incidents and that regular instruction for medical staff and patients is necessary. To prevent untoward and adverse events, evidence based guidelines, recommendations on the preferred methods for managing the equipment, troubleshooting techniques for potential complications and monitoring activities are necessary [ 67 , 68 ]. Faratro et al. [ 68 ] added that key performance and quality indicators are important mechanisms to ensure patient safety when using a medical device in the home. Methods to address or evaluate patient safety issues are for example, a home visit audit tool, a nationwide adverse event reporting system, programs such as the Medical Product Safety Network HomeNet, or, in the case of peripherally inserted central catheters (PICCs) a central catheter stabilization system [ 69 , 70 , 71 , 72 ]. However, a study conducted by Pourrat and Neuville [ 73 ] in France found that there are very few internal medical devices vigilance reports found within organizations that deliver devices for home parenteral nutrition and that safety management could be improved. The safe transfer of medical devices from a hospital setting to the home and vice versa, comes with several challenges regarding technological, environmental and human factors [ 14 ]. While many hospitals have developed policies to control the pathways of home-used devices in the hospitals, in case patients take them into the hospital when they are admitted for treatment [ 74 ]. Improvement of the safety of devices intended for use in home settings, implies also improvement of safety when their transfer to the hospital settings is urgently needed.

One article considered the technological factors, three the environmental and two the human factors. An example of research on the technological factors of safety related aspects of medical technologies used in home settings by Hilbers et al. [ 75 ] found that manufacturers pay insufficient attention to safety-related items in technical documentation for the use in the home setting. For instance, the environmental factor of electricity blackout leads to electrically powered medical devices failing. Studies show that this type of event causes a dramatic increase in appeal for access to emergency or hospital facilities, and that disaster preparation needs to include the specific needs of patients reliant on electrically driven devices [ 76 , 77 , 78 ]. Regarding human factors impacting on safety aspects, one article assessed the suitability of a particular theoretical framework for understanding safety-critical interactions of patients using medical devices in the home [ 79 ], while Tennankore et al. [ 80 ] described adverse events in home haemodialysis by the use of patients. It was remarkable that none of the articles focused on human factors with regard to the use of medical technologies at home by nurses or other professional caregivers.

Of those articles that focused on this topic, ten reported on the comparison between different types of medical technologies, or their advantages and disadvantages. The comparison of different devices for oxygen therapy was made by two articles [ 81 , 82 ] and one reported on the comparison of two types of enteral nutrition tubes [ 83 ]. Some studies regarding respiratory support considered the process of making a choice between different types of devices [ 84 , 85 , 86 ] while one paper considered the conditions for home-based haemo dialysis [ 87 ]. A minority, explored the individual characteristics and the clinical applications of several devices for respiratory support [ 88 , 89 ] and one considered devices for insulin pump therapy [ 90 ]. Seven papers discussed the technological development or effectiveness of medical technologies. The testing of devices for external electro-stimulation was described in two papers [ 91 , 92 ], with the testing of a new design patient lift was subject of one study [ 93 ]. Hanada and Kudou [ 94 ] explored the current status of electromagnetic interference with medical devices in the home setting, an issue of importance as more devices are considered for home use. The technological development of respiratory support for home use was part of one study [ 95 ], as were the possibilities of solar-assisted home haemo dialysis [ 96 ]. While the study by Pourtier [ 97 ] describes the advantages of analgesia pumps that can be read remotely by nurses, but also emphasizes the central position of a professional nurse in the transfer of information within a multi-disciplinary team.

Application with regard to certain diseases or disorders, indications for and extent of use

All articles described several aspects that need to be considered for use, such as clinical characteristics of the patients, indications for the use in the home setting, the technical availability of devices, the extent of their use at home or eventual complications and morbidity. It was important to note that all but one article ( n  = 6) were about children or related to adults with what are usually regarded as paediatric diseases. Results show that the use of AMTs at home among children after hospital discharge is common (in 20%–60% of cases), or is standard for patients with some disorders [ 98 , 99 , 100 , 101 ]. The timely application of advanced home medical technology benefits patients and can help to reduce respiratory morbidity [ 102 ]. Nevertheless, the rate of death of patients with Möbius syndrome using the devices at home was high (30%) [ 98 ], as was that of patients with intestinal failure dependent on home parental nutrition therapy in Brazil (75% for 5 years) [ 103 ]. The average cumulative survival of children needing home ventilation was found to be between 75 and 90%, depending on the medical diagnosis [ 104 ].

Three of the papers were concerned with costs and/or reimbursement. The application of medical technologies in the home environment can be cost-effective when compared to institutionalized care [ 22 , 105 , 106 ]. Nevertheless, successful employment of medical technologies in the home necessitates medical guidelines for the indicators for use, careful identification of patients as well as careful planning and attention to details [ 105 , 106 , 107 ]. Two studies concerned the dilemma’s for implementation of the technologies in home healthcare and emphasized the importance of cooperation in the chain of key stakeholders to maximize efficiency of high-tech healthcare at home, one with regard to the purchasing policy of medical technologies [ 108 ] and one with regard to the interventions of local community service centres and hospitals supporting optimal use of these technologies in the home setting [ 5 ].

The use of medical technologies in the home setting has drawn increased attention in health care over the last 15 years, as the feasibility of this type of medical support has rapidly grown. This article systematically reviewed the international literature with regard to the state of the art on this subject, in order to provide a comprehensive overview.

Trend analysis over the period 2000–2015 shows that most research has been conducted about respiratory support, dialysis and oxygen therapy; relatively little about vacuum assisted wound closure and continuous passive motion, and no about decubitus treatment, skeletal traction and UV therapy. A substantial increase in publications was found in the period 2011–2015. Although the number of studies on technologies is indicative of the extent to which they are used in home settings, however, no firm conclusions can be drawn about this.

This review also identified that most research is conducted with regard to ‘user experiences’ of medical technologies in the home, ‘safety, risks, incidents and complications’, and ‘design and technological development of medical technologies’. There have been relatively few studies which have explored the topic of training, instruction and education. Content analysis showed that the use of AMTs in the home setting can have both a positive and a negative psychosocial impact on the patients and their families, and that it has become part of self-management and patient empowerment. Successful use of advanced equipment requires adequate education and training programmes for both patients, informal caregivers and nurses or other professionals. When trying to maximize or assure safety, technological, environmental and human factors have to be taken into account, and it is evident that human factors are the main reason for critical incidents. Studies on the design and technological development of medical technologies emphasize that research is necessary to improve its possibilities and effectiveness. The research found on the application of the technologies focused predominantly on children and the results indicate that the rate of the use of home medical devices among children after hospital discharge is common. Also that when compared to institutionalized care, the application of medical technologies in the home environment can be cost-effective. Much is known, but information on several key issues is limited or lacking.

An important finding was that in almost all the reviewed articles, the study subjects were patients or informal caregivers with very few studies focused on the role and activities of nurses or other professionals as users. This was unexpected as nurses are the main group of users of AMTs at home and they have to transfer knowledge and skills on how to use the devices to patients and other caregivers. Nurses also have a key role in setting up and maintaining collaboration between all actors involved in the process of care with regard to the use of home medical technologies and in giving support to patients and family members in this respect. There is need to initiate further in depth research on AMTs use at home focusing on the role of specifically nurses.

Another interesting result was that, despite the fact that most adverse events with AMTs at home are caused by human factors, hardly any studies conducted on this subject were found. None of the articles focused on related human factors regarding the use by nurses or other professional caregivers, although this is the main user group. Research on this area could contribute to improved patient safety and quality of care. The results also revealed the tension between the advantages and disadvantages of medical technologies as experienced by patients at home. Important aspects needed to promote the benefits include improving the user-friendliness of the devices and attuning their designs for the use in home settings. This emphasizes the importance of professionals (and patient groups) working together with the designers with regard to sharing knowledge and user experiences of the use of AMTs at home in order to improve quality of care and patient safety. This collaboration emerged as of key importance in the successful use of AMTs in the home as well.

Although all included articles were retrieved from academic databases and served our purpose, there was considerable heterogeneity of quality of the studies. Most of the studies have explicitly described their research design, albeit to a greater or lesser extent. On the other hand, there were a few studies that did not even mention their methodological approach, though it could be derived from the description. Most included reviews are of moderate quality. Although findings are almost always described clearly, the search strategy and selection criteria used are often lacking. The quantitative studies are generally well described in different methodological aspects, such as selection of respondents, research design, data collection methods and analyses. Studies of qualitative nature show more variation in the depth with which the design is described. However, almost all qualitative studies have described the research instruments very well, such as semi-structured interviews or questionnaires. Despite the varying quality of the studies, we believe that the whole of different methodological approaches and the relatively large number of included studies ( n  = 87) has yielded a fairly reliable overview on the international state of art concerning various aspects of the use of advanced medical technologies at home. For future research, we recommend to emphasize the development of a more detailed methodological design, zooming in on specific technologies, using large databases or conducting large surveys, and focusing on specific groups of respondents. Both in quantitative and in qualitative studies, a good definition of the research question(s), selection of respondents, development of instruments and analysis of findings, contributes to validity, consistency and neutrality.

Some limitations do have to be taken into account with this review. Although we used the RIVM-definition of ‘advanced medical technology’, not all devices are considered as ‘complex devices’ by nurses in practice. For example, the use of an anti-decubitus mattress in the context of ‘decubitus treatment’ and ‘patient lifting hoists’ are considered by nurses as being of less or lower complexity. However, overall the RIVM-classification was found to be a good starting point, and provided a practical and useful framework from which to work to gain an insight and overview of available medical technologies. Of some of the chosen technologies defined using the RIVM-classification of AMTs, questions do have to be asked as to whether they really are part of the technical skills in nursing process. For example, ‘external electrostimulation’ and ‘continuous passive motion’ are mainly applied by physiotherapists, although with appropriate training nurses can apply them. Then too, devices regarded as only ‘monitoring’ were excluded from the review.

This systematic review study was designed to fill a gap in the current research by investigating what is known about different aspects of medical technologies used in the home. From the results it is obvious that a wide and growing range of medical technologies are used at home. Different types of technologies have been subject of study, increasingly –also in scope- over the period 2011–2015.

Professional nurses have a central role in the process of homecare which has to be recognized when considering use of AMTs at home. Nurses have to support patients and family caregivers and in consequence have a key role in providing information for, and as a member of multi-disciplinary teams. Closer collaboration by all actors involved in the process of care and feedback of user experiences to the designers is essential for the provision of high quality of care and patient safety.

This review also identified a lack of research exploring the perspectives of nurses in the processes involved in introducing and maintaining technology in homecare. Most of the research has been conducted regarding the experiences of patient experience and how informal caregivers perceive their role in using medical technologies at home. The few studies that were found, demonstrate the need for more research focused on the experiences of nurses working with advanced technologies in the home. The same applies to research on training, instruction and education to use medical technologies, as in these areas too, there was limited available research so here again there is need for further research. Despite the fact that most adverse events with medical technologies in home settings are caused by human factors, our findings also identified a lack of research in this area for nurses.

This study demonstrates that, although there is increasing attention on and recognition of the need for the use of medical technologies in the environment of the home, the research has not kept pace with the advances in care. Subjects such as user experiences of nurses with different technologies, training, instruction and education of nurses and human factors by nurses in risk management and patient safety urgently need to be investigated by further research.

Abbreviations

Automatic external defibrillator

Advanced medical technology

Continuous positive airway pressure

European Commission

Information technology

National Center for Health Statistics

Negative pressure ventilation

Peripherally inserted central catheters

Randomized Control Trial

National Institute for Public Health and the Environment

Ultraviolet

Ventricular assist device

World Health Organization

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The authors thank Ronnie van de Riet, head of the Medical Technical Care Team of the hospital ZiekenhuisGroep Twente, for his time and commitment to this project.

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Ingrid ten Haken is researcher in the research group Technology, Health & Care at Saxion University of Applied Sciences, Enschede, The Netherlands. Somaya Ben Allouch is head of the research group. Wim van Harten is professor at the University of Twente, Faculty Behavioural, Management and Social Sciences, department Health Technology & Services Research and CEO of Rijnstate general hospital, Arnhem, The Netherlands.

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ten Haken, I., Ben Allouch, S. & van Harten, W.H. The use of advanced medical technologies at home: a systematic review of the literature. BMC Public Health 18 , 284 (2018). https://doi.org/10.1186/s12889-018-5123-4

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The Internet of Medical Things (IoMT): opportunities and challenges

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• Published: 21 May 2024

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• Ayman A. El-Saleh 1 ,
• Abdul Manan Sheikh   ORCID: orcid.org/0000-0001-5506-6427 1 ,
• Mahmoud A. M. Albreem 2 &
• Mohamed Shaik Honnurvali 3  

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The Internet of Medical Things (IoMT) is a transformative concept in healthcare, leveraging the power of connected devices and technology to improve patient care and health outcomes. These devices are typically connected to the internet or a network and can communicate with each other to exchange data and provide insights to healthcare providers, patients, and other stakeholders. Advanced digital technologies like artificial intelligence, machine learning, and Blockchain integrated into the Internet of Medical Things (IoMT) can better mitigate the impact of pandemics and protect public health. IoMT utilizes medical sensors to capture real-time physiological data of patients and is available to a medical professional to diagnose, recognize, analyze, and make appropriate decisions. Data breaches or cyberattacks could compromise the security and integrity of IoMT devices and data, exposing sensitive information or causing malfunctions or disruptions. Consequently, to make IoMT systems reliable, data protection and secure communication must conform to security standards. Blockchain technology is being used in the healthcare industry to ensure the security of patient records and to streamline the sharing of information among healthcare providers, laboratories, pharmaceutical firms, and other healthcare providers. Overall, digital technologies have been instrumental in managing the COVID-19 pandemic, enabling more efficient surveillance, response, and care delivery. By leveraging these technologies, public health authorities and healthcare providers have been able to better mitigate the impact of the pandemic and protect public health.

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This research has been financially supported by the Research Council (TRC) of the Sultanate of Oman (agreement No. TRC/BFP/ASU/01/2019).

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El-Saleh, A.A., Sheikh, A.M., Albreem, M.A.M. et al. The Internet of Medical Things (IoMT): opportunities and challenges. Wireless Netw (2024). https://doi.org/10.1007/s11276-024-03764-8

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The impact of medical technology on healthcare today

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David Banta

Annetine Gelijns

Alexander Mebius

Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies (i.e., pharmaceuticals, devices, procedures, and organizational systems) perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and assessing technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory (i.e., testimony and evidence of mechanisms) is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine (EBM) has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, in providing justification for health technologies.

Mario Coccia , Coccia Mario

Tabish S. A.

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The 1970s and early 1980s was the period in which high technology medicine became dominant. It had begun in the late 1950s with the introduction of effective artificial respiratory technology. This gave physicians, patients, and families the hope that the threats to fundamental life processes such as breathing could be countered by technology, and the dilemma of both meeting its costs and the ethical challenges of how to remove it when its use no longer produced benefits.

Science Park Research Organization & Counselling

Nowadays, innovation and medicine go together. Today, inefficient and ineffective health care is dying for innovations and technological improvements in medicine. Medical care has been transformed by technological innovations in medicine, inspiring hope for better clinical outcomes with less invasive procedures and shorter recovery times. Now, medicine has become a remedy for diseases that in previous, caused great mortalities and total destruction of many societies. Medicine slowly transformed from the use of subjective evidence provided by the patient to objective evidence obtained by mechanical and chemical technology devices. Advances in medical technology have resulted in access to many blessings of better diagnosis and treatment options. In this article many great technological innovations are put in discussion to show how these improvements help the physicians to make an accurate, fast diagnosis with minimal errors and also to provide better treatment options which in turn result in enhancing quality and quantity of life.

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Review SUMMARY New discoveries in technology indeed enabled significant improvement of health care in the last three decades. Only during the last few years a significant breakthrough is achieved in the field of antiviral drugs, biotechnology, digital diagnostic technology, molecular diagnosis, tissues and organs transplantation as well as surgical and information technologies, which all contributed to the improvement of health care. Rapid growth of medical technology has led to the increase in costs of health care, increased access to these technologies and improvement of health care that is permanently encouraging the further development of technology. Technology encompasses the skills, knowledge and ability to understand, use and create useful things. It is the practical application of knowledge. Evaluation of health technology is the systematic evaluation of characteristics, results or impact of health technologies. The primary purpose of evaluation is to provide information to ...

Revolutionising health care: Exploring the latest advances in medical sciences

Gehendra mahara.

1 Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China

4 Shantou University Medical College, Shantou, Guangdong, China

Cuihong Tian

2 Center for Precision Health, Edith Cowan University, Perth, Australia

3 Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China

5 Department of Infection Control, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangzhou, China

Photo: Human heart, anterior view, artificial valve, coronary bypass. Illustration by Patrick J. Lynch. Source: Flickr, free to use under Creative Commons Attribution 2.5 License ( https://creativecommons.org/licenses/by/2.5/ ).

Recent years have seen a revolution in the domain of medical science, with ground-breaking discoveries changing health care as we once knew it [ 1 ]. These advances have considerably improved disease diagnosis, treatment, and management, improving patient outcomes and quality of life [ 2 - 5 ]. These innovations range from the creation of novel medications and treatments to the utilization of cutting-edge technologies. For instance, gene editing technologies like Clustered Regularly Interspaced Palindromic Repeats (CRISPR-Cas9) have opened up new treatment options for genetic illnesses [ 6 ], while the development of mRNA vaccines has offered a desperately needed response to the coronavirus disease 2019 (COVID-19) pandemic [ 7 ]. Moreover, wearable technology and telemedicine have improved accessibility, convenience, and personalization of health care, whereas 3D printing and nanotechnology breakthroughs have made it possible to create individualized implants and drug delivery systems [ 8 - 10 ]. This article examines some of the most recent developments in medical research and how they might completely change health care delivery.

The selection process for identifying the latest advances in medical sciences for this article was as follows. We aimed to showcase ground-breaking developments with the potential to revolutionise health care practices and significantly impact patient outcomes. We extensively searched reputable scientific journals, conferences, and reports from recognized health care organisations and institutes. We included the novelty and significance of the advancements, their ability to address existing health care challenges, the level of scientific evidence supporting their efficacy, and their potential for widespread adoption and implementation. By utilizing this process, we ensured that the selected advancements represent diverse medical fields and have the capacity to drive significant advancements in patient care, diagnostics, treatment modalities, and health care delivery.

REGENERATIVE THERAPY TREATMENT

Regenerative medicine is a rapidly growing field that seeks to restore, replace, or regenerate damaged tissues and organs using a variety of approaches, including cell therapy, tissue engineering, and gene therapy [ 11 ]. This field has the potential to revolutionise the treatment of many diseases and injuries that are currently incurable or difficult to treat. For example, stem cell therapy has been shown to be effective in treating spinal cord injuries [ 12 ], with several studies reporting significant improvements in motor function and sensory perception [ 13 ]. Tissue engineering approaches are being developed to replace damaged or diseased organs using 3D printing, such as the liver, pancreas, and heart [ 11 , 14 ]. Gene therapy is being used to target genetic disorders, such as sickle cell anaemia and cystic fibrosis, with promising results [ 15 ]. The development of regenerative medicine has the potential to transform the treatment of many diseases and injuries, providing hope for patients with conditions that are currently considered untreatable [ 16 - 18 ].

DEVELOPMENT OF IMPLANTABLE ARTIFICIAL ORGANS

Various replacement or augmentation devices for organs, such as the eyes, kidneys, heart, muscle, liver, skin, and brain, have been developed due to the creation of implantable artificial organs [ 4 ]. Artificial organs can be developed from a number of substances, such as polymers and biological tissues, and are intended to mimic the shape and functionality of actual organs [ 19 ]. For instance, the Wearable Artificial Kidney (WAK) has promise for enhancing the quality of life for individuals with end-stage of renal illness [ 20 ]. The creation of artificial hearts ( Figure 1 ), such as the Total Artificial Heart (TAH), has the potential to extend the lives of patients awaiting heart transplants [ 21 - 23 ].

Artificial Intelligence, Brain. Image by Gerd Altmann. Source: Pixabay, free to use under Content License ( https://pixabay.com/service/license-summary/ ).

Furthermore, scientists are developing artificial muscles, liver tissue replicas, skin grafts, and brain implants. For instance, a study by Kolesky et al. [ 24 ] reported the successful implantation of a 3D-printed artificial skin graft. Additionally, a study by White [ 25 ] and Weng et al. [ 26 ] revealed the development of a 3D-printed muscle tissue construct [ 26 ]. Although the research into implantable artificial organs is still in its infancy, it has the potential to transform how organ failure is treated and enhance patient outcomes [ 4 ].

ADVANCEMENTS IN NANOTECHNOLOGY IN HEALTH SCIENCE

Another fast-expanding and highly promising area of use for nanotechnology is in the field of medicine. Drugs and other therapeutic substances can be delivered directly to a disease site using nanoparticles because they can target particular cells or tissues in the body [ 27 ]. This technology may improve the efficacy of therapies, lessen their negative effects, and potentially enable the treatment of previously incurable diseases [ 28 ].

Current developments in nanotechnology have demonstrated considerable promise for the medical field. A study by Foglizzo and Marchio [ 10 ] created a multifunctional nano platform that delivered chemotherapeutic medication and an immunomodulatory substance to tumour cells, increasing antitumor activity and minimizing adverse effects. Using nanotechnology, a magnetic resonance imaging (MRI) contrast agent that can specifically target and image pancreatic cancer cells was created [ 29 ]. Moreover, nanotechnology has demonstrated promise in the treatment of diseases like brain tumours that were previously incurable. A study by Chen et al. [ 30 ] created a nano platform that specifically targeted and delivered medications to brain tumour cells, improving survival rates in a mouse model. These recent developments show how nanotechnology has the potential to enhance therapeutic efficacy, lessen adverse effects, and broaden the scope of diseases that can be treated [ 31 , 32 ].

DEVELOPMENT OF CRISPR-Cas9 GENE EDITING TECHNOLOGY

A rapidly developing technique called gene editing could revolutionise medicine by enabling researchers to change cells' genetic makeup. CRISPR-Cas9, a promising method for gene editing, allows for accurate targeting and editing of particular regions of the genome [ 33 ]. Genetic disorders like cystic fibrosis and sickle cell anaemia, which were once thought to be incurable, could potentially be cured because of this technique [ 34 , 35 ]. Also, scientists are looking at its therapeutic potential for a number of illnesses, such as Alzheimer’s disease, human immunodeficiency virus (HIV), and cancer [ 34 , 36 ].

Yet there are also moral questions raised by using gene editing on people, so it's important to use the technology sensibly and morally. Until the hazards and moral issues surrounding germline editing, which edits the genes that can be passed on to future generations, are better known, a group of scientists called for a moratorium on its clinical usage in 2019 [ 37 ].

ARTIFICIAL INTELLIGENCE (AI) FOR MEDICAL SCIENCE

Recent years have seen considerable advancements in the use of artificial intelligence (AI) and machine learning in the health care industry. In order to find trends and forecast health outcomes, AI systems can evaluate enormous amounts of medical data, including images, test results, and patient records [ 38 ]. This may result in more accurate diagnosis, individualized treatment strategies, and effective patient monitoring.

The promise of AI in health care has been proved by a number of studies. For instance, Esteva et al. [ 39 ], created an AI model with skin cancer detection accuracy on par with dermatologists. Rajkomar et al. [ 40 ] use of machine learning to forecast patient mortality and hospital readmission rates may aid health care professionals in identifying patients who need more care. Moreover, Chung et al. [ 41 ], created an AI algorithm that could anticipate the onset of psychosis in individuals who had clinical high-risk signs.

Predicting the risk of cardiovascular illness using AI has also shown promise. For example, Khera et al. [ 42 ] developed a model using machine learning to identify patients with a high risk of developing heart disease, potentially allowing for early intervention and preventative measures.

Yet, there are also issues with using AI in health care that need to be resolved, such as the requirement for strong data protection and ethical concerns with the use of AI algorithms to clinical decision-making [ 43 ].

CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL THERAPY TO TREAT CANCER

Chimeric Antigen Receptor (CAR) T-cell therapy, a form of immunotherapy that employs T cells to recognize and target cancer cells, depends heavily on genetically transformed T cells [ 44 ]. Recent studies have demonstrated that CAR T treatment is very effective in treating a range of lymphoma types, including diffuse large B-cell lymphoma and mantle cell lymphoma [ 45 , 46 ].

Despite the positive outcomes, CAR T therapy has drawbacks, such as a high price and risk for toxicity. In order to increase the effectiveness and safety of CAR T treatment and broaden its use to treat additional cancer types, research is now being done by Ren et al. [ 47 ]. For instance, a recent study by Yang et al. [ 48 ] discovered that multiple myeloma, a kind of blood cancer, that has relapsed or become resistant to treatment, can be effectively treated with CAR T therapy that targets the B-cell maturation antigen (BCMA). Researchers are also investigating combination therapies, which couple CAR T therapy with additional medications, including checkpoint inhibitors, to enhance results [ 49 ].

DEVELOPMENT OF mRNA VACCINE

The development of mRNA vaccines has been a significant milestone in the fight against COVID-19 [ 50 ]. The Pfizer-BioNTech and Moderna mRNA vaccines have demonstrated remarkable efficacy and safety profiles in preventing COVID-19 infection and its complications [ 7 , 51 , 52 ]. The mRNA technology used in these vaccines has several advantages over traditional vaccine production methods, including faster development and manufacturing times, lower production costs, and greater flexibility in responding to emerging viral variants [ 53 , 54 ].

Clinical trials of the Pfizer-BioNTech and Moderna vaccines have shown high levels of protection against COVID-19. A study by Polack et al. [ 55 ] found that the Pfizer-BioNTech vaccine had an efficacy rate of 95% in preventing COVID-19 infection, while a study by Baden et al. [ 56 ] reported a similar efficacy rate of 94.1% for the Moderna vaccine. Additionally, real-world data has confirmed the high effectiveness of mRNA vaccines in preventing severe disease, hospitalization, and death caused by COVID-19 [ 57 ].

Another company that has been working on developing mRNA vaccines for COVID-19 is Novavax [ 58 ]. The company's vaccine candidate combines mRNA technology with nanoparticles to enhance the body's immune response [ 59 ]. In clinical trials, the vaccine demonstrated efficacy against both the original strain of COVID-19 and certain variants of the virus [ 60 ].

Companies such as Moderna and BioNTech are now exploring the potential of mRNA vaccines for a wide range of illnesses, including cancer and influenza [ 61 ]. The development of mRNA vaccines also holds promise for creating rapid responses to new and emerging infectious diseases, as the technology allows for quick adaptation to new viral strains [ 7 , 54 , 61 , 62 ].

Overall, the development of mRNA vaccines for COVID-19 represents a significant breakthrough in vaccine technology, with potential implications for future disease prevention and treatment [ 53 ].

ADVANCES IN 3D PRINTING FOR MEDICAL APPLICATIONS

The development of complex anatomical models, prostheses, implants, and drug delivery systems has been made possible by advances in 3D printing technology [ 8 ]. 3D printing has enabled the development of custom-made implants, reducing the need for invasive surgeries and improving patient outcomes. The successful implantation of 3D printed titanium-mesh implants for the repair of bone deformities was described in a study by Ma et al. [ 63 ]. Anatomical models that have been 3D printed have been proven to be useful for planning surgeries and advancing medical knowledge. The use of 3D printed models for surgical planning in complicated craniofacial patients was reported in a study by Charbe et al. [ 64 ]. The development of 3D printing technology has the potential to revolutionise the medical industry by enabling more individualized and efficient patient care [ 65 ].

TELEMEDICINE TO PROVIDE REMOTE CARE

Over the past few years, telemedicine – the use of technology to deliver medical treatments remotely – has grown in popularity, especially during the COVID-19 pandemic [ 66 ]. Telemedicine allows health care providers to offer virtual consultations, monitor patients remotely, and provide access to medical services in areas with limited health care resources [ 67 ]. Telemedicine was linked to better health care access and outcomes for patients with cardiovascular disease during the COVID-19 pandemic [ 9 ]. Telemedicine also has the potential to lower medical expenses and raise patient satisfaction. High levels of patient satisfaction with teleconsultations for dermatology services were observed in a study by Nicholson et al. [ 68 ]. Telemedicine use is anticipated to increase over the next few years, which might have a significant impact on how health care is delivered in the future [ 9 , 69 ].

VERTUAL REALITY IN MEDICAL TRAINING

Medical students can practice and hone their skills in a safe and controlled environment with the help of virtual reality (VR), which has grown in popularity in recent years [ 70 ]. Students can practice medical procedures and scenarios using VR technology, which helps them become more adept at diagnosing and treating patients [ 71 ]. According to a recent study by Yiasemidou et al. [ 72 ], medical students' performance and confidence improved when VR was used for surgical instruction. Moreover, using VR technology can replace animal or cadaveric models in training for less common medical operations. The effective use of VR technology in training for transesophageal echocardiography was described in a study by Arango et al. [ 73 ]. The use of VR in medical education has the potential to raise the standard of medical instruction and increase patient safety [ 74 ].

DEVELOPMENT OF WEARABLE DEVICES FOR HEALTH MONITORING

The development of wearable health monitoring technology has completely revolutionised how people track and manage their health [ 75 ]. Individuals can receive real-time feedback on their health state by using wearable devices, such as fitness trackers and smartwatches, which can gather data on physical activity, heart rate, blood oxygen saturation, sleep habits, and other health markers [ 76 ]. These devices capture data that can be analysed to find trends and patterns that can provide important information about a person's general health and well-being [ 77 , 78 ]. According to research by Patel et al. [ 79 ], adult users of wearable technology had increases in physical activity and weight loss. Moreover, wearable technology can be used to monitor patients with chronic illnesses remotely, enabling health care professionals to monitor patient progress and take appropriate action as needed. According to a study by Gautam et al. [ 80 ], wearable devices are useful for remotely monitoring patients with heart failure [ 80 , 81 ]. By encouraging early disease identification and prevention, wearable health monitoring technology has the potential to enhance health outcomes and save health care costs [ 78 ].

CONCLUSIONS

In conclusion, the most recent developments in medical science have the potential to completely revolutionise the way health care is provided and greatly enhance patient outcomes. With the advent of modern technologies like telemedicine, gene editing, and AI, doctors are now able to detect and treat illnesses more precisely and effectively. Moreover, the application of nanotechnology, 3D printing, and regenerative medicine is bringing about ground-breaking treatments for previously incurable diseases. The advances being made in medical science are genuinely astonishing and give hope for a healthier future, even though there are still obstacles to be addressed. In the years to come, we may anticipate even more interesting advances with ongoing innovation and investment.

Acknowledgements

We would like to acknowledge the support of Prof Xuerui Tan, from Shantou University Medical College. Additionally, we extend our gratitude to the clinical research center team at the first affiliated Hospital of Shantou University Medical College.

Funding: This work was funded by the Provincial Science and Technology Special Fund of Guangdong, China (2021123071-1).

Authorship contributions: GM and WW conceived the research idea. GM drafted the manuscript. CT and XX, collected information and reviewed the manuscript. WW, acting as the principal investigator, assisted in revising the manuscript. The final version of the manuscript was critically reviewed and approved by all authors.

Disclosure of interest: The authors have completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.

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Understanding why autism symptoms sometimes improve amid fever

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Scientists are catching up to what parents and other caregivers have been reporting for many years: When some people with autism spectrum disorders experience an infection that sparks a fever, their autism-related symptoms seem to improve.

With a pair of new grants from The Marcus Foundation, scientists at MIT and Harvard Medical School hope to explain how this happens in an effort to eventually develop therapies that mimic the “fever effect” to similarly improve symptoms.

“Although it isn’t actually triggered by the fever, per se, the ‘fever effect’ is real, and it provides us with an opportunity to develop therapies to mitigate symptoms of autism spectrum disorders,” says neuroscientist Gloria Choi , associate professor in the MIT Department of Brain and Cognitive Sciences and affiliate of The Picower Institute for Learning and Memory.

Choi will collaborate on the project with Jun Huh, associate professor of immunology at Harvard Medical School. Together the grants to the two institutions provide $2.1 million over three years.

“To the best of my knowledge, the ‘fever effect’ is perhaps the only natural phenomenon in which developmentally determined autism symptoms improve significantly, albeit temporarily,” Huh says. “Our goal is to learn how and why this happens at the levels of cells and molecules, to identify immunological drivers, and produce persistent effects that benefit a broad group of individuals with autism.”

The Marcus Foundation has been involved in autism work for over 30 years, helping to develop the field and addressing everything from awareness to treatment to new diagnostic devices.

“I have long been interested in novel approaches to treating and lessening autism symptoms, and doctors Choi and Huh have honed in on a bold theory,” says Bernie Marcus, founder and chair of The Marcus Foundation. “It is my hope that this Marcus Foundation Medical Research Award helps their theory come to fruition and ultimately helps improve the lives of children with autism and their families.”

Brain-immune interplay

For a decade, Huh and Choi have been investigating the connection between infection and autism. Their studies suggest that the beneficial effects associated with fever may arise from molecular changes in the immune system during infection, rather than on the elevation of body temperature, per se.

Their work in mice has shown that maternal infection during pregnancy, modulated by the composition of the mother’s microbiome, can lead to neurodevelopmental abnormalities in the offspring that result in autism-like symptoms, such as impaired sociability. Huh’s and Choi’s labs have traced the effect to elevated maternal levels of a type of immune-signaling molecule called IL-17a, which acts on receptors in brain cells of the developing fetus, leading to hyperactivity in a region of the brain’s cortex called S1DZ. In another study , they’ve shown how maternal infection appears to prime offspring to produce more IL-17a during infection later in life.

Building on these studies, a 2020 paper clarified the fever effect in the setting of autism. This research showed that mice that developed autism symptoms as a result of maternal infection while in utero would exhibit improvements in their sociability when they had infections — a finding that mirrored observations in people. The scientists discovered that this effect depended on over-expression of IL-17a, which in this context appeared to calm affected brain circuits. When the scientists administered IL-17a directly to the brains of mice with autism-like symptoms whose mothers had not been infected during pregnancy, the treatment still produced improvements in symptoms.

New studies and samples

This work suggested that mimicking the “fever effect” by giving extra IL-17a could produce similar therapeutic effects for multiple autism-spectrum disorders, with different underlying causes. But the research also left wide-open questions that must be answered before any clinically viable therapy could be developed. How exactly does IL-17a lead to symptom relief and behavior change in the mice? Does the fever effect work in the same way in people?

In the new project, Choi and Huh hope to answer those questions in detail.

“By learning the science behind the fever effect and knowing the mechanism behind the improvement in symptoms, we can have enough knowledge to be able to mimic it, even in individuals who don’t naturally experience the fever effect,” Choi says.

Choi and Huh will continue their work in mice seeking to uncover the sequence of molecular, cellular and neural circuit effects triggered by IL-17a and similar molecules that lead to improved sociability and reduction in repetitive behaviors. They will also dig deeper into why immune cells in mice exposed to maternal infection become primed to produce IL-17a.

To study the fever effect in people, Choi and Huh plan to establish a “biobank” of samples from volunteers with autism who do or don’t experience symptoms associated with fever, as well as comparable volunteers without autism. The scientists will measure, catalog, and compare these immune system molecules and cellular responses in blood plasma and stool to determine the biological and clinical markers of the fever effect.

If the research reveals distinct cellular and molecular features of the immune response among people who experience improvements with fever, the researchers could be able to harness these insights into a therapy that mimics the benefits of fever without inducing actual fever. Detailing how the immune response acts in the brain would inform how the therapy should be crafted to produce similar effects.

"We are enormously grateful and excited to have this opportunity," Huh says. "We hope our work will ‘kick up some dust’ and make the first step toward discovering the underlying causes of fever responses. Perhaps, one day in the future, novel therapies inspired by our work will help transform the lives of many families and their children with ASD [autism spectrum disorder]."

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A new future of work: The race to deploy AI and raise skills in Europe and beyond

At a glance.

Amid tightening labor markets and a slowdown in productivity growth, Europe and the United States face shifts in labor demand, spurred by AI and automation. Our updated modeling of the future of work finds that demand for workers in STEM-related, healthcare, and other high-skill professions would rise, while demand for occupations such as office workers, production workers, and customer service representatives would decline. By 2030, in a midpoint adoption scenario, up to 30 percent of current hours worked could be automated, accelerated by generative AI (gen AI). Efforts to achieve net-zero emissions, an aging workforce, and growth in e-commerce, as well as infrastructure and technology spending and overall economic growth, could also shift employment demand.

By 2030, Europe could require up to 12 million occupational transitions, double the prepandemic pace. In the United States, required transitions could reach almost 12 million, in line with the prepandemic norm. Both regions navigated even higher levels of labor market shifts at the height of the COVID-19 period, suggesting that they can handle this scale of future job transitions. The pace of occupational change is broadly similar among countries in Europe, although the specific mix reflects their economic variations.

Businesses will need a major skills upgrade. Demand for technological and social and emotional skills could rise as demand for physical and manual and higher cognitive skills stabilizes. Surveyed executives in Europe and the United States expressed a need not only for advanced IT and data analytics but also for critical thinking, creativity, and teaching and training—skills they report as currently being in short supply. Companies plan to focus on retraining workers, more than hiring or subcontracting, to meet skill needs.

Workers with lower wages face challenges of redeployment as demand reweights toward occupations with higher wages in both Europe and the United States. Occupations with lower wages are likely to see reductions in demand, and workers will need to acquire new skills to transition to better-paying work. If that doesn’t happen, there is a risk of a more polarized labor market, with more higher-wage jobs than workers and too many workers for existing lower-wage jobs.

Choices made today could revive productivity growth while creating better societal outcomes. Embracing the path of accelerated technology adoption with proactive worker redeployment could help Europe achieve an annual productivity growth rate of up to 3 percent through 2030. However, slow adoption would limit that to 0.3 percent, closer to today’s level of productivity growth in Western Europe. Slow worker redeployment would leave millions unable to participate productively in the future of work.

Demand will change for a range of occupations through 2030, including growth in STEM- and healthcare-related occupations, among others

This report focuses on labor markets in nine major economies in the European Union along with the United Kingdom, in comparison with the United States. Technology, including most recently the rise of gen AI, along with other factors, will spur changes in the pattern of labor demand through 2030. Our study, which uses an updated version of the McKinsey Global Institute future of work model, seeks to quantify the occupational transitions that will be required and the changing nature of demand for different types of jobs and skills.

Our methodology

We used methodology consistent with other McKinsey Global Institute reports on the future of work to model trends of job changes at the level of occupations, activities, and skills. For this report, we focused our analysis on the 2022–30 period.

Our model estimates net changes in employment demand by sector and occupation; we also estimate occupational transitions, or the net number of workers that need to change in each type of occupation, based on which occupations face declining demand by 2030 relative to current employment in 2022. We included ten countries in Europe: nine EU members—the Czech Republic, Denmark, France, Germany, Italy, Netherlands, Poland, Spain, and Sweden—and the United Kingdom. For the United States, we build on estimates published in our 2023 report Generative AI and the future of work in America.

We included multiple drivers in our modeling: automation potential, net-zero transition, e-commerce growth, remote work adoption, increases in income, aging populations, technology investments, and infrastructure investments.

Two scenarios are used to bookend the work-automation model: “late” and “early.” For Europe, we modeled a “faster” scenario and a “slower” one. For the faster scenario, we use the midpoint—the arithmetical average between our late and early scenarios. For the slower scenario, we use a “mid late” trajectory, an arithmetical average between a late adoption scenario and the midpoint scenario. For the United States, we use the midpoint scenario, based on our earlier research.

We also estimate the productivity effects of automation, using GDP per full-time-equivalent (FTE) employee as the measure of productivity. We assumed that workers displaced by automation rejoin the workforce at 2022 productivity levels, net of automation, and in line with the expected 2030 occupational mix.

Amid tightening labor markets and a slowdown in productivity growth, Europe and the United States face shifts in labor demand, spurred not only by AI and automation but also by other trends, including efforts to achieve net-zero emissions, an aging population, infrastructure spending, technology investments, and growth in e-commerce, among others (see sidebar, “Our methodology”).

Our analysis finds that demand for occupations such as health professionals and other STEM-related professionals would grow by 17 to 30 percent between 2022 and 2030, (Exhibit 1).

By contrast, demand for workers in food services, production work, customer services, sales, and office support—all of which declined over the 2012–22 period—would continue to decline until 2030. These jobs involve a high share of repetitive tasks, data collection, and elementary data processing—all activities that automated systems can handle efficiently.

Up to 30 percent of hours worked could be automated by 2030, boosted by gen AI, leading to millions of required occupational transitions

By 2030, our analysis finds that about 27 percent of current hours worked in Europe and 30 percent of hours worked in the United States could be automated, accelerated by gen AI. Our model suggests that roughly 20 percent of hours worked could still be automated even without gen AI, implying a significant acceleration.

These trends will play out in labor markets in the form of workers needing to change occupations. By 2030, under the faster adoption scenario we modeled, Europe could require up to 12.0 million occupational transitions, affecting 6.5 percent of current employment. That is double the prepandemic pace (Exhibit 2). Under a slower scenario we modeled for Europe, the number of occupational transitions needed would amount to 8.5 million, affecting 4.6 percent of current employment. In the United States, required transitions could reach almost 12.0 million, affecting 7.5 percent of current employment. Unlike Europe, this magnitude of transitions is broadly in line with the prepandemic norm.

Both regions navigated even higher levels of labor market shifts at the height of the COVID-19 period. While these were abrupt and painful to many, given the forced nature of the shifts, the experience suggests that both regions have the ability to handle this scale of future job transitions.

Businesses will need a major skills upgrade

The occupational transitions noted above herald substantial shifts in workforce skills in a future in which automation and AI are integrated into the workplace (Exhibit 3). Workers use multiple skills to perform a given task, but for the purposes of our quantification, we identified the predominant skill used.

Demand for technological skills could see substantial growth in Europe and in the United States (increases of 25 percent and 29 percent, respectively, in hours worked by 2030 compared to 2022) under our midpoint scenario of automation adoption (which is the faster scenario for Europe).

Demand for social and emotional skills could rise by 11 percent in Europe and by 14 percent in the United States. Underlying this increase is higher demand for roles requiring interpersonal empathy and leadership skills. These skills are crucial in healthcare and managerial roles in an evolving economy that demands greater adaptability and flexibility.

Conversely, demand for work in which basic cognitive skills predominate is expected to decline by 14 percent. Basic cognitive skills are required primarily in office support or customer service roles, which are highly susceptible to being automated by AI. Among work characterized by these basic cognitive skills experiencing significant drops in demand are basic data processing and literacy, numeracy, and communication.

Demand for work in which higher cognitive skills predominate could also decline slightly, according to our analysis. While creativity is expected to remain highly sought after, with a potential increase of 12 percent by 2030, work activities characterized by other advanced cognitive skills such as advanced literacy and writing, along with quantitative and statistical skills, could decline by 19 percent.

Demand for physical and manual skills, on the other hand, could remain roughly level with the present. These skills remain the largest share of workforce skills, representing about 30 percent of total hours worked in 2022. Growth in demand for these skills between 2022 and 2030 could come from the build-out of infrastructure and higher investment in low-emissions sectors, while declines would be in line with continued automation in production work.

Business executives report skills shortages today and expect them to worsen

A survey we conducted of C-suite executives in five countries shows that companies are already grappling with skills challenges, including a skills mismatch, particularly in technological, higher cognitive, and social and emotional skills: about one-third of the more than 1,100 respondents report a shortfall in these critical areas. At the same time, a notable number of executives say they have enough employees with basic cognitive skills and, to a lesser extent, physical and manual skills.

Within technological skills, companies in our survey reported that their most significant shortages are in advanced IT skills and programming, advanced data analysis, and mathematical skills. Among higher cognitive skills, significant shortfalls are seen in critical thinking and problem structuring and in complex information processing. About 40 percent of the executives surveyed pointed to a shortage of workers with these skills, which are needed for working alongside new technologies (Exhibit 4).

Companies see retraining as key to acquiring needed skills and adapting to the new work landscape

Surveyed executives expect significant changes to their workforce skill levels and worry about not finding the right skills by 2030. More than one in four survey respondents said that failing to capture the needed skills could directly harm financial performance and indirectly impede their efforts to leverage the value from AI.

To acquire the skills they need, companies have three main options: retraining, hiring, and contracting workers. Our survey suggests that executives are looking at all three options, with retraining the most widely reported tactic planned to address the skills mismatch: on average, out of companies that mentioned retraining as one of their tactics to address skills mismatch, executives said they would retrain 32 percent of their workforce. The scale of retraining needs varies in degree. For example, respondents in the automotive industry expect 36 percent of their workforce to be retrained, compared with 28 percent in the financial services industry. Out of those who have mentioned hiring or contracting as their tactics to address the skills mismatch, executives surveyed said they would hire an average of 23 percent of their workforce and contract an average of 18 percent.

Occupational transitions will affect high-, medium-, and low-wage workers differently

All ten European countries we examined for this report may see increasing demand for top-earning occupations. By contrast, workers in the two lowest-wage-bracket occupations could be three to five times more likely to have to change occupations compared to the top wage earners, our analysis finds. The disparity is much higher in the United States, where workers in the two lowest-wage-bracket occupations are up to 14 times more likely to face occupational shifts than the highest earners. In Europe, the middle-wage population could be twice as affected by occupational transitions as the same population in United States, representing 7.3 percent of the working population who might face occupational transitions.

Enhancing human capital at the same time as deploying the technology rapidly could boost annual productivity growth

About quantumblack, ai by mckinsey.

QuantumBlack, McKinsey’s AI arm, helps companies transform using the power of technology, technical expertise, and industry experts. With thousands of practitioners at QuantumBlack (data engineers, data scientists, product managers, designers, and software engineers) and McKinsey (industry and domain experts), we are working to solve the world’s most important AI challenges. QuantumBlack Labs is our center of technology development and client innovation, which has been driving cutting-edge advancements and developments in AI through locations across the globe.

Organizations and policy makers have choices to make; the way they approach AI and automation, along with human capital augmentation, will affect economic and societal outcomes.

We have attempted to quantify at a high level the potential effects of different stances to AI deployment on productivity in Europe. Our analysis considers two dimensions. The first is the adoption rate of AI and automation technologies. We consider the faster scenario and the late scenario for technology adoption. Faster adoption would unlock greater productivity growth potential but also, potentially, more short-term labor disruption than the late scenario.

The second dimension we consider is the level of automated worker time that is redeployed into the economy. This represents the ability to redeploy the time gained by automation and productivity gains (for example, new tasks and job creation). This could vary depending on the success of worker training programs and strategies to match demand and supply in labor markets.

We based our analysis on two potential scenarios: either all displaced workers would be able to fully rejoin the economy at a similar productivity level as in 2022 or only some 80 percent of the automated workers’ time will be redeployed into the economy.

Exhibit 5 illustrates the various outcomes in terms of annual productivity growth rate. The top-right quadrant illustrates the highest economy-wide productivity, with an annual productivity growth rate of up to 3.1 percent. It requires fast adoption of technologies as well as full redeployment of displaced workers. The top-left quadrant also demonstrates technology adoption on a fast trajectory and shows a relatively high productivity growth rate (up to 2.5 percent). However, about 6.0 percent of total hours worked (equivalent to 10.2 million people not working) would not be redeployed in the economy. Finally, the two bottom quadrants depict the failure to adopt AI and automation, leading to limited productivity gains and translating into limited labor market disruptions.

Four priorities for companies

The adoption of automation technologies will be decisive in protecting businesses’ competitive advantage in an automation and AI era. To ensure successful deployment at a company level, business leaders can embrace four priorities.

Understand the potential. Leaders need to understand the potential of these technologies, notably including how AI and gen AI can augment and automate work. This includes estimating both the total capacity that these technologies could free up and their impact on role composition and skills requirements. Understanding this allows business leaders to frame their end-to-end strategy and adoption goals with regard to these technologies.

Plan a strategic workforce shift. Once they understand the potential of automation technologies, leaders need to plan the company’s shift toward readiness for the automation and AI era. This requires sizing the workforce and skill needs, based on strategically identified use cases, to assess the potential future talent gap. From this analysis will flow details about the extent of recruitment of new talent, upskilling, or reskilling of the current workforce that is needed, as well as where to redeploy freed capacity to more value-added tasks.

Prioritize people development. To ensure that the right talent is on hand to sustain the company strategy during all transformation phases, leaders could consider strengthening their capabilities to identify, attract, and recruit future AI and gen AI leaders in a tight market. They will also likely need to accelerate the building of AI and gen AI capabilities in the workforce. Nontechnical talent will also need training to adapt to the changing skills environment. Finally, leaders could deploy an HR strategy and operating model to fit the post–gen AI workforce.

Pursue the executive-education journey on automation technologies. Leaders also need to undertake their own education journey on automation technologies to maximize their contributions to their companies during the coming transformation. This includes empowering senior managers to explore automation technologies implications and subsequently role model to others, as well as bringing all company leaders together to create a dedicated road map to drive business and employee value.

AI and the toolbox of advanced new technologies are evolving at a breathtaking pace. For companies and policy makers, these technologies are highly compelling because they promise a range of benefits, including higher productivity, which could lift growth and prosperity. Yet, as this report has sought to illustrate, making full use of the advantages on offer will also require paying attention to the critical element of human capital. In the best-case scenario, workers’ skills will develop and adapt to new technological challenges. Achieving this goal in our new technological age will be highly challenging—but the benefits will be great.

Eric Hazan is a McKinsey senior partner based in Paris; Anu Madgavkar and Michael Chui are McKinsey Global Institute partners based in New Jersey and San Francisco, respectively; Sven Smit is chair of the McKinsey Global Institute and a McKinsey senior partner based in Amsterdam; Dana Maor is a McKinsey senior partner based in Tel Aviv; Gurneet Singh Dandona is an associate partner and a senior expert based in New York; and Roland Huyghues-Despointes is a consultant based in Paris.

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Research highlights urgent need to tackle health challenges for migrants in Europe

by University of Bergen

The Lancet Regional Health - Europe has launched, on May 28, a new series of seven papers presented alongside the World Health Organization European Assembly.

One of the papers is led by the University of Bergen. In the paper titled, "Capacity building in migration and health in higher education : lessons from five European countries" Esperanza Diaz and colleagues from other four European countries, illustrate good examples in higher education, identify gaps in the further advancement of capacity building and summarize key recommendations for the advancement of capacity building in migration and health.

According to the authors, to be able to deliver equitable care, European health services need to build capacity at high education level to be able to improve the care for migrants. Here are their recommendations that should be also implemented in Norway:

• Create spaces to share concrete teaching experiences that can be adapted and replicated
• Promote diversity-sensitive communication skills programs for trainers and teachers
• Integrate training on migration and health within the broader framework of social determinants of health
• Develop participatory and intersectional approaches that focus on improving attitudes and skills
• Capacity building should be both top-down (leadership) as well as bottom-up (involving teachers and students ).
• Advocate for curricula development to reflect and include diversity-sensitive approaches in content and implementation
• Medical and continuous education accreditations should include new standards for diversity-sensitive health care
• Prioritize student assessments and course evaluations instead of seeing them as optional
• Promote mandatory diversity -related competences in both undergraduate and specialized training
• Co-create and maintain dialogue with key stakeholders, different members of the health care team and migrants

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