Wild card

This wild card assumes that nano-enabled self-diagnosis and self-treatment becomes pervasive. This would allow the general public to diagnose, monitor and treat illness themselves having their own ‘Doc in a Box’. Doctors may become redundant and the ageing population could increase. Although this occurrence is considered ‘wild’, it is very interesting as there are a number of ongoing research projects based around this technology, which if exploited could trigger this wild card. This would have a huge impact on people’s lives, drastically changing the way that we diagnose and treat illness and disease.

Surprises ("wild" scenario features)

Treating illness is clearly of huge importance globally, and this wild card would not only dramatically alter the way in which aliments are treated, but also change the way in which we monitor and diagnose illness. Imagine the scenario whereby everybody has a small microchip which gives a morning report on the state of heath of an individual, for example, specific actions are proposed over breakfast such as ‘take the pill’. It is feasible that high throughput scanners could be achieved by 2030 thus providing cheap personal genome at €10 overnight and giving automatic interpretations/diagnosis. The potential is high for the knock-on effect of early diagnosis and treatment available to all increasing the ageing population – significant increases of having ‘too many healthy people’ would be highly likely. Further societal effects would include the expansion of health communities as the centralised medicine system is redundant and dissolves.

Possible interpretations

It is considered that there is certainly a need for technical progress in this field, and one way of interpreting this wild card is to consider it as an aid to enhancing the quality of life (which is clearly high on the global agenda). Equally, this technology would be available cheaply and as such has the potential to be accessible by the global population. However, as much as this could be considered as a great benefit, it is apparent that with these developments, there would be a rise in the ageing population. There would also be ‘opportunities’ in other sectors as there would be a need for proper databases to be developed to ensure the accuracy of such technology.

Key actors

• Scanners or "early warners" such as public and private organisations involved with patient safety and medical malpractice, health incurrence and legal services providers as well as health and safety agencies.
• Shapers (i.e. enablers/inhibitors) : regulators and the global society, especially the ageing population who are more reliant on diagnose and monitoring of treatments.
• Stakeholders positively or negatively impacted include several actors of the health care system. Clearly, the effects of such a wild card would be of significance and concern to doctors, pharmaceutical employees and other health care workers who could be rendered redundant (or at least the reliance on them for diagnosis would be drastically reduced). In parallel to this, health care systems would be altered, for instance, far less people would require hospital attention, and perhaps there will be less people inclined to become involved in health care (and if the technology ‘collapsed’, there could be a global lack of qualified pharmaceutical and health workers).

Potential impacts

This wild card could bring about a number of different impacts, and it is uncertain as to whether this would be primarily beneficial or unwanted. With the development of this advanced technology and the realisation that it is available to the global population, what would happen if this was rejected by society? For instance, what if people still preferred the personal relationship and comfort that can be afforded by visiting the doctor? With the technology rejected, will there still be enough qualified health care specialists? This would have a dramatic global impact. Similarly, if the ‘doc-in-a-box’ patents were controlled by Russian-Chinese conglomerates, there could be a US boycott of the world intellectual property system. A further impact could be that big Pharmaceutical organisations can no longer be sustainable and they disappear. Of course, there is the possibility of people living longer and having a greater quality of life, but again this will lead to a rise in the ageing population. Careful considerations would need to be maintained with regard to disposing of the units – millions of doc-in-a-box may end up in landfill. There is the impact on social well being to consider as social isolation could lead to large bouts of depression. Regarding actual technological impacts, complicated diagnostic systems could become unpredictable for outlaying cases and may lead to death of users of prescriptions; this means that regulation is needed.

Potential actions

There are a number of actions that should be considered with regard to this wild card, for example, there may be a need for Nano Education from primary school or the Development of databases for self diagnosis and problems to diagnose leading to something like www.doctorgoogle.com. For As such, a number of early actions (pre-wild card) and early reactions (if the wild card occurs) should be considered:

• Policy actions

  Early actions: Stakeholder and public debate; New infrastructure; Educational system; New legislation – specific legislation; International dimension (negotiation).

  Early reactions: Monitoring systems and regulations at policy level.

• Business actions

  Early actions: Public- private partnerships; Business planning – forecasting of market entry; Technological improvements; Development of databases of medical conditions on blood, urine and other tests; Development of programs for analysis of the tests available online www.docgoogle.com; Disruptive technology for pharmaceutical; Positioning new business for new product.

  Early reactions: Commercialising, Cooperation with R&D groups (this post it was placed on the before/after border); Technological advancement.

• Research actions

  Early actions: Development of algorithmic descriptions of diseases; Developing self-diagnosis technology roadmaps; Identification key technologies; Research on standardised analysis of medical data (blood results, urine results) by deduction from many possibilities to the one which someone is ill; Public perception – acceptance of technology.

  Early reactions: State-of-art analysis, technology analysis (this post it was placed on the before/after border); Risk analysis (this post it was placed on the before/after border).