Dx + Tx = Ix


Integrated treatment is an important step in service innovation, and it is no less important to see how the convergence of diagnostic technologies and methods with treatment methods will lead to integrated, one-stop encounters.  This is more than an integrated provider, but the development of theranostics (therapy/diagnostics), which combine what in the past have been discreet clinical steps into a single diagnostic and treatment encounter.

We are still developing methods here, but in the image guided surgery is an example. The ability to bring together disparate knowledge, currently spread across different brains (i.e. experts) into a single brain will create new clinical professions, shift knowledge from higher levels of expertise to others who delivery services augmented with machine intelligence embedded in the devices. These sorts of development disintermediate clinical workflow, to use disruptive terminology, but reintegrate the clinical workflow in new ways, this time around the patient, rather than the clinician.

Importantly, the diagnostic bottleneck which health systems find causes waiting and delay is likely to be largely eliminated for a wide range of procedures, as at the point of diagnosis, treatment would also be provided. With improved detection methods, too, this treatment will start sooner — we are still learning of the clinical benefits of bio-conjugated quantum dots, and biosilicon, and other new materials, but they are likely to underpin a new health service delivery paradigm.

The equation in the title simplistically represents the shift toward integrated therapeutics, which in the end may be the biggest next step in medicine since discovering germs as will germs came specialisation and the burgeoning of clinicians and expertise, coupled with the universities in creating specialist bodies of knowledge. Ix, integrated care, builds on integrated knowledge (IKnow?) which is something we are slowly appreciating as the problems we face effectively challenge the narrow disciplinary models we see at university and in clinical practice.

The question though is whether policy and decision makers will be bold enough to face up to these opportunities or will vested legacy interests prevail?