“Medicine 2.0”: who is responsible for your health?

who is responsible for your health?

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Max Wolf | 07/15/2020

“Medicine 2.0”: who is responsible for your health?

Pandemic COVID 19 became a kind of trigger for the development of medicine and the health care system, stimulating the transition to a new level to “Medicine 2.0”. In this case, on the one hand,
the situation with coronavirus showed that the industry noticeably lagged behind in the technological and organizational plan from the development of society, and on the other hand, it showed the need for adjustment
development vector taking into account new serious risks.

The lag is noticeable primarily on the level of accessibility, convenience and speed of obtaining qualified medical services. In recent years, society has become accustomed to the fact that either
with a serious degree of automation, it can receive services not only from commercial entities, but also from the state. Medicine, despite some progress, remained one of the most
conservative industries precisely in terms of interaction with consumers.

Perhaps one of the reasons lies in the traditional closeness of the medical community, which was laid down, you will be surprised, by Hippocrates, who did not advise to disclose to patients all the details of the disease,
limited to stingy treatment recommendations. Digitalization contradicts this principle, as it simplifies access to information not only for priests of medicine, but also for mere mortals –
patients who can, if not understand, at least see what the doctor sees.

As for the adjustment of the vector of development of medicine and the health care system as a whole, the pandemic has shown that many developed countries, in particular the United States, are investing huge amounts of money in
pharmacology, the latest methods of treatment and diagnosis, did not achieve adequate success in a crisis situation, for a number of indicators showing not only not the best, but rather the worst results. Moreover, even
In terms of telemedicine penetration, the United States was among the world leaders even before the pandemic. But this did not help either.

There are two problems with the construction of “Medicine 2.0”: the development of technologies (medical and those that make it easy to obtain high-quality medical services) and the choice of health principles for which you can
rely, building a system of protection and improvement of health.

These questions are interconnected, because it depends on what system it is based on which system we are building. And vice versa, the technological base is the basis of what we are at
In principle, we can build a really working healthcare.

In the era of the industrial revolution, it was believed that society should strive to ensure that a sick person, more precisely who has lost the ability to work at full strength, is returned to
to the machine tool. The growth of production has contributed to the formation of a consumer society, where medical services have become the object of sale. The more sick people we find and
the more ailments we find, the more medicines and services we can sell.

It turned out that it was not necessary to sell the treatment to the person himself. You can do this indirectly – by selling medicines and services for treating citizens to the state, which is forming a system of free
health care. It has become necessary for the state, since it supports the population, ensures GDP growth and guarantees an adequate level of public satisfaction, at which
the state, in fact, stands, or rather balances, as long as there is such an opportunity.

Nationwide health systems, as we know them today, appeared at the beginning of the last century. In continental Europe, insurance-based standards have become a reference.
the Bismarck system, introduced first in Germany and then, with some changes, migrated to other countries. And in the USSR in the 1920s, the efforts of Nikolai Semashko created their own system, which
that moment became one of the most advanced and even served as a prototype of the British – the one that they began to build in the kingdom after the Second World War.

All these systems were distinguished by one thing: they adapted to the industrial society, that is, to people who massively moved from villages to cities and started working in industrial enterprises. TO
In short, the pandemic problem sounded a new one even then – one who had tuberculosis endangered the activities of an entire enterprise, and hence its counterparties. Accordingly, the system
began to look for ways to confront, to form a model for preventing epidemics and the quick return of sick people to work.

This has led to a change in the attitude of a person to his health. The principle was formed in the subconscious mind: “if I get sick, they must treat me – this is written in the Constitution, it is beneficial for the company where I
I work. ” That is, human health, in fact, began to belong not to him personally, but to the state and business.

The industrial approach also touched on the approach to the concept of health, which, like everything else, was made universal. For each age, the system gradually selected the optimal characteristics –
by pressure, visual acuity, etc. The rules of the TRP, if you want. Naturally, they were adjusted in accordance with how working conditions changed. At first, the foundation of an industrial society was blue
collars are hard workers, then, with the transition to a service economy, white collars came, in other words, office plankton. Now there is another transformation – under the specifics of labor, providing
products and services of the current “information era.”

In the process of this transformation, an understanding has emerged that a layer of people is growing in society who are doing something extraordinary. And in terms of results, and in terms of the approach to work. In the last century
they came up with the term “creative class” for them. These are not only artists and writers, but representatives of various professions, from whom they expect a non-routine result and, accordingly, allow them
liberties – waste from the strict rules of the organization of the labor process.

Historical experience has shown that in many ways, global trends directly depend on the “creative people” mentioned above. Those that change the course of history. Accelerate or slow it down. It is these people
able to bring industrial revolutions closer (not to be confused with color revolutions), during which a country that had not previously played a significant role in world history could suddenly become a global player. And that means
The creative class is worth developing. The more it is, the more developed it is, the better for the country.

How does this affect medicine and healthcare? In the most direct and radical way. The very ones created in the industrial era, universal health templates are collapsing. And not only
because people differ in genotype, working and living conditions, and because even the same person needs a different “amount” of health, depending on his mood and
goals that he sets for himself. For example, if you need to get in slippers from the sofa to the refrigerator in your home office, you need “one health”, and if you, obeying some crazy idea,
decided to conquer Everest (which from the traditional point of view is more likely harmful – extreme loads, wear of organs, etc.), then a completely different margin of safety is needed.

The second important point – the information age has led to the consumption of much larger amounts of data by people. We are all quietly hooked on the flows of facts and figures, visual and other images, pictures,
plots that are used to constantly receive and somehow process within themselves. This need of society can no longer be ignored. Including in medicine. So, to ensure stability
it needs to be regulated. Manage her. And thus, we come to the basic principle of the formation of “Medicine 2.0” – a personal approach to personal medical data based on
personal goals and objectives.

That is, it is no longer about treatment, not about prevention as such, much less about a return to a specific machine. And not even about life expectancy. The thing is that a part is returned to a person
responsibility for his health (the state and business go for it, as always, voluntarily-forcibly), give him much more information (sorry, Hippocrates). But the most important thing is that all this
It is not done in exchange for the number of nuts that a person will wrap for a shift, but for the development that he will ensure for himself, and at the same time for society.

But the “war of standards” is superimposed on this, in which today both medical and technology companies are fighting for control of markets in different countries and are waiting
new breakthrough technology, which will form the basis of the next industrial revolution. It can become, as already widely known, but not yet brought to mind directions, such as thermonuclear
synthesis, quantum computers, genetic research, and some kind of unpopular idea, the implementation of which into technology will give impetus to global changes in society.

Of course, this is just my humble attempt to formulate the principles that state, commercial and industry experts in different countries are considering today. Including in
Skolkovo, where the Leader of Russia Prize winner Maxim Chernin, who has spent his entire presidential grant on this business, is working on the Healthcare 2.0 project. He immediately asked not to bind this
work and those thoughts that he shared with readers (and will soon share with representatives of the Ministry of Health), with his commercial activities (Mr. Chernin heads the board of directors of the company
“Doctor is near” – the largest and fastest growing telemedicine project in Russia).

The fact is that an independent expert approach can and should differ from lobbying for a specific business project. Actually, all systems, including Medicine 2.0, line up in different
countries and the world as a whole as a kind of compromise between the interests of lobbyists on the part of business and the needs of society.

At Skolkovo, by the way, they tried to start with the best-practice search principle, which is traditional for business projects, but faced with the fact that in the world there is not just better, but even just
user approved healthcare system. The United States, investing incomparably more than other countries (18% of its colossal GDP) in health care, failed during the pandemic, and in addition,
they are not even included in the top 30 for such a key indicator as the expected (that is, predicted for the current generation) healthy life expectancy. And Japan, among 40 developed countries, is the leading
according to this indicator, it takes the penultimate, 39th place. And such a mismatch between the important characteristics of health care and the rating of satisfaction with it is observed everywhere.

Thus, ready-made recipes for medicine and healthcare in the world so far, in principle, do not exist. Therefore, after the pandemic began, all countries promptly took up the development of new, more
suit the population and business schemes. In parallel, the technological leaders of the pharmaceutical industry offer, or rather, impose their know-how on the world. So that someone does not invent more effective methods, technologies
and standards.

As for the most promising medical technologies, which after the coronavirus are developing at an accelerated pace, for the investments are huge here (including in the formation of
national and global medical safety systems), one of the most important trends is the accelerated formation by countries with IT potential of their own medical databases. In
the number of genotype bases (DNA profiles). The last one is occupied by all key players – China, the USA and Europe. The driver is the state everywhere. To speed up the process, everything is done voluntarily and forcibly.

Russia is officially among the lagging behind in this race. And this is very bad for the reason that then, while catching up, we will have to, as usual, use not our own, but other people’s achievements (standards and
technology). And this means not only sponsoring foreign specialists, but also an increased risk – frankly speaking, the inevitable leak of our data to political and economic competitors.

But, who said that testing for coronavirus is not one of the possible methods to replenish the base of DNA profiles? And if so, then it becomes clear why all the leading countries synchronously under the pretext
(or under pressure) pandemics conducted a mass diagnosis of the population. Perhaps this is evidence that we are already on the verge of the very new technological revolution that can be called


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