Decentralized Model in Detail - Health

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Health

In health the big trend is personalisation of interventions. Today in medicine best practices are based on what works on population level well. In future dosage will be different for each user. Wearables will monitor vitals and other cheap home diagnostics kits and health devices used for additional data. This constant feed of data allows health care to become real time and personal. It is possible to see exactly how certain dosage of a medicine works in any given patient. Ill side effects can be detected immediately and dosages adjusted. This combined with DNA information (should patient allow this), gives unpresented accuracy.

For research purposes health data can either be available in anonymized sand box storage for researchers. Another technical implementation is so called Federated Learning of Cohorts (FLOC) where data never leaves citizens’ private devices. The idea there is to have a common machine learning model that everyone starts with and then locally train the models to make better predictions just for this individual. Rather than data shared, the trained models are shared and a combined and improved global model baked from them.

Other trends are automated analytics meaning that a pocket doctor is available 24/7 globally wherever you are. These models can be open sourced enabling less affluent regions to pick them up and localize. In more demanding cases online appointments allow interaction with a human doctor, skipping travel times and associated wait times and costs.

Recovery can be gamified so that people play games that work out the just the rights parts of their body after an operation. Dull repetitions become fun.

The patient data will become indispensable in future treatments and drug discovery. The problem is that the value of each individual data set is very small but as a combined entity they have enormous value. One way to address this is through gamification. Since pharma companies need this data, the public side can agree to allow access against a set compensation that is % based on revenue. This generates a revenue stream that can go to “Patient Treasury”. Value from there could be allotted based on daily/weekly raffle where each winner gets say a million euros. Changes are low for those who allowed their data to be used, but if you are a winner, it is a life changing event.

We discussed the model for producing chemical feedstocks and more complex molecules like medicines from them in a previous post on flow chemistry.

In fact the whole antiseptic model of health care is built around plastics and is ultimately oil based. And as discussed in the rather long set of posts starting with the Unfactory, pretty much anything chemical (plastics, colorants, rubbers, fertilisers, etc.) can be made locally once you have local energy source.

In health antiseptic gloves are made of different polymers like latex, nitrile rubber, polyvinyl chloride and neoprene. Syringes are polypropylene or polyethylene. intravenous tubing from PVC, polyethylene, or polypropylene plastic. PVC tubing is softened with plasticisers, oxygen masks are made from transparent soft PVC etc.

Wide variety of plastics are used for medical packaging such as polypropylene, PET, lineal low-density polyethylene and vinyl. Plastics offer variety in aesthetics, for example, appearances range from clear to opaque.  And plastics are compatible with sterilization methods that don’t require porosity.

Fibrous polymers are also used as sutures and arterial, skin, hernia repair meshes and other prostheses. Their main benefit is that fibrous polymers can be chemically modified to meet a wide set of uses. For example, sutures made from polyglycolic acid are absorbable and are degraded by the body over time.

There are thousands of medical molecules in use today making local medicine production a large task. It makes sense to focus first on common diseases. Each region tends to have their own hereditary diseases leading to need for local development as well.

For finding out the right areas to focus one can look at either the WHO list of essential medicines or this list . There is another list of essential medication for children.

Having ability to synthesise pharmaceuticals in decentralised manner means that the world is much more robust against supply shocks whether due to pandemic or political pressuring. Thus, every single compound that can be produced locally makes the system less fragile.

As a downside it needs to be considered that pharmaceutical have both the ability to do good but also to cause potential harm to users. Every medical intervention has risks associated with it. This means that local production through open-sourced recipes carries risks with it.

Noncommunicable diseases (NCF) like cardiovascular diseases, cancers, chronic respiratory diseases and diabetes are the biggest cause of death worldwide (over 60% of deaths). Any medicine for these diseases needs to be at the top of the list of decentralized medicine. Most premature deaths of these diseases are linked to common risk factors like tobacco, unhealthy diet with too much sugar, salt and fats, not exercising enough, air pollution and harmful use of alcohol. Addressing the causes directly would be a cheaper method than medication in the long run.

Once the active ingredient has been manufactured, it needs to be made into a dosage form. For orally administered (eaten), this means a tablet or capsule of some format. This does not need to be complex. Binding and filling agents are needed. Often, they are the same substance. And a lubricant to make it easier to swallow. For example, aspirin tablets only require four ingredients – acetylsalicylic acid, corn starch as filler and binder, water and a lubricant that can be hydrogenated vegetable oil (adding hydrogen makes oil into solid or semi-solid), stearic acid, talc etc. The actual formulation involves weighting, mixing, dry screening, compression into tables, testing and bottling. All possible in decentralised manner.

Another emerging category are biosimilar medicines made in bioreactors with modified micro-organisms. Insulin has been produced for this for longest time but many other drugs that are similar to natural hormones can be produced. The science behind it is discussed in this post on decentralized medicine manufacturing (somewhat misleading header as its really just on biosimilars).

(this turned out not to be a summary on health as we had discussed decentralised health in partial fragments earlier).