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The role of data science in healthcare advancements: applications, benefits, and future prospects

• Review Article
• Open access
• Published: 16 August 2021
• Volume 191 , pages 1473–1483, ( 2022 )

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• Sri Venkat Gunturi Subrahmanya 1 ,
• Dasharathraj K. Shetty   ORCID: orcid.org/0000-0002-5021-4029 2 ,
• Vathsala Patil   ORCID: orcid.org/0000-0002-8656-8080 3 ,
• B. M. Zeeshan Hameed   ORCID: orcid.org/0000-0002-2904-351X 4 ,
• Rahul Paul 5 ,
• Komal Smriti   ORCID: orcid.org/0000-0002-7061-9883 3 ,
• Nithesh Naik   ORCID: orcid.org/0000-0003-0356-7697 6 &
• Bhaskar K. Somani   ORCID: orcid.org/0000-0002-6248-6478 7  

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Data science is an interdisciplinary field that extracts knowledge and insights from many structural and unstructured data, using scientific methods, data mining techniques, machine-learning algorithms, and big data. The healthcare industry generates large datasets of useful information on patient demography, treatment plans, results of medical examinations, insurance, etc. The data collected from the Internet of Things (IoT) devices attract the attention of data scientists. Data science provides aid to process, manage, analyze, and assimilate the large quantities of fragmented, structured, and unstructured data created by healthcare systems. This data requires effective management and analysis to acquire factual results. The process of data cleansing, data mining, data preparation, and data analysis used in healthcare applications is reviewed and discussed in the article. The article provides an insight into the status and prospects of big data analytics in healthcare, highlights the advantages, describes the frameworks and techniques used, briefs about the challenges faced currently, and discusses viable solutions. Data science and big data analytics can provide practical insights and aid in the decision-making of strategic decisions concerning the health system. It helps build a comprehensive view of patients, consumers, and clinicians. Data-driven decision-making opens up new possibilities to boost healthcare quality.

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Introduction

The evolution in the digital era has led to the confluence of healthcare and technology resulting in the emergence of newer data-related applications [ 1 ]. Due to the voluminous amounts of clinical data generated from the health care sector like the Electronic Health Records (EHR) of patients, prescriptions, clinical reports, information about the purchase of medicines, medical insurance-related data, investigations, and laboratory reports, there lies an immense opportunity to analyze and study these using recent technologies [ 2 ]. The huge volume of data can be pooled together and analyzed effectively using machine-learning algorithms. Analyzing the details and understanding the patterns in the data can help in better decision-making resulting in a better quality of patient care. It can aid to understand the trends to improvise the outcome of medical care, life expectancy, early detection, and identification of disease at an initial stage and required treatment at an affordable cost [ 3 ]. Health Information Exchange (HIE) can be implemented which will help in extracting clinical information across various distinct repositories and merge it into a single person’s health record allowing all care providers to access it securely. Hence, the organizations associated with healthcare must attempt to procure all the available tools and infrastructure to make use of the big data, which can augment the revenue and profits and can establish better healthcare networks, and stand apart to reap significant benefits [ 4 , 5 ]. Data mining techniques can create a shift from conventional medical databases to a knowledge-rich, evidence-based healthcare environment in the coming decade.

Big data and its utility in healthcare and medical sciences have become more critical with the dawn of the social media era (platforms such as Facebook and Twitter) and smartphone apps that can monitor personal health parameters using sensors and analyzers [ 6 , 7 ]. The role of data mining is to improvise the stored user information to provide superior treatment and care. This review article provides an insight into the advantages and methodologies of big data usage in health care systems. It highlights the voluminous data generated in these systems, their qualities, possible security-related problems, data handling, and how this analytics support gaining significant insight into these data set.

Search strategy

A non-systematic review of all data science, big data in healthcare-related English language literature published in the last decade (2010–2020) was conducted in November 2020 using MEDLINE, Scopus, EMBASE, and Google Scholar. Our search strategy involved creating a search string based on a combination of keywords. They were: “Big Data,” “Big Data Analytics,” “Healthcare,” “Artificial Intelligence,” “AI,” “Machine learning,” “ML,” “ANN,” “Convolutional Networks,” “Electronic Health Records,” “EHR,” “EMR,” “Bioinformatics,” and “Data Science.” We included original articles published in English.

Inclusion criteria

Articles on big data analytics, data science, and AI.

Full-text original articles on all aspects of application of data science in medical sciences.

Exclusion criteria

Commentaries, reviews, and articles with no full-text context and book chapters.

Animal, laboratory, or cadaveric studies.

The literature review was performed as per the above-mentioned strategy. The evaluation of titles and abstracts, screening, and the full article text was conducted for the chosen articles that satisfied the inclusion criteria. Furthermore, the authors manually reviewed the selected article’s references list to screen for any additional work of interest. The authors resolved the disagreements about eligibility for a consensus decision after discussion.

Knowing more about “big data”

Big data consists of vast volumes of data, which cannot be managed using conventional technologies. Although there are many ways to define big data, we can consider the one defined by Douglas Laney [ 8 ] that represents three dimensions, namely, volume, velocity, and variety (3 Vs). The “big” in big data implies its large volume. Velocity demonstrates the speed or rate at which data is processed. Variety focuses on the various forms of structured and raw data obtained by any method or device, such as transaction-level data, videos, audios, texts, emails, and logs. The 3 Vs became the default description of big data, while many other Vs are added to the definition [ 9 ]. “Veracity” remains the most agreed 4th “V.” Data veracity focuses on the accuracy and reliability of a dataset. It helps to filter through what is important and what is not. The data with high veracity has many records that are valuable to analyze and that contribute in a meaningful way to the overall results. This aspect poses the biggest challenge when it comes to big data. With so much data available, ensuring that it is relevant and of high quality is important. Over recent years, big data has become increasingly popular across all parts of the globe.

Big data needs technologically sophisticated applications that use high-end computing resources and Artificial Intelligence (AI)-based algorithms to understand such huge volumes of data. Machine learning (ML) approaches for automatic decision-making by applying fuzzy logic and neural networks will be added advantage. Innovative and efficient strategies for dealing with data, smart cloud-based applications, effective storage, and user-friendly visualization are required for big data to gain practical insights [ 10 ].

Medical care as a repository for big data

Healthcare is a multilayered system developed specifically for preventing, diagnosing, and treating diseases. The key elements of medical care are health practitioners (physicians and nurses), healthcare facilities (which include clinics, drug delivery centers, and other testing or treatment technologies), and a funding agency that funds the former. Health care practitioners belong to different fields of health such as dentistry, pharmacy, medicine, nursing, psychology, allied health sciences, and many more. Depending on the severity of the cases, health care is provided at many levels. In all these stages, health practitioners need different forms of information such as the medical history of the patient (data related to medication and prescriptions), clinical data (such as data from laboratory assessments), and other personal or private medical data. The usual practice for a clinic, hospital, or patient to retain these medical documents would be maintaining either written notes or in the form of printed reports [ 11 ].

The clinical case records preserve the incidence and outcome of disease in a person’s body as a tale in the family, and the doctor plays an integral role in this tale [ 12 ]. With the emergence of electronic systems and their capacity, digitizing medical exams, health records, and investigations is a common procedure today. In 2003, the Institute of Medicine, a division in the National Academies of Sciences and Engineering coined the term “Electronic Health Records” for representing an electronic portal that saves the records of the patients. Electronic health records (EHRs) are automated medical records of patients related to an individual’s physical/mental health or significant reports that are saved in an electronic system and used to record, send, receive, store, retrieve, and connect the medical personnel and patient with medical services [ 13 ].

Open-source big data platforms

It is an inefficient idea to work with big data or vast volumes of data into storage considering even the most powerful computers. Hence, the only logical approach to process large quantities of big data available in a complex form is by spreading and processing it on several parallel connected nodes. Nevertheless, the volume of the data is typically so high that a large number of computing machines are needed in a reasonable period to distribute and finish processing. Working with thousands of nodes involves coping with issues related to paralleling the computation, spreading of data, and manage failures. Table 1 shows the few open sources of big data platforms and their utilities for data scientists.

• Data mining

Data types can be classified based on their nature, source, and data collection methods [ 14 ]. Data mining techniques include data grouping, data clustering, data correlation, and mining of sequential patterns, regression, and data storage. There are several sources to obtain healthcare-related data (Fig.  1 ). The most commonly used type (77%) is the data generated by humans (HG data) which includes Electronic Medical Records (EMR), Electronic Health Records (EHR), and Electronic Patient Records (EPR). Online data through Web Service (WS) is considered as the second largest form of data (11%) due to the increase in the number of people using social media day by day and current digital development in the medical sector [ 15 ]. Recent advances in the Natural Language Processing (NLP)-based methodologies are also making WS simpler to use [ 16 ]. The other data forms such as Sensor Data (SD), Big Transactional Data (BTD), and Biometric Data (BM) make around 12% of overall data use, but wearable personal health monitoring devices’ prominence and market growth [ 17 ] may need SD and BM data.

Sources of big data in healthcare

Applications of analytics in healthcare

There are six areas of applications of analytics in healthcare (Fig.  2 ) including disease surveillance, health care management and administration, privacy protection and fraud detection, mental health, public health, and pharmacovigilance. Researchers have implemented data extraction for data deposition and cloud-based computing, optimizing quality, lowering costs, leveraging resources, handling patients, and other fields.

Various applications of data science in healthcare

Disease surveillance

It involves the perception of the disease, understanding its condition, etiology (the manner of causation of a disease), and prevention (Fig.  3 ).

The disease analysis system

Information obtained with the help of EHRs, and the Internet has a huge prospect for disease analysis. The various surveillance methods would aid the planning of services, evaluation of treatments, priority setting, and the development of health policy and practice.

Image processing of healthcare data from the big data point of view

Image processing on healthcare data offers valuable knowledge about anatomy and organ functioning and identifies the disease and patient health conditions. The technique currently has been used for organ delineation, identification of lung tumors, diagnosis of spinal deformity, detection of arterial stenosis, detection of an aneurysm, etc. [ 18 ]. The wavelets technique is commonly used for image processing techniques such as segmentation, enhancement, and noise reduction. The use of artificial intelligence in image processing will enhance aspects of health care including screening, diagnosis, and prognosis, and integrating medical images with other types of data and genomic data will increase accuracy and facilitate early diagnosis of diseases [ 18 , 19 ]. The exponential increase in the count of medical facilities and patients has led to better use of clinical settings of computer-based healthcare diagnostics and decision-making systems.

Data from wearable technology

Multi-National Companies like Apple and Google are working on health-based apps and wearable technology as part of a broader range of electronic sensors, the so-called IoT, and toolkits for healthcare-related apps. The possibility of collecting accurate medical data on real-time (e.g., mood, diet followed, exercise, and sleep cycles patterns), linked to physiological indicators (e.g., heart rate, calories burned, level of blood glucose, cortisol levels), is perhaps discrete and omnipresent at minimum cost, unrelated to traditional health care. “True Colors” is a wearable designed to collect continuous patient-centric data with the accessibility and acceptability needed to allow for accurate longitudinal follow-up. More importantly, this system is presently being piloted as a daily health-monitoring substitute.

Medical signal analytics

Telemetry and the devices for the monitoring of physiological parameters generate large amounts of data. The data generated generally are retained for a shorter duration, and thus, extensive research into produced data is neglected. However, advancements in data science in the field of healthcare attempt to ensure better management of data and provide enhanced patient care [ 20 , 21 , 22 , 23 ].

The use of continuous waveform in health records containing information generated through the application of statistical disciplines (e.g., statistical, quantitative, contextual, cognitive, predictive, etc.) can drive comprehensive care decision-making. Data acquisition apart from an ingestion-streaming platform is needed that can control a set of waveforms at various fidelity rates. The integration of this waveform data with the EHR’s static data results in an important component for giving analytics engine situational as well as contextual awareness. Enhancing the data collected by analytics will not just make the method more reliable, but will also help in balancing predictive analytics’ sensitivity and specificity. The signal processing species must mainly rely on the kind of disease population under observation.

Various signal-processing techniques can be used to derive a large number of target properties that are later consumed to provide actionable insight by a pre-trained machine-learning model. Such observations may be analytical, prescriptive, or predictive. Such insights can be furthermore built to activate other techniques such as alarms and physician notifications. Maintaining these continuous waveforms–based data along with specific data obtained from the remaining sources in perfect harmony to find the appropriate patient information to improve diagnosis and treatments of the next generation can be a daunting task [ 24 ]. Several technological criteria and specifications at the framework, analytical, and clinical levels need to be planned and implemented for the bedside implementation of these systems into medical setups.

Healthcare administration

Knowledge obtained from big data analysis gives healthcare providers insights not available otherwise (Fig.  4 ). Researchers have implemented data mining techniques to data warehousing as well as cloud computing, increasing quality, minimizing costs, handling patients, and several other fields of healthcare.

Role of big data in accelerating the treatment process

Data storage and cloud computing

Data warehousing and cloud storage are primarily used for storing the increasing amount of electronic patient-centric data [ 25 , 26 ] safely and cost-effectively to enhance medical outcomes. Besides medical purposes, data storage is utilized for purposes of research, training, education, and quality control. Users can also extract files from a repository containing the radiology results by using keywords following the predefined patient privacy policy.

Cost and quality of healthcare and utilization of resources

The migration of imaging reports to electronic medical recording systems offers tremendous potential for advancing research and practice on radiology through the continuous updating, incorporation, and exchange of a large volume of data. However, the heterogeneity in how these data can be formatted still poses major challenges. The overall objective of NLP is that the natural human language is translated into structured with a standardized set of value choices that are easily manipulated into subsections or searches for the presence or absence of a finding through software, among other things [ 27 ].

Greaves et al. [ 28 ] analyzed sentiment (computationally dividing them into categories such as optimistic, pessimistic, and neutral) based on the online response of patients stating their overall experience to predict healthcare quality. They found an agreement above 80% between online platform sentiment analysis and conventional paper-based quality prediction surveys (e.g., cleanliness, positive conduct, recommendation). The newer solution can be a cost-effective alternative to conventional healthcare surveys and studies. The physician’s overuse of screening and testing often leads to surplus data and excess costs [ 29 ]. The present practice in pathology is restricted by the emphasis on illness. Zhuang et al. [ 29 ] compared the disease-based approach in conjunction with database reasoning and used the data mining technique to build a decision support system based on evidence to minimize the unnecessary testing to reduce the total expense of patient care.

Patient data management

Patient data management involves effective scheduling and the delivery of patient care during the period of a patient’s stay in a hospital. The framework of patient-centric healthcare is shown in Fig.  5 . Daggy et al. [ 30 ] conducted a study on “no shows” or missing appointments that lead to the clinical capability that has been underused. A logistical regression model is developed using electronic medical records to estimate the probabilities of patients to no-show and show the use of estimates for creating clinical schedules that optimize clinical capacity use while retaining limited waiting times and clinical extra-time. The 400-day clinical call-in process was simulated, and two timetables were developed per day: the conventional method, which assigns one patient per appointment slot, and the proposed method, which schedules patients to balance patient waiting time, additional time, and income according to no-show likelihood.

Elemental structure of patient-centric healthcare and ecosystem

If patient no-show models are mixed with advanced programming approaches, more patients can be seen a day thus enhancing clinical performance. The advantages of implementation of planning software, including certain methodologies, should be considered by clinics as regards no-show costs [ 30 ].

A study conducted by Cubillas et al. [ 31 ] pointed out that it takes less time for patients who came for administrative purposes than for patients for health reasons. They also developed a statistical design for estimating the number of administrative visits. With a time saving of 21.73% (660,538 min), their model enhanced the scheduling system. Unlike administrative data/target finding patients, a few come very regularly for their medical treatment and cover a significant amount of medical workload. Koskela et al. [ 32 ] used both supervised and unsupervised learning strategies to identify and cluster records; the supervised strategy performed well in one cluster with 86% accuracy in distinguishing fare documents from the incorrect ones, whereas the unsupervised technique failed. This approach can be applied to the semi-automate EMR entry system [ 32 ].

Privacy of medical data and fraudulency detection

The anonymization of patient data, maintaining the privacy of the medical data and fraudulency detection in healthcare, is crucial. This demands efforts from data scientists to protect the big data from hackers. Mohammed et al. [ 33 ] introduced a unique anonymization algorithm that works for both distributed and centralized anonymization and discussed the problems of privacy security. For maintaining data usefulness without the loss of any data privacy, the researchers further proposed a model that performed far better than the traditional K-anonymization model. In addition to this, their algorithm could also deal with voluminous, multi-dimensional datasets.

A mobile-based cloud-computing framework [ 34 ] of big data has been introduced to overcome the shortcomings of today’s medical records systems. EHR data systems are constrained due to a lack of interoperability, size of data, and privacy. This unique cloud-based system proposed to store EHR data from multiple healthcare providers within the facility of an internet provider to provide authorized restricted access to healthcare providers and patients. They used algorithms for encryption, One Time Password (OTP), or a 2-factor authentication to ensure data security.

The analytics of the big data can be performed using Google’s efficient tools such as big query tools and MapReduce. This approach will reduce costs, improve efficiency, and provide data protection compared to conventional techniques that are used for anonymization. The conventional approach generally leaves data open to re-identification. Li et al. in a case study showed that hacking can make a connection between tiny chunks of information as well as recognize patients [ 35 ]. Fraud detection and abuse (i.e., suspicious care behavior, deliberate act of falsely representing facts, and unwanted repeated visits) make excellent use of big data analytics [ 36 ].

By using data from gynecology-based reports, Yang et al. framed a system that manually distinguishes characteristics of suspicious specimens from a set of medical care plans that any doctor would mostly adopt [ 37 ]. The technique was implemented on the data from Taiwan’s Bureau of National Health Insurance (BNHI), where the proposed technique managed to detect 69% of the total cases as fraudulent, enhancing the current model, which detected only 63% of fraudulent cases. To sum up, the protection of patient data and the detection of fraud are of significant concern due to the growing usage of social media technology and the propensity of people to place personal information on these platforms. The already existing strategies for anonymizing the data may become less successful if they are not implemented because a significant section of the personal details of everyone is now accessible through these platforms.

Mental health

According to National Survey conducted on Drug Use and Health (NSDUH), 52.2% of the total population in the United States (U.S.) was affected by either mental problems or drug addiction/abuse [ 38 ]. In addition, approximately 30 million suffer from panic attacks and anxiety disorders [ 39 ].

Panagiotakopoulos et al. [ 40 ] developed a data analysis–focused treatment technique to help doctors in managing patients with anxiety disorders. The authors used static information that includes personal information such as the age of the individual, sex, body and skin types, and family details and dynamic information like the context of stress, climate, and symptoms to construct static and dynamic information based on user models. For the first three services, relationships between different complex parameters were established, and the remaining one was mainly used to predict stress rates under various scenarios. This model was verified with the help of data collected from twenty-seven volunteers who are selected via the anxiety assessment survey. The applications of data analytics in the disease diagnosis, examination, or treatment of patients with mental wellbeing are very different from using analytics to anticipate cancer or diabetes. In this case, the data context (static, dynamic, or non-observable environment) seems to be more important compared to data volume [ 39 ].

The leading cause of perinatal morbidity and death is premature birth, but an exact mechanism is still unclear. The research carried by Chen et al. [ 41 ] intended to investigate the risk factors of preterm use of neural networks and decision tree C5.0 data mining. The original medical data was obtained by a specialist study group at the National University of Taiwan from a prospective pregnancy cohort. A total of 910 mother–child dyads from 14,551 in the original data have been recruited using the nest case–control design. In this data, thousands of variables are studied, including basic features, medical background, the climate and parents’ occupational factors, and the variables related to children. The findings suggest that the main risk factors for pre-born birth are multiple births, blood pressure during pregnancy, age, disease, prior preterm history, body weight and height of pregnant women, and paternal life risks associated with drinking and smoking. The results of the study are therefore helpful in the attempt to diagnose high-risk pregnant women and to provide intervention early to minimize and avoid early births in parents, healthcare workers, and public health workers [ 41 , 42 ].

Public health

Data analytics have also been applied to the detection of disease during outbreaks. Kostkova et al. [ 43 ] analyzed online records based on behavior patterns and media reporting the factors that affect the public as well as professional patterns of search-related disease outbreaks. They found distinct factors affecting the public health agencies’ skilled and layperson search patterns with indications for targeted communications during emergencies and outbreaks. Rathore et al. [ 44 ] have suggested an emergency tackling response unit using IoT-based wireless network of wearable devices called body area networks (BANs). The device consists of “intelligent construction,” a model that helps in processing and decision making from the data obtained from the sensors. The system was able to process millions of users’ wireless BAN data to provide an emergency response in real-time.

Consultation online is becoming increasingly common and a possible solution to the scarcity of healthcare resources and inefficient delivery of resources. Numerous online consultation sites do however struggle to attract customers who are prepared to pay and maintain them, and health care providers on the site have the additional challenge to stand out from a large number of doctors who can provide similar services [ 45 ]. In this research, Jiang et al. [ 45 ] used ML approaches to mine massive service data, in order (1) to define the important characteristics related to patient payment rather than free trial appointments, (2) explore the relative importance of those features, and (3) understand how these attributes work concerning payment, whether linearly or not. The dataset refers to the largest online medical consultation platform in China, covering 1,582,564 consultation documents among patient pairs between 2009 and 2018. The results showed that compared with features relating to reputation as a physician, service-related features such as quality of service (e.g., intensity of consultation dialogue and response rate), the source of patients (e.g., online vs offline patients), and the involvement of patients (e.g., social returns and previous treatments revealed). To facilitate payment, it is important to promote multiple timely responses in patient-provider interactions.

Pharmacovigilance

Pharmacovigilance requires tracking and identification of adverse drug reactions (ADRs) after launch, to guarantee patient safety. ADR events’ approximate social cost per year reaches a billion dollars, showing it as a significant aspect of the medical care system [ 46 ]. Data mining findings from adverse event reports (AERs) revealed that mild to lethal reactions might be caused in paclitaxel among which docetaxel is linked with the lethal reaction while the remaining 4 drugs were not associated with hypersensitivity [ 47 ] while testing ADR’s “hypersensitivity” to six anticancer agents [ 47 ]. Harpaz et al. [ 46 ] disagreed with the theory that adverse events might be caused not just due to a single medication but also due to a mixture of synthetic drugs. It is found that there is a correlation between a minimum of one drug and two AEs or two drugs and one AE in 84% of AERs studies. Harpaz R et al. [ 47 ] improved precision in the identification of ADRs by jointly considering several data sources. When using EHRs that are available publicly in conjunction with the AER studies of the FDA, they achieved a 31% (on average) increase in detection [ 45 ]. The authors identified dose-dependent ADRs with the help of models built from structured as well as unstructured EHR data [ 48 ]. Of the top 5 ADR-related drugs, 4 were observed to be dose-related [ 49 ]. The use of text data that is unstructured in EHRs [ 50 ]; pharmacovigilance operation was also given priority.

ADRs are uncommon in conventional pharmacovigilance, though it is possible to get false signals while finding a connection between a drug and any potential ADRs. These false alarms can be avoided because there is already a list of potential ADRs that can be of great help in potential pharmacovigilance activities [ 18 ].

Overcoming the language barrier

Having electronic health records shared worldwide can be beneficial in analyzing and comparing disease incidence and treatments in different countries. However, every country would use their language for data recording. This language barrier can be dealt with the help of multilingual language models, which would allow diversified opportunities for Data Science proliferation and to develop a model for personalization of services. These models will be able to understand the semantics — the grammatical structure and rules of the language along with the context — the general understanding of words in different contexts.

For example: “I’ll meet you at the river bank.”

“I have to deposit some money in my bank account.”

The word bank means different things in the two contexts, and a well-trained language model should be able to differentiate between these two. Cross-lingual language model trains on multiple languages simultaneously. Some of the cross lingual language models include:

mBERT — the multilingual BERT which was developed by Google Research team.

XLM — cross lingual model developed by Facebook AI, which is an improvisation over mBERT.

Multifit — a QRNN-based model developed by Fast.Ai that addresses challenges faced by low resource language models.

Millions of data points are accessible for EHR-based phenotyping involving a large number of clinical elements inside the EHRs. Like sequence data, handling and controlling the complete data of millions of individuals would also become a major challenge [ 51 ]. The key challenges faced include:

The data collected was mostly either unorganized or inaccurate, thus posing a problem to gain insights into it.

The correct balance between preserving patient-centric information and ensuring the quality and accessibility of this data is difficult to decide.

Data standardization, maintaining privacy, efficient storage, and transfers require a lot of manpower to constantly monitor and make sure that the needs are met.

Integrating genomic data into medical studies is critical due to the absence of standards for producing next-generation sequencing (NGS) data, handling bioinformatics, data deposition, and supporting medical decision-making [ 52 ].

Language barrier when dealing data

Future directions

Healthcare services are constantly on the lookout for better options for improving the quality of treatment. It has embraced technological innovations intending to develop for a better future. Big data is a revolution in the world of health care. The attitude of patients, doctors, and healthcare providers to care delivery has only just begun to transform. The discussed use of big data is just the iceberg edge. With the proliferation of data science and the advent of various data-driven applications, the health sector remains a leading provider of data-driven solutions to a better life and tailored services to its customers. Data scientists can gain meaningful insights into improving the productivity of pharmaceutical and medical services through their broad range of data on the healthcare sector including financial, clinical, R&D, administration, and operational details.

Larger patient datasets can be obtained from medical care organizations that include data from surveillance, laboratory, genomics, imaging, and electronic healthcare records. This data requires proper management and analysis to derive meaningful information. Long-term visions for self-management, improved patient care, and treatment can be realized by utilizing big data. Data Science can bring in instant predictive analytics that can be used to obtain insights into a variety of disease processes and deliver patient-centric treatment. It will help to improvise the ability of researchers in the field of science, epidemiological studies, personalized medicine, etc. Predictive accuracy, however, is highly dependent on efficient data integration obtained from different sources to enable it to be generalized. Modern health organizations can revolutionize medical therapy and personalized medicine by integrating biomedical and health data. Data science can effectively handle, evaluate, and interpret big data by creating new paths in comprehensive medical care.

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Rethinking approaches of science, technology, and innovation in healthcare during the COVID-19 pandemic: the challenge of translating knowledge infrastructures to public needs

• Renan Gonçalves Leonel da Silva   ORCID: orcid.org/0000-0001-9679-6389 1 ,
• Roger Chammas 2 &
• Hillegonda Maria Dutilh Novaes 3  

Health Research Policy and Systems volume  19 , Article number:  104 ( 2021 ) Cite this article

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The coronavirus disease 2019 (COVID-19) outbreak made it clear that despite the potential of science, technology, and innovation (ST&I) to positively impact healthcare systems worldwide, as shown by the rapid development of SARS-CoV-2 test diagnostics and new mRNA vaccines, healthcare stakeholders have faced significant challenges in responding to the crisis through well-integrated ST&I-oriented health initiatives and policies. Therefore, the pandemic has mobilized experts, industry, and governments to evaluate alternative trajectories to promote a more efficient dialogue between ST&I and public health. This article presents a critical thinking about the contemporary asymmetries in the technical and political infrastructures available for particular approaches in ST&I in health, such as precision medicine, and for public health systems worldwide, uncovering a persistent gap in the translation of knowledge and technologies to adequately coordinated responses to the pandemic. We stimulate the understanding of this process as a matter of translation between platforms of knowledge and policy rationales shaped by different institutionalized frames of organizational practices and agendas. We draw attention to the need to strengthen governance tools for the promotion of ST&I as a strategic component of the post-pandemic agenda in public health, to prepare societies to respond efficiently to future emergencies.

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Introduction

The coronavirus 2019 (COVID-19) pandemic has changed how we understand and approach problems in science, technology, and innovation (ST&I) in health in contemporary society. The current situation has produced specific demands for health systems, and an inconvenient paradox has become visible: we have never had such a supply of qualified scientific and technological knowledge infrastructures in health and biomedical sciences, but at the same time a viable translation of this knowledge to public health systems has shown itself flawed and inefficient. This paradox raises questions about what has brought us to this inconvenient reality, and the importance of paying greater attention to the mechanisms of governance and implementation of ST&I in public health in a more systemic way.

Inevitably, it pushes us back to reflect about how health research has been institutionalized by contemporary science and technology policy (S&TP) agendas and regimes of knowledge in biomedical sciences. Over the past few decades, governments, top-ranked academic institutions, and the S&TP around the world have funded biomedical research with a focus on expanding our understanding of the processes of health, illness, and medicalization through the introduction of new gene and immune cell therapies to molecular levels [ 1 ]. Although the anticipated impacts of genomic sciences have not yet been fulfilled, their implementation has been promoted as a potential transformative agent in healthcare, leading to significant impacts in public health systems internationally [ 2 , 3 ]. The utilization of molecular data as a basis for clinical diagnosis and practice has led to the proposition of fields such as so-called precision medicine (PM), a name advocated by a wide range of United States experts, entrepreneurs, and politicians since 2015, which has led to a significant push to reorganize interests and political agendas in academia, governments, and industry [ 4 ].

PM is an example of political viability in the making for ST&I-oriented agendas in health. The generous availability of resources accumulated and used for PM have stimulated stakeholders in healthcare to pursue new biotechnologies and personalized therapies making use of high-tech-based machines from well-furnished and expensive molecular biology laboratories. It has made possible the creation of a new research infrastructure, leading to fruitful spillovers into the international research on non-transmissible chronic, genetic, and autoimmune diseases [ 5 ].

The drive toward PM has built itself as an achievement of ST&I incursions into health in the recent years, capable of attracting media attention and large public and private investments. However, since knowledge is a human entrepreneurship that is not played in a political vacuum—that is, it results from choices about what research to undertake, and what research to leave undone [ 6 ]—it is particularly relevant to ask why this technical and political infrastructure has not been properly used by public health providers as a viable knowledge platform to reduce the negative impacts of the pandemic. Recent work has shown that the international PM community did not respond to the COVID-19 pandemic with practical solutions or clear political positioning in favour of national public health policies [ 7 ]. Thus, the recent impact of ST&I infrastructures on public health in general, and of PM infrastructures on the COVID-19 outbreak responses specifically, has not yet been determined, and it is clear that its potential should be explored through systematic multidisciplinary research as a tool of preparedness for future emergencies and better use of ST&I resources and capacity.

This article presents a critical thinking about the contemporary asymmetries in the technical and political infrastructures available for particular approaches in ST&I in health, such as PM, and for health policies and systems worldwide, uncovering a persistent gap in the translation of knowledge and technologies into adequately coordinated responses to the pandemic. Through the multidisciplinary theoretical background, we stimulate the understanding of this process as a matter of translation between platforms of knowledge and policy rationales shaped by different institutionalized frames of organizational practices and agendas.

The paper is organized as follows. The first section, “ST&I in healthcare during the COVID-19 pandemic”, traces introductory remarks regarding the importance of thinking critically on the global asymmetry of infrastructures of ST&I in health and the importance of the communication between that and public health agendas as a lesson learned during the pandemic. In the following section, “Translating precision medicine infrastructures to public health: a difficult challenge”, we present PM as an ST&I approach in health in which clinical and healthcare delivery operates out of the technical and political toolbox of public health. To illustrate, after pointing out some characteristics of PM, we show how it becomes explicit in the incorporation of technologies in health systems—typically misinterpreted as an ultimate way to approximate ST&I and public health. Next, the third section “Improving governance of ST&I for public health needs as a post-pandemic outcome” addresses the necessity of strengthening governance tools for the promotion of ST&I as a strategic component of the post-pandemic agenda in public health, particularly inspired by recent achievements reported in the literature on the politics of science and technology in health, and implementation sciences (IS). In the conclusion section, we call attention to the urgence of an academic multidisciplinary research agenda that looks for ways to shorten the distance between platforms of knowledge and rationales of decision-making in PM and public health, with the potential to be reached by the institutionalization of suitable political and cultural frames that facilitate dialogue and bridge common solutions between ST&I-oriented health approaches and the public health policies and systems.

ST&I in healthcare during the COVID-19 pandemic

The rapid spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has given rise to novel elements for the study of cultural implications of agendas of ST&I in contemporary healthcare. During the COVID-19 pandemic, societies have demonstrated great fragility in translating science and technology infrastructures into more efficient public health solutions to mitigate the disease around the world [ 8 ]. It revealed strong asymmetries in the global platforms of biomedical and health knowledge, as well as an inefficient system of governance and communication between approaches of ST&I and public health.

According to Jasanoff and colleagues (2021), during the novel coronavirus outbreak, decisions that were made in the past positioned some countries better than others in terms of their capability to respond to the crisis. It has been a particular way to approach the development of knowledge infrastructures in health in the field of science and technology studies (STS), and researchers in this field have been paying attention to the evolution of the pandemic responses from an international comparative perspective, taking into account the role of the political and knowledge platforms to respond to the rise in infections [ 9 ]. Countries such as Japan, South Korea, and Singapore have become leaders in health innovation over the past few decades, producing new technologies and devices, but have also experienced a positive movement of policy-making directed at facilitating and fostering research and technological development regionally [ 10 ]. Governments from countries such as the United States and United Kingdom mobilized their national systems of innovation to produce new diagnostics, devices, and technologies, but delayed in adequately producing and delivering molecular diagnostics. These countries have a sophisticated health innovation infrastructure and should have been capable of large-scale production of molecular tests in order to monitor the escalation of the pandemic and propose adequate public policies.

However, the availability of well-funded infrastructures of ST&I in health in certain countries cannot be considered as the only aspect associated with better COVID-19 responses; the inequality between those platforms around the world produced additional complications in the coordination of inter- and intra-national public health providers in their capacity to control the rapid spread of the virus. In the pandemic, even well-prepared societies faced substantial challenges to achieving an optimal encounter between ST&I and public health interests over the course of the outbreak. Countries have failed due to several factors unrelated to available scientific knowledge, such as the degree of investment in sustainable technological development, public healthcare, and health policies in general [ 11 ], resulting in ineffective systems for the prevention, vigilance, and monitoring of the spread of the novel coronavirus.

In 2020, despite the geographically unequal delivery, the unprecedented rapid technological development of several COVID-19 vaccines was proven to move in the opposite direction. It demonstrated the great capacity of scientific knowledge-based solutions to respond efficiently to the outbreak, with a strong impact on global public health strategies—an example of what is possible when a sociopolitical deal is guaranteed by governments, industry, and the global scientific community [ 12 ].

The pandemic showed that, under extreme conditions, scientists, companies, and the public sector might have the ability to implement actions addressing the provision of services and products for public health, as discussed by da Silva and colleagues (2020), with university participation in the production of molecular diagnostic tests such as reverse transcription polymerase chain reaction (RT-PCR) for the novel coronavirus in Brazil as one example [ 13 ]. This initiative faced important management sustainability challenges, but stimulated an approximation of the local scientific community around this issue [ 14 ].

Research policies in Europe, the United States, and developing countries have recognized that knowledge does not create a social impact by itself, and that all types of research are relevant, from “theoretical” to “applied”. Research agencies must use strategies that bring together a larger and more heterogeneous group of agents from different economic and social sectors, who are essential to the process from knowledge to utilization. In the health sector this has proven to be especially relevant, due to the active participation of health systems and services, health policies, health professionals, patients, and populations in this market [ 15 ].

The debate on the development of socially responsible regimes of ST&I in health has been the object of intense investigation. Researchers have recommended that academic research institutions, companies, and funding agencies take into consideration the new demands of democratic societies, in terms of financial and environmental sustainability and social equity, in the production and diffusion of novel knowledge and technologies. Institutions must, hence, commit to ethical guidelines and best practices in research, and effectively respond to fast-growing denialism, fake news, digital platforms, and other types of political and cultural production of ignorance and disinformation [ 16 ].

New expertise from interdisciplinary fields has been required to understand that the lack of dialogue and integration between ST&I platforms and agendas of public health might be a problem played out in cultural arenas. Researchers such as Parthasaraty (2020) [ 17 ] have addressed the societal implications of the problems related to ST&I in health during the pandemic from a political and policy perspective. In the same direction, Cruz and colleagues (2020) advocate that S&TP must act to ensure more responsible, equitable, and socially inclusive technological development in the coming years [ 18 ].

Since the aim of this paper is to provide a critical thinking about the contemporary asymmetries in the technical and political infrastructures available for particular approaches in ST&I in health and for the public health systems worldwide, we thus want to illustrate this by presenting the field of PM as one important approach in terms of its recent historical capacity to mobilize resources and technical and material knowledge infrastructures in the healthcare sector. Years of robust investments in labs, research facilities, projects, and consortia in PM improved the technical capacity of some countries in tailoring rapid development of medical devices, drugs, and sophisticated mathematical predictive models applied to the forecasting and management of the infections [ 19 ]. Then, based on the example of PM, we show how the global emergency of the coronavirus disease uncovers a persistent gap in the translation of knowledge and technologies into adequate responses to the pandemic. Despite the global stock of ST&I infrastructures in healthcare, it was inconveniently unavailable for solving public health needs, for reasons we will try to touch on introductorily in this work.

Translating PM infrastructures to public health needs: a difficult challenge

PM has been largely described in the literature as an approach to the social organization of medicine, in particular addressing challenges of this field at the level of the physician–patient relationship. A team of experts from Columbia University’s Precision Medicine and Society Program in New York City recently addressed this issue in Genetics in Medicine (2018):

PM is part of a longstanding attempt to reorient medical diagnosis and treatment to take advantage of genomics research and other approaches leveraging big data, such as electronic medical record research and crowd-sourced health tracking. These efforts are progressively elaborating an increasingly coherent vision of a different kind of medicine. [ 20 ]

It has had unprecedented implications in the arena of medicine and healthcare, pushing institutions to rethink healthcare practices, medical education, and the limits of introducing those technologies in physicians’ daily work. But here we go in a different direction, calling attention to the aspect of PM as an ST&I approach in health [ 21 ]. Therefore, a possible way to describe this approach is that it guides academic activities and narratives of the scientific community, policy-makers , and business agendas, fostering the development of new research, health products, and services tailored to the individual. It is based on intensive knowledge production in molecular biology, bioinformatics, genomics, data science, machine learning, and artificial intelligence-based tools, producing diagnostics, inputs, drugs, and management systems to prevent, monitor, and treat users, clients, and patients [ 22 ].

PM can also be understood as a bandwagon tool in the sciences, being introduced consistently by the broad community of molecular biology, epidemiology, and translational sciences as a political flag to claim higher investments but also to improve interdisciplinarity in biomedicine around the world [ 4 ]. Data from the Institute for Scientific Information Web of Science (ISI WoS) Core Collection illustrate the growth of scientific production related to PM over recent decades, with a total of 22,524 articles by 2019. The decade of 2010 to 2019 accounted for 88.81% of all articles identified in the database, while the period from 2015 to 2019 alone had 69.23% of all publications, evidencing a growing interest in this research topic in recent years.

Experts from governmental boards and international associations such as the Centers for Disease Control and Prevention (CDC) Genomics and Precision Health and Precision Medicine Coalition advocate that this multidisciplinary and multisectoral approach has practical implications in the technical, intellectual, and political platforms of health research and practice [ 23 ]. However, when we analyse the recent trajectory of this movement internationally, we see central aspects of it built and being played far from the reach and scope of public health interests [ 24 ].

Although tailored medicine has been valued in academic research for some time, since 2010 this subject has gained wide interest and space in S&TP, media, business, and political discourse. The development of precision high-tech-based goods has become a popular pursuit in both Western and Eastern societies [ 25 ], especially when then United States President Barack Obama launched the Precision Medicine Initiative (PMI) in 2015. It had a strong symbolic impact in the international scientific community and for its global governmental and private stakeholders. In 2016, the United States Senate approved a budget of US$300 million for PMI for the 2017 fiscal year, $100 million more than in the previous year. The budget for all ongoing PM-based projects under the National Institutes of Health (NIH) umbrella, such as research on Alzheimer’s and rare genetic diseases, reached US$34 billion [ 26 ]. Investments in research and development (R&D) were directed to novel biotechnologies for human health, and new university–industry partnerships emerged to design and produce innovative clinical diagnostics, medical devices, data-based management systems for hospitals and health professionals, and off-the-shelf products. An important aspect of PM is its focus on the design of technologies and solutions to problems in rare, chronic, noncommunicable diseases, presenting a new package of problems to be solved to the public and private healthcare systems.

Although this is an emerging approach which has encountered challenges in its establishment, profits and commercial outcomes in this field are evident, and it gives an idea of the constraints faced by low- and middle-income countries' economies in accessing developments in this sector. According to Global Market Insights, the market for PM stood at around $57 billion in 2019, with predicted growth of 11% per year for the period 2020–2026. It is estimated that more than 40% of the sector is concentrated in North America around university-related biotechnology hubs. The year 2018 was a hallmark for this sector, as 25 products based on PM were approved by the Food and Drug Administration (FDA), with an estimated 40% of all new products in the pharmaceutical industry having a PM origin by 2025 [ 27 ].

But to what extent has this new technical and knowledge platform contributed to the improvement of infrastructures, capabilities, and preparedness of public health systems? A pragmatic way to address this is to know a bit more about current challenges for these technologies in reaching users of public health systems. According to Patricia Danzon, although innovation in health favours the supply of improved drugs and other products from the healthcare market, the introduction of new knowledge-intensive technologies (such as diagnostics and biological therapies based on genomics and molecular biology) has been one of the main factors contributing to increased healthcare expenditures for countries and families, impacting the financial sustainability of health systems worldwide [ 28 , 29 ].

Not only has the fiscal unviability of PM technologies and healthcare solutions been gaining attention in recent years as a topic in official boards of experts of international organizations, but the role of innovations themselves as societal phenomena in replacing political arenas and organizational cultures has also come to the fore. In 2016, after a public debate on “Disruptive innovation: Considerations for health and health care in Europe”, the Expert Panel on Effective Ways of Investing in Health (EXPH) signed a final opinion published by the European Commission (EC).

The Expert Panel understands “disruptive innovation” in health care as a type of innovation that creates new networks and new organisational cultures involving new players, and that has the potential to improve health outcomes and the value of health care. This innovation displaces older systems and ways of doing things. The Expert Panel conceptualizes disruptive innovations as complex and multidimensional, categorizing five dimensions of disruptive innovations: typology of business model, fluency of implementation, health purposes, fields of application and pivoting values. The Expert Panel identified five strategic areas for disruptive innovation: translational research, access to new innovative technologies, precision medicine, health and care professional education and health promotion. [ 30 ]

The Expert Panel then recalled that disruptive innovations, as PM most certainly is, imply a certain degree of competition and tension with existing technologies and organizational cultures, reshaping older systems and ways of doing things, and that the overall sustainability of the healthcare system must always be considered. However, experts usually overestimate the promise and scope of technological innovations in healthcare, making recommendations to public health providers and hands-on stakeholders that are too general, and only rarely move toward a practical framework of effective actions [ 31 , 32 ].

The poor adhesion to those recommendations has made the divergence of rationales between PM and public health explicit especially in the context of poor resource availability for both ST&I in health and the functioning of the health systems. In developing countries such as Brazil, for instance, this debate was recently raised by Novaes and Soárez (2019) in discussing the challenges of incorporating so-called orphan drugs for treatment of rare diseases in the Brazilian National Health System (Sistema Único de Saúde, SUS) [ 33 ].

Low- and middle-income countries also possess significant budget restrictions and large regional asymmetries in the delivery of health technologies and inputs that hinder the incorporation and measurement of the results of these initiatives—which may have a permanent fiscal impact on health systems [ 34 ]. Several public health analysts go in a similar direction: Jorge Iriart (2019) advocates that the introduction of PM-based technologies in healthcare systems could increase inequality in access to health [ 35 ]; Rey-López et al. (2018) stress the importance of critically assessing the role of PM in healthcare development, and they consider that the emphasis on technology-based solutions to prevent and treat disease individually disregards the fact that public health depends essentially upon favourable social conditions [ 36 ].

It is also an issue which has been studied by researchers and analysts in developed countries like the United States, despite the active role of the stakeholders in this country in the fields of ST&I in health and its central position in leading initiatives and disruptive innovations in PM. Lindsey Konkel (2020) recently called attention to the challenges of current research agendas in PM, and the limited potential of those technologies to be delivered broadly to the public. Interviewed by the author, Professor Esteban Burchard, MD, PhD, the Hind Distinguished Professor of Pharmaceutical Sciences and co-director of the University of California, San Francisco (UCSF) Center for Genes, Environment, and Health, gave his opinion that “in 30 years, health care will look really good for some people and really bad for others, simply because modern scientific advances have not been applied to all populations equally” [ 37 ], in a clear reminder that PM should not be taken for granted as the future of healthcare even in high-income societies.

The previous examples show how difficult it is to approach the topic of merging knowledge platforms and rationales in PM and healthcare. Traditionally, the challenge of putting this agenda into practice places technological innovation and the promotion of public health in supposedly opposing fields—something that, at the same time, reinforces the idea that PM is only useful in the scope of discourse, and the belief that ST&I infrastructures would be available only for business ventures in the health sector.

The pandemic made us critically rethink this relationship, as knowledge and practices in ST&I in health in general, and those adopted in PM specifically, could be applied to reduce the negative impacts of the pandemic, guiding more precisely the actions in public health based on previously accumulated knowledge.

Improving governance of ST&I for public health needs as a post-pandemic outcome

Why, then, has the increased investment and research in PM over the past decades not led to improved public health with the same dynamism? The answer lies in the fact that the limited translation of ST&I infrastructures and knowledge platforms from PM into public health agendas stems from, among other factors, the lack of governance tools, institution-building, and political coordination between different stakeholders of ST&I and of the public health systems and services. A possible way to address this challenge is found in the literature on the politics of science and technology in health, and its relationship with the logics of the healthcare systems per se [ 38 ]. This interdisciplinary domain is moving toward understanding the translation of knowledge platforms as a set of sociotechnical processes played in specific political arenas, in which the coproduction of new entities in ST&I-based healthcare “or the meaningful collaboration among stakeholders in planning, implementation, and evaluation” needs efficient tools of governance to enable the multi-directional flow of knowledge through  the academic, business and clinical environments [ 39 ].

As mentioned above, issues involving the cultural setting of the regimes of knowledge production, technology development, and decision-making in PM and public health can partially help to explain the lack of dialogue between the two approaches. Then, we point to the existence of at least four interpretative societal dimensions that can help move toward a better understanding of this issue: (1) Epistemic attitudes: Public health providers look at improve healthcare access, coverage, and equity at the population level, exploring what makes groups as homogeneous as possible for efficient policy interventions, while PM knowledge-making aims and its stakeholders’ rationales expend resources addressing what is specific of individuals, exploring the complexity of potential healthcare interventions at a molecular-gene level [ 40 ]; (2) Communicational: Expert knowledge from PM brings unknown methodologies, tools, and vocabulary from molecular and biomedical sciences to clinicians, increasing uncertainty and creating additional complications in the physician–patient interaction [ 31 ], and low ability to avoid inefficient risk communication by governments as we recently experienced in the pandemic [ 41 ]; (3) Health policy pragmatism: Health systems have limited resources and time and are surrounded by governmental political interference and change, while PM initiatives are usually too expensive, slow, and constantly underestimate the role of politics in choosing priorities that have nothing to do with what is relevant for science [ 24 ]; and (4) Innovation/regulation paradox: Since public health providers have built rigid (and necessary) health surveillance systems and regulatory policies, as well as sophisticated health technology assessment models, PM stakeholders have claimed that it has limited flexibility to let governments adopt new technologies, raising ethical issues, holding back political decisions, and hampering innovation in the public health sector [ 42 ].

Since the 2000s, theoretical frameworks have been dedicated to this issue in the literature from the IS. This field still receives limited attention from researchers in public health, but the novel coronavirus crisis may change this reality. Internationally, this field has been integrated with important studies to measure the implications of PM in health research and systems [ 43 ]. Eccles and Mittman (2006) define IS as “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services” [ 44 ]. Bauer and colleagues (2015) affirm that “[a]s healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science (IS) plays a critical role in supporting these efforts” [ 45 ].

The dissemination of IS could be one possible outcome of the pandemic for national systems of science, technology, and health. It is important to recognize the need to move forward in new ways to integrate knowledge generated by scientific knowledge production regimes and public health practice [ 46 ].

New research has been rapidly emerging as potential solutions to overcome this gap. So-called precision public health (PPH) has been advocated by analysts from PM and health systems around the world [ 47 ] as a potential agenda to overcome the lack of dialogue and to balance the asymmetries between the two approaches. However, we will not dedicate time to this topic in this paper, since the aim here is to point out problems raised by the pandemic and understand them from a theoretical interdisciplinary perspective.

Conclusions

The COVID-19 pandemic presented an important contradiction in health research policies and systems globally: despite the rapid development of technological solutions, PM approaches and those infrastructures did not provide an adequate response to the public health crisis. A gap became apparent between the science and innovation agendas and public health demands, as the production of technologies and delivery of science-based solutions ran in parallel with public sector demands.

A central objective of our paper is to stimulate thinking on how the public relevance of technological development in public health can be understood as a problem of governance and capacity [ 48 ]. Institutional change is fundamental to advancing the use of PM for public health in different contexts, with improvement in the collaboration between experts, S&TP, the healthcare industry, and the healthcare system. Kukk and colleagues (2015) advocate institutional change as a crucial component in fostering a favourable environment for technological development, learning, and more resilient collaboration networks between key stakeholders [ 49 ]. An analysis of ST&I and regulatory movements in public health is crucial to improving processes of institutional design, that is, strategies and tools of governance of knowledge platforms in healthcare, and its specific historical and cultural contexts [ 50 ].

Bottlenecks such as those presented by the pandemic are research findings per excellence of the importance of strengthening the interchange between different theoretical approaches in STS, IS, and PPH. They can help to significantly advance an interdisciplinary academic space for the discussion of technological development approaches and initiatives in public health.

In the sphere of policy-making, the COVID-19 pandemic has led us to reflect on the importance of pursuing political pacts for ST&I in public health that ensures equitable and responsible access to new health technologies to respond to future health crises. The novel coronavirus outbreak has proven that only a collective, interdisciplinary, cross-sectoral, and integrative framework of policies can respond effectively to potential new healthcare emergencies.

Among the main lessons learned from the pandemic experience, we can highlight three claims toward improving the public relevance of ST&I approaches in healthcare in the post-pandemic context. First, the relevant role of policy-makers in integrating S&TP with the public healthcare system’s planning and policies. Before the outbreak, policy-makers were instrumental in translating the potential of S&TP toward efficient governance schemes for science and public health innovation, at the national and international levels. However, over the course of the pandemic, they faced a lack of governance capacity for leading global health programmes and providing accelerated emergency health assistance, as well as for advancing the production of knowledge addressing unmet public health needs.

Secondly, the pandemic led to an optimistic scenario about ST&I and its potential to react to future crises in public health. The learning generated by this experience should serve as a lever for the construction of a more specific system of public policies that takes into account the potential of national actors, and that is capable of effectively seeking complementary expertise to improve mechanisms of management of S&T for public health, both inside and outside the country. This system must always seek to implement measures that guarantee equity in healthcare, even when using PM approaches to offer products and services of higher quality. The promotion of a new deal between industry and society could accelerate this progress toward more well-balanced infrastructural and financial support, both in “research for innovation” and “research for public health”.

Lastly, we learn that continuing the practice of primarily responding to problems is not the most effective way to solve challenges that require planning, management, and preparing for future scenarios. Future preparedness assessment reports and panels must be institutionalized by health systems, and articulated alongside other actors from academia and the health industry, so that responses to future health crises will result in a lower cost of lives and resources.

The COVID-19 pandemic has underscored the existence of a socially responsible and active scientific community and a capillary universal health system. A long-term S&TP must now be better articulated within academia as part of the solution for more equitable knowledge platforms between ST&I landscapes and the health system. The critical assessment and development of (not only) technology-oriented responses are among the first objectives toward achieving results in this direction.

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Abbreviations

Centers for Disease Control and Prevention

Coronavirus disease 2019

Science, technology, and innovation

Food and Drug Administration

Institute for Scientific Information Web of Science

Implementation sciences

• Precision medicine

Precision medicine coalition

Precision public health

Expert Panel on Effective Ways of Investing in Health

Research and development

Reverse transcription polymerase chain reaction

Science and technology policy

Obama Administration’s Precision Medicine Initiative 2015

Severe acute respiratory syndrome coronavirus 2

European Commission

Sistema Único de Saúde

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Acknowledgements

The authors acknowledge the financial support from the National Institute of Science and Technology on Health Technology Assessment (INCT-IATS) and the São Paulo Research Foundation FAPESP. Also, the first author acknowledges the financial support and the outstanding management from the SSRC through the “Rapid-Response Grant on Social Sciences of the COVID-19”, possible thanks the Henry Luce Foundation; the amazing work environment provided by the Health Ethics and Policy Lab at ETH Zürich, Switzerland, with special regards to the gentle review and commentaries made by my dear colleagues Shannon Hubs, Julia Amann, Caroline Brall, Joana Sleigh, and Constantin Landers, and finally to the qualified review done by the associate editor and reviewers of this journal, which consistently improved the final version of this paper.

This work was possible thank to the scheme of funding from the following agencies: Coordination for the Improvement of Higher Education Personnel CAPES (Grant No. 8887.358509/2019-00), São Paulo Research Foundation FAPESP (Grant No. 2015/24133-5), and the National Council for Scientific and Technological Development (CNPq) (Grant No. 306536/2015-3).

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RC participated actively in the literature review, writing of the manuscript, articulation of the parts, discussion, and conclusions. MN was responsible for the literature review, data collection and analysis, writing, articulation of the parts, presentation of its main theoretical discussions, and reviewing of the manuscript. MN and RC facilitated the documentary research and access to data, and also provided assistance with the data catalogue and reviewing. All the authors read and approved the final manuscript.

Renan Gonçalves Leonel da Silva is a postdoctoral researcher in the Health Ethics and Policy Lab of the Department of Health Sciences and Technology, Institute of Translational Medicine, ETH Zurich, Switzerland, currently affiliated to the Swiss National Science Foundation’s National Centre of Competence in Research Molecular Systems Engineering (NCCR-MSE) and former PI/recipient of a Rapid-Response Grant on COVID-19 and Social Sciences awarded by the Social Science Research Council of New York City (SSRC). He works in the field of science and technology studies and ethics of biomedicine, and his current research interests include the social and epistemic dimensions of knowledge production in molecular and synthetic biology-related domains; emerging bioethical issues in regenerative medicine; and practices, discourses, and promises of precision medicine.

Roger Chammas is Full Professor of Basic Oncology in the Faculty of Medicine of the University of São Paulo, Brazil, and Head of the Center for Translational Research in Oncology of the São Paulo Cancer Institute, Brazil. He works with biology of cancer, and his main interests are tumour progression, carbohydrate-dependent progression markers, and characterization of tumour microenvironments.

Hillegonda Maria Dutilh Novaes is Associate Professor in the Department of Preventive Medicine of the Faculty of Medicine of the University of São Paulo, Brazil. She works in the field of collective health, and her main interests are ST&I in health, and policy, planning, management, and evaluation of healthcare systems.

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da Silva, R.G.L., Chammas, R. & Novaes, H.M.D. Rethinking approaches of science, technology, and innovation in healthcare during the COVID-19 pandemic: the challenge of translating knowledge infrastructures to public needs. Health Res Policy Sys 19 , 104 (2021). https://doi.org/10.1186/s12961-021-00760-8

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Why technology matters as much as science in improving healthcare

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More than half a million new items of biomedical research are generated every year and added to Medline. How successful are we at applying this steady accumulation of scientific knowledge and so improving the practice of medicine in the USA?

The conventional wisdom is that the US healthcare system is plagued by serious cost, access, safety and quality weaknesses. A comprehensive solution must involve the better translation of an abundance of clinical research into improved clinical practice.

Yet the application of knowledge (i.e. technology) remains far less well funded and less visible than the generation, synthesis and accumulation of knowledge (i.e. science), and the two are only weakly integrated. Worse, technology is often seen merely as an adjunct to practice, e.g. electronic health records.

Several key changes are in order. A helpful first step lies in better understanding the distinction between science and technology, and their complementary strengths and limitations. The absolute level of funding for technology development must be increased as well as being more integrated with traditional science-based clinical research. In such a mission-oriented federal funding strategy, the ties between basic science research and applied research would be better emphasized and strengthened.

It bears repeating that only by applying the wealth of existing and future scientific knowledge can healthcare delivery and patient care ever show significant improvement.

Peer Review reports

More than half a million new items of biomedical research are generated every year and added to Medline. How successful are we at applying this steady accumulation of scientific knowledge and so improving the practice of medicine? The conventional wisdom is that the US healthcare system is plagued by serious cost,[ 1 ] access,[ 2 ] safety,[ 3 ] fairness,[ 4 ] and quality[ 5 ] weaknesses. In combination, these many weaknesses yield a system which provides sub-optimal value[ 6 , 7 ].

A comprehensive solution must involve the more efficient translation of an abundance of clinical research into improved clinical practice[ 8 , 9 ]. Yet the application of knowledge (i.e. technology) still remains far less well funded and less visible than the generation, accumulation and synthesis of knowledge (i.e. science),[ 10 ] and the two are only weakly integrated despite attempts to spur translational research with large NIH Translation awards[ 11 ]. Worse, technology is often seen merely as an adjunct to practice, e.g. electronic health records. In this paper we discuss these issues and suggest potential solutions.

Funding for translation of research

The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency sponsoring the application of health services knowledge, but has a budget of less than $400 million per year. Adding the various translational research budgets in the National Institutes of Health (NIH) comes to less than $1 billion per year, with a focus predominantly on therapeutics as opposed to health services and care delivery. Despite unprecedented support at NIH’s most senior levels for translational research, 11 and a commitment of around $500 million per year for the Clinical and Translational Science Awards,[ 12 , 13 ] there is still no empirical evidence that clinical research has actually become more efficient[ 14 ]. Given a total of nearly $32 billion in funded research,[ 15 ] the amount and proportion spent implementing medical knowledge and improving care delivery may be too small.

Several key changes are in order. We argue that the absolute level of funding for technology development must be increased as well as being more integrated with traditional science-based clinical research. In such a more mission-oriented federal funding strategy, the ties between basic science research and applied research would be better emphasized and strengthened. A helpful first step lies in better understanding the distinction between science and technology, and their complementary strengths and limitations.

The distinction between science and technology

Science is generally considered the search for and construction of theories about cause [ 16 ]. Science generates, synthesizes and accumulates knowledge in one narrow area; its models hold much else ‘fixed’. On the other hand, technology is the search for and production of theories about new processes . Technology is the application of existing knowledge; its models allow most everything to vary. Simply put, science is the ‘why’, while technology is the ‘how’ of improvement.

Advances in scientific knowledge in medicine are well-known and manifold and steady scientific progress will continue to lead to incremental improvements in accumulated knowledge. But only the appropriate and effective application of technology, through successful modification and application of existing knowledge, can realize the promised gains in cost, safety and efficacy.

In the health care domain, however, technology is best known as an enabler of process standardization and communication between providers[ 17 ]. The federal government’s Health Information Technology for Economic and Clinical Health (HITECH) Act reflects this important strength of technology, and rightly seeks to improve practice by significant technology investments.

The full potential of technology

Yet electronic health records and process control do not capture the full potential of what technology can offer. For example, by integrating existing knowledge from behavioral science, organization science, engineering and clinical research and applying this in simulated environments, technology can improve and redesign existing care processes as well as engineer new ones.

More generally, technology allows researchers and stakeholders to overcome the inherently complex, interacting and dynamic nature of healthcare systems[ 18 ]. It is difficult to grasp all the linkages and interactions between humans, equipment, medical devices, care processes and biological systems. Faced with the need to improve such chaotic systems scientists simplify the problem and abstract the clinical setting. Clinical research routinely and deliberately seeks to hold many aspects of the problem fixed, and attempts to estimate the positive impact of making a small, isolated change in one component (e.g. the maximum hours worked by a provider).

This approach of holding many factors constant, and making small, incremental changes in a small number of factors is described as local optimization. However, such local optimization may hide the much larger impact of global optimization: making a larger number of coordinated changes to multiple components at once (e.g. the configuration of a medical instrument, the training of a provider and the mix of patients admitted to the system).

To view this conceptually, consider a system’s performance as being highly non-linearly impacted by two factors. Here non-linearity signifies that the response of a system to one factor changes both with the level of that factor and the level of the other factor, and that those responses vary in a complex way. One way to visualize this is by taking a three dimensional coordinate system. Plot the levels of the two factors in the two horizontal dimensions and let performance be measured in the vertical dimension.

The non-linearity of the relationships between the two factors and overall performance leads to a rugged ‘performance landscape’ with hills, ridges and valleys representing respectively better performance, knife-edge performance and worse performance for particular combinations of the two factors[ 19 ]. Local optimization can be represented as slow and steady progress up small ‘hills and ridges’, following the simple rule that ‘a little further is better’. Clearly, this type of optimization can lead to the system getting stuck at sub-optimal performance levels. Global optimization of would represent the skipping of small hills, the traversing of deep valleys, on the way to attaining the highest peak that represents optimal performance.

There is a trade-off between results and effort in contrasting these two different types of optimization. Local optimization is straightforward: for example, a simple regression analysis will suggest that a factor is significantly related to overall performance. However, global optimization often requires advanced simulation and modeling technology. Similar to other complex domains, these approaches are indispensable in a clinical context since the results of hypothesized changes to multiple system components cannot be predicted ahead of time and require in vitro experimentation.

An illustrative example

Consider the differences between traditional research and applied research in, for example, improving the quality of intensive care for cardiovascular disease. A common clinical imperative is to measure and reduce variability and improve end outcomes through process standardization and improvement[ 20 ]. Classical use of static regression-based models, no matter how detailed, is unlikely to capture the complexity of cardiac surgery processes or the interactions between providers and hospitals[ 21 ]. Surveys and case studies may only isolate some of the key success factors that allow hospital cath labs to improve coronary intervention processes,[ 22 ] and not be able to model all the interactions. These methods are essentially all local optimization techniques, familiar and easy to use. However, as local optimization techniques, they are thus prone to missing potentially far more significant improvement opportunities.

On the other hand, a holistic simulation approach, using real-time data, could allow for safe experiential learning and experimentation, and thus significant improvements in the quality of such intensive care[ 23 ]. Coupled with multidisciplinary and trans disciplinary teams, this less familiar and less widely used approach would offer a more global optimization.

This trade-off between the ease of approach and potential benefits may also partly underpin the well-known phenomenon of the ‘flattening of the curve’ that represents US progress on health outcomes over time. Despite continual advances in accumulated knowledge, healthcare system performance often appears to have reached a plateau in the US[ 24 ]. This is likely due to the complex interplay between social determinants of health such as education, knowledge, income, and location[ 25 ]. To some degree, the ‘flattening’ of the value curve is also likely also due to the medical epidemics of diabetes,[ 26 ] obesity,[ 27 ] especially amongst the young. We speculate, however, that the flattening of the performance curve is partly also due to the delivery system’s failure to adequately apply existing clinical knowledge, or its application using local rather than global optimization techniques.

Increasing the application of scientific knowledge

Clinical medicine is becoming increasingly comfortable with the use of technology to store patient data and guide the provision of care[ 28 ]. A similar technology-enabled shift towards deeper and more consistent application of existing scientific knowledge is necessary. While there is an emerging appreciation of the need for different,[ 29 ] more systems-based research,[ 30 ] most US federal funding for healthcare remains science-, and not technology-based[ 9 ].

To redress this, we believe, requires an unavoidable change in funding priorities and a substantial increase in the level of funding for technology development and the application of existing scientific knowledge. Equally important is how such scarce funding resources are allocated. Merely raising the proportion of NIH funding for applied research or increasing AHRQ’s limited budget will not suffice, especially if funding is generally limited to projects involving the adoption of commercial off the shelf based technologies such as electronic health records.

To truly reap the returns on science-based research, the increased funding for technology development must also be better integrated with science-based research. Adapting the mission orientation of the Department of Defense, basic clinical science research must also include technology transition plans. In this different paradigm, research conducted ‘upstream’ with the objective of increasing scientific knowledge must be held closer to account in terms of ‘downstream’ applications and ultimately delivering mission-critical performance.

While our focus in this article is on the US health system, it is noteworthy that other large healthcare systems have wrestled with similar concerns and have implemented similar recommendations as ours. For example, in the UK, the proportion of total funded research activity accounted for by basic biomedical research was most recently estimated as approximately two thirds of which the majority was laboratory-based biomedical research[ 31 ]. Another sixth of UK health research spending went to treatment development and evaluation, which includes applied and translational research.

In the Cooksey Report, Sir David Cooksey examined publicly funded healthcare research and sought to provide recommendations to optimize its potential to benefit patients, the National Health Servie and the wider healthcare economy, on behalf of the UK Treasury. This inquiry found that the UK risked failing to reap the full economic, health and social benefits of the large investments being made by taxpayers into health research[ 31 ].

In particular, the report diagnosed an absence of an overarching strategy to translate ideas from basic and clinical research into the development of new products and approaches to treatment of disease and illness. Similarly, another key gap noted was the absence of a strategy to implement those new products and approaches into clinical practice. Both gaps are ones we argue are still present in the US healthcare system.

To a more limited extent the Report’s recommendations on prioritizing projects in view of potential downstream significance are also in line with our recommendation to insist on an implementation plan for all basic research, tying them more closely to applied research[ 31 ]. Beyond this, the UK is seeking to implement cultural and organizational changes in the delivery system and in the research enterprise to better close the gaps between basic and applied science, and theory and practice[ 31 ].

To a large extent, the degree of non-market control of research and practice by centralized decision-makers is arguably much stronger in the UK’s essentially nationalized delivery system with centralized cost and comparative effectiveness functions. We are not convinced that changes to practice in the US will occur through organizational and cultural changes alone. We believe that demand-side consumer incentives and supply-side payment reform as well as institutional innovation in the markets for insurance and provision of care will be required[ 32 ].

We remain convinced that system performance can improve and that any real reductions of the returns to investment or innovation are still far off. This performance deficit could, we argue, be addressed by implementing and applying some of those half a million items of scientific knowledge recently accumulated. This would be a good start to improving the practice of medicine in the US. These transformational improvements in the practice of medicine could have positive impacts in other countries around the world as well, as dissemination of applied knowledge and innovations improves[ 33 ].

The next step is making sure that the next million funded pieces of scientific research are also coupled to technology applications to the fullest extent possible. It bears repeating that only by applying the wealth of existing and future scientific knowledge can healthcare delivery and patient care ever improve.

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Acknowledgements

Dr Szczerba is an employee of Lockheed Martin and was funded through a salary as part of his current job description. Dr Huesch is an employee of the University of Southern California and was funded through a salary and through an unrestricted research allowance. Dr Huesch also reports receiving salary and research support from Lockheed Martin through a grant to the University of Southern California. He also holds an adjunct appointment at Duke University’s Fuqua School of Business and reports receiving research support there for attending a private healthcare conference supported by Lockheed Martin. No other financial consideration or technical review of the manuscript was provided by Lockheed Martin. Dr Huesch reports receiving translational and applied science research support as well as salary support from the Agency for Healthcare Research and Quality through a grant to the University of Southern California.

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Szczerba, R.J., Huesch, M.D. Why technology matters as much as science in improving healthcare. BMC Med Inform Decis Mak 12 , 103 (2012). https://doi.org/10.1186/1472-6947-12-103

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7 Ways Healthcare Science And Technology Benefit Medicine

• 1. It’s Making Treatments More Effective
• 2. Digital Dispensation Is Accelerating The Prescription Process
• 3.  Real-time patient data
• 4. Software Is Improving Healthcare Efficiency
• 5. Fast And Seamless Patient-Doctor Interaction
• 6. Robots Are Making Surgeries More Successful And Less Expensive
• 7. Easier To Predict Outbreaks

Technology is changing every aspect of our lives including the ever-evolving world of medicine. Technology has enabled physicians to collect data in a more systematic way, explore different treatment methods, and find new tools to practice medicine. Robots have made surgeries more effective and digital dispensation has made it easier to fill and update prescriptions with the right dosage. Doctor-patient communication has improved significantly – both through education (as doctors can use tools and 3D images to show patients what’s happening) and through Telehealth (as it’s never been easier for patients to see specialists through video calls). Here are seven ways healthcare science and technology are benefiting the medical industry:

1. It’s Making Treatments More Effective

Some of the top industry experts believe that one of the core benefits of improved healthcare technology is the increased accessibility of treatment. Health IT has opened up possibilities of new discoveries and better, more focused research. Data gathered from different hospitals, electronic devices, apps, and Artificial Intelligence (AI) models can now be trained to evaluate the risks of patients. 

Artificial intelligence (AI) is the simulation of human intelligence in machines wherein the latter is programmed to think like humans and mimic their actions–only it’s much more powerful. For example, Babylon and Canada’s Telus Health teamed up to develop a Canada-specific AI app that scans a patient’s survey answers, then connects them via video with the right healthcare provider or professional. AI eases the lives of patients and doctors by performing tasks that are normally done by humans, but in less time and at a fraction of the cost.  

Ensuring that all patients have the right prescription with the right dosage is crucial. But storing all this data in a systematic way can be challenging. The digital dispensation of prescriptions has significantly streamlined and accelerated the process of making and renewing prescriptions on time.

There are many startups in the healthcare space that are constantly innovating and creating apps for smartphones that send notifications to patients when it’s time to renew their prescriptions. Most of the time you can even renew it within the app in just a few simple taps. Some pharmaceutical companies are taking this a step further and introducing digital doctor visits through their apps. All this ensures that the patients and their doctors are in sync and there are no loopholes in effective patient care.

3.  Real-time patient data

Patient care was and continues to be at the core of healthcare and all its technological advancements. The growth in healthcare science and technology has made patient care far superior and more reliable in most cases by providing new machines (such as MRIs), medicines, and treatments that save lives and improve the chance of recovery for many.

One of the core benefits of health IT is that medical professionals can now use tablets and mobile devices to record real-time patient data. For example, you can quickly update a patient’s chart and then share it instantly with their latest medical history. 

Today, important patient details such as lab results, records of vital signs, or other important patient information can be centralized and easily accessed. This level of information storage has transformed the level of care of efficiency that doctors can offer to their patients as you’re always up-to-date on what’s going on. Not only does this data collection help doctors but it also helps scientists and researchers to study patient history to find new trends and innovate better advancements to treat different ailments.

Medical software is vital to the healthcare industry since it allows healthcare providers to monitor and manage organization and patient data efficiently. Software can help with everyday operations and streamline clinical workflows. Take for example, the World Health Organization that has been able to categorize ailments plus their causes and symptoms, into a large database that contains more than 14,000 individual codes . Resources such as these allow medical professionals and researchers to study the ailment from all different angles and find solutions that can not only control the illness but also improve the overall healthcare outcome in general.

Another important aspect where software is making the lives of physicians easier is medical billing. Billing requires a ton of paperwork and an easy to use billing software not only streamlines the billing process but also shaves off the amount of time you spend on admin work.

In the end, software and electronic medical records help both doctors and patients. The former gets all the patient-related information in one place and the latter enjoys a great degree of transparency in the healthcare system. For instance, one of the key areas where transparency is crucial between physicians and patients is around issues like medical errors. The patient’s information and the physician’s prescribed treatment must be recorded in detail and should be easily available in the future. 

Back in the day when a patient wanted to see a doctor, they’d have to call to make an appointment, speak with a receptionist, and potentially have long waiting times. Today, all this can be done easily via a mobile app or even virtually–you can set up a consultation without ever leaving your couch!

Startups around the world are improving the ways patients interact with their doctors. For example, the content marketing platform PharmaPhorum highlighted a US-based startup that created an app called HoyDoc which allows patients and doctors to access their medical records in English and Spanish.

Robots performing surgery may have seemed like a horror sci-fi idea in earlier years but today, not only is it common but highly recommended. Human prowess can only take surgeons so far into the deep, difficult-to-access areas of the human body. But there’s no limitation for robots; they can go where humans can’t and this minor detail has resulted in more successful surgeries than ever before. 

For example, some surgeons use robots to assist them with brain tumour removal procedures . In one recent case involving a teenage patient, a doctor used a high-tech robotic microscope during surgery. The doctor said the tool had a robotic arm, a GPS component that showed where his tools were, and a heads-up display with a better view of the area during the operation.

The global medical robots market is expected to reach USD 12.7 billion by 2025 from an estimated USD 5.9 billion in 2020 at a CAGR of 16.5% during the forecast period. The key factors propelling the growth of this market are the advantages offered by robotic-assisted surgery and robot-assisted training in rehabilitation therapy and more.

Robots have made certain surgeries less invasive and in recent reports , it’s been observed that robots are helping hospitals not just save lives but also reduce labor costs. For example, in some places, there are even robots who’re taking food to the patient’s room and cleaning.

AI and big data are playing a key role in the healthcare industry. Big Data is a collection of data that is huge in volume and growing exponentially with time. To properly understand and study many diseases, AI-based data analytics and predictive models can be used by medical professionals. A Toronto-based artificial-intelligence company called BlueDot, which uses machine learning to monitor outbreaks of infectious diseases around the world, alerted clients—including various governments, hospitals, and businesses—to an unusual bump in pneumonia cases in Wuhan, China. This later became what we’ve all come to know as Covid-19. Healthcare technology can play a crucial role in the future to identify patterns and spot an outbreak sooner so that protective measures can be taken.

This is a great time to observe and be a part of all the improvements that are being made thanks to healthcare science technology. There are better treatments available that are more easily accessible and innovations have made it possible to research and find newer, more effective ways to offer patient care. The overall landscape of healthcare is a lot more fast-paced and patient-friendly than it was ever before, all thanks to health IT. It’ll be exciting to see what new innovations and discoveries await in healthcare science and technology.

This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.

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Essay on the Impact of Technology on Health Care

Technology has grown to become an integral part of health. Healthcare organizations in different parts of the world are using technology to monitor their patients’ progress while others are using technology to store patients’ data (Bonato 37). Patient outcomes have improved due to technology, and health organizations that sought profits have significantly increased their income because of technology. It is no doubt that technology has influenced medical services in varied ways. Therefore, it would be fair to conclude that technology has positively affected healthcare.

First, technology has improved access to medical information and data (Mettler 33). One of the most significant advantages triggered by technology is the ability to store and access patient data. Medical professionals can now track patients’ progress by retrieving data from anywhere. At the same time, the internet has allowed doctors to share medical information rapidly amongst themselves, an instance that leads to more efficient patient care.

Second, technology has allowed clinicians to gather big data in a limited time (Chen et al. 72). Digital technology allows instant data collection for professionals engaged in epidemiological studies, clinical trials, and those in research. The collection of data, in this case, allows for meta-analysis and permits healthcare organizations to stay on top of cutting edge technological trends.

In addition to allowing quick access to medical data and big data technology has improved medical communication (Free et al. 54). Communication is a critical part of healthcare; nurses and doctors must communicate in real-time, and technology allows this instance to happen. Also, healthcare professionals can today make their videos, webinars and use online platforms to communicate with other professionals in different parts of the globe.

Technology has revolutionized how health care services are rendered. But apart from improving healthcare, critics argue that technology has increased or added extra jobs for medical professionals (de Belvis et al. 11). Physicians need to have excellent clinical skills and knowledge of the human body. Today, they are forced to have knowledge of both the human body and technology, which makes it challenging for others. Technology has also improved access to data, and this has allowed physicians to study and understand patients’ medical history. Nevertheless, these instances have opened doors to unethical activities such as computer hacking (de Belvis et al. 13). Today patients risk losing their medical information, including their social security numbers, address and other critical information.

Despite the improvements that have come with adopting technology, there is always the possibility that digital technological gadgets might fail. If makers of a given technology do not have a sustainable business process or a good track record, their technologies might fail. Many people, including patients and doctors who solely rely on technology, might be affected when it does. Apart from equipment failure, technology has created the space for laziness within hospitals.

Doctors and patients heavily rely on medical technology for problem-solving. In like manner, medical technologies that use machine learning have removed decision-making in different hospitals; today, medical tools are solving people’s problems. Technology has been great for our hospitals, but the speed at which different hospitals are adapting to technological processes is alarming. Technology often fails, and when it does, health care may be significantly affected. Doctors and patients who use technology may be forced to go back to traditional methods of health care services.

Bonato, P. “Advances in Wearable Technology and Its Medical Applications.”  2010 Annual International Conference of The IEEE Engineering in Medicine and Biology , 2010, pp. 33-45.

Chen, Min et al. “Disease Prediction by Machine Learning Over Big Data from Healthcare Communities.”  IEEE Access , vol. 5, 2017, pp. 69-79.

De Belvis, Antonio Giulio et al. “The Financial Crisis in Italy: Implications for The Healthcare Sector.”  Health Policy , vol. 106, no. 1, 2012, pp. 10-16.

Free, Caroline et al. “The Effectiveness of M-Health Technologies for Improving Health and Health Services: A Systematic Review Protocol.”  BMC Research Notes , vol. 3, no. 1, 2010, pp. 42-78.

Mettler, Matthias. “Blockchain Technology in Healthcare: The Revolution Starts Here.”  2016 IEEE 18Th International Conference On E-Health Networking, Applications and Services (Healthcom) , 2016, pp. 23-78.

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Contribution of Science, Technology and Innovation is Key for Facing Challenges in the Health Industry and for Economic Recovery after the Pandemic

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• Production, productivity and management

ECLAC’s Executive Secretary, Alicia Bárcena, held a virtual meeting with ministers and senior officials from ministries and bodies in charge of science and technology from 15 of the region’s countries.

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See ECLAC's Executive Secretary Alicia Bárcena presentation here (in Spanish) .

The contribution of science, technology and innovation at this time of crisis linked to the coronavirus disease (COVID-19) is key for facing current health challenges, but also for supporting production efforts aimed at economic recovery after the pandemic, according to ministers, deputy ministers and senior authorities from ministries and governing bodies in these areas from numerous governments in the region, speaking at a virtual meeting held with Alicia Bárcena, Executive Secretary of the Economic Commission for Latin America and the Caribbean (ECLAC).

The informational meeting for the member countries of the Conference on Science, Innovation and Information and Communications Technologies (ICTs) – a subsidiary body of ECLAC – drew the participation of officials from 15 countries in the region: Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, the Dominican Republic, Ecuador, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru and Uruguay. It was led by Alicia Bárcena, along with Shamila Nair-Bedouelle, Assistant Director-General for Exact and Natural Sciences at the United Nations Educational, Scientific and Cultural Organization (UNESCO), and Luis Adrián Salazar Solís, the Minister of Science, Technology and Telecommunications of Costa Rica, in its capacity as Chair of the Conference on Science, Innovation and Information and Communications Technologies .

During the event, ECLAC’s Executive Secretary presented an overview of the current scientific and technological system in Latin America and the Caribbean and its main challenges. She noted that digital infrastructure lags particularly far behind compared to other regions and, for that reason, the development and adoption of digital solutions must contemplate countries’ structural elements and enabling factors. “Regional integration must be strengthened, along with capacities in the health industry, and the digital economy,” she stated.

“The pandemic has revealed the need for an approach that goes beyond national borders and strengthens regional integration based on Science and Technology systems that are linked among countries and among their production systems. Humankind is racing to find a vaccine and treatments that would allow for neutralizing the health impacts of the pandemic, and that is where joint and coordinated efforts become essential,” Alicia Bárcena asserted.

She added that the contribution of science, technology and innovation at this time of pandemic, and of the policies and institutions that promote them, is not limited to prevention or treatment of the disease. “We have to bring science, technology and innovation closer to productive sectors,” she indicated, such as in the case of manufacturing medical supplies, diverse products for health protection, tests to detect the virus, and critical medical equipment such as mechanical ventilators, among other items.

She also explained that the pandemic has forced us to adopt new ways of working, educating and relating to one another. The technological and social challenges involved in offering the possibility of working remotely (telecommuting) to the maximum number of people, and in providing opportunities for distance learning so that children and adolescents can continue their studies, have been significant and must be taken into account at this time, she said.

“We know that, in this crisis, the contribution of science, technology and innovation is immediate. Therefore, in these times of pandemic, we have to think about how we can address the current situation and the post COVID-19 one as well. In that sense, the relationship between science, technology and national production systems is going to be critical. Above all because there are going to be very significant changes in international trade and the supply chain in key sectors will be severed or weakened and, therefore, it will be necessary, at a local and regional level, to develop a new way of producing goods and services more locally,” Alicia Bárcena indicated.

In her presentation, ECLAC’s highest authority explained that the contribution of science, technology and innovation in the face of the COVID-19 crisis can be seen in several areas: first, in research and development to understand the disease and its effects on the population, as well as for vaccines and medication; second, in the management of critical supplies and equipment, such as diagnostic tests, mechanical ventilators and the development of applications for tracking and prevention; and third, in the economic recovery, with the development of digital platforms for health, education and work at a distance, and technological transfer and industrial reconversion.

However, low investment in research and development (R&D), which amounts to 0.7% of regional GDP on average, and the low percentage of researchers dedicated to R&D (3%) cries out for urgent strategic management, Alicia Bárcena stressed. She also underscored that the development and adoption of digital solutions are conditioned by structural factors in the region’s countries. For example, with regard to telecommuting, on average just 26.6% of formally employed persons in the region can do their jobs from home, with a significant variation between countries. In addition, teleworking has a differentiated impact on women due to the unfair sexual division of labor and their excessive unpaid workload, involving care work and domestic tasks.

Meanwhile, with regard to online learning, she explained that there are still significant connectivity problems – lack of access to computers and an Internet connection – that hamper distance learning in the region. In countries with lower levels of connectivity, less than 20% of students live in a home with an Internet connection, Bárcena indicated. In addition, the high incidence of overcrowding, especially in the lowest-income quintiles, affects the quality of distance learning, she warned.

According to data from ECLAC’s Regional Broadband Observatory , there is great inequality in digital connectivity in the region. Economic status, age and geographical location limit access to connectivity, and there are significant gaps in access between the highest and lowest-income households. Thus, access to digital platforms – for example, for telecommuting– is not affordable for the entire population.

“In this urgent context, ECLAC’s Conference on Science, Innovation and ICTs appears as a space for collaboration and joint construction of regional initiatives and capacities; and, at the same time, for publicizing the efforts and policies that the region’s countries are undertaking to create outlets for coordination and cooperation among the region’s countries. I would like to take advantage of this opportunity to thank the leadership of the government of Costa Rica, in its role as Chair of the Conference, along with the countries that make up this Conference’s Executive Committee,” Bárcena stated.

ECLAC’s Executive Secretary also informed the meeting’s participants that the Commission is conducting specialized studies and reports on analysis of digital technology use in times of COVID-19, while also working on a position document regarding the digital panorama in the region. Furthermore, it is organizing a high-level, technical dialogue with countries regarding the use of digital technologies amid the pandemic.

“The post COVID-19 world demands more regional integration from us. We must think about the region’s future in the new economic geography in order to depend less on imported manufactured goods and imagine regional value chains. Industrial and technological policies are needed that will allow the region to strengthen its production capacities and generate new strategic sectors,” the senior United Nations official stressed.

“To have an impact in the new global economy, the region must move towards greater innovation and productive, trade and technological integration. An integrated market of 650 million inhabitants would constitute an important insurance policy against shocks produced outside the region,” added Alicia Bárcena. She also recalled that ECLAC is working on a proposal for a new universal social protection scheme with a basic income for citizens, as well as on inclusive and sustainable international governance based on the 2030 Agenda for Sustainable Development.

“What we seek is to put science and technology at the service of people, to open a new space for development with new sectors, services and products, development related to production and technology. I want to emphasize that now is the time for the region to make a very important step forward and to advance together with greater cooperation. ECLAC is committed to this and puts itself at the disposal of countries to carry out all the initiatives that you have set out to do,” the organization’s Executive Secretary said at the conclusion of the meeting.

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Emerging Applications of Nanotechnology in Healthcare and Medicine

Shiza malik.

1 Bridging Health Foundation, Rawalpindi 46000, Pakistan

Khalid Muhammad

2 Department of Biology, College of Science, UAE University, Al Ain 15551, United Arab Emirates

Yasir Waheed

3 Office of Research, Innovation and Commercialization, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad 44000, Pakistan

4 Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 1401, Lebanon

Associated Data

Not applicable.

Knowing the beneficial aspects of nanomedicine, scientists are trying to harness the applications of nanotechnology in diagnosis, treatment, and prevention of diseases. There are also potential uses in designing medical tools and processes for the new generation of medical scientists. The main objective for conducting this research review is to gather the widespread aspects of nanomedicine under one heading and to highlight standard research practices in the medical field. Comprehensive research has been conducted to incorporate the latest data related to nanotechnology in medicine and therapeutics derived from acknowledged scientific platforms. Nanotechnology is used to conduct sensitive medical procedures. Nanotechnology is showing successful and beneficial uses in the fields of diagnostics, disease treatment, regenerative medicine, gene therapy, dentistry, oncology, aesthetics industry, drug delivery, and therapeutics. A thorough association of and cooperation between physicians, clinicians, researchers, and technologies will bring forward a future where there is a more calculated, outlined, and technically programed field of nanomedicine. Advances are being made to overcome challenges associated with the application of nanotechnology in the medical field due to the pathophysiological basis of diseases. This review highlights the multipronged aspects of nanomedicine and how nanotechnology is proving beneficial for the health industry. There is a need to minimize the health, environmental, and ethical concerns linked to nanotechnology.

1. Introduction

The world is theorized to have accidentally formed via the Big Bang that occurred from an unstable microscopic-sized energized particle (atom). A single bit created an entire universe, and now scientists are working again on similar small particles to create marvels of science. From here, the world of nanoscience has arrived and taken a firm place in every aspect of science and technology [ 1 ]. The vision for nanotechnology was presented by Nobel Prize-winning physicist Richard P. Feynman, who proposed the application of more significant objects and mechanistic tools at a smaller tool and particle scale, as he believed that “there is plenty of room at the bottom” [ 1 , 2 ]. Nowadays, apart from physicists, scientists from multiple fields believe that in the future, nanoscale manufacturing technologies and instrumentation such as nanomachines, robotics, nanomedicine, and diagnostic devices, among many others, will bring grand biomedical miracles to the world of medicine and other industries [ 3 , 4 , 5 , 6 , 7 ].

Nanoscale pertains to the size of one-billionth or 10 −9 m of a material. A new scientific field of science in the form of nanotechnology was created because it was observed that materials, products, and devices developed from nanoscale particles almost always exhibit properties different from those of large-scale bulk materials. This follows the basic principles of physics and chemistry that as the state of matter is composed of atoms, any changes in atomic size, shape, and arrangement directly affect the material’s properties [ 7 , 8 ]. Scientists think that nanotechnology is the future of science and thus they are looking forward to benefitting from the application of nanotechnology in almost every possible way. The unique properties and behavioral features of nanoscale products have also drawn the attention of clinicians, physicians, and biological researchers [ 9 , 10 ]. The effort is on its way to applying unique quantum phenomena at the nanoscale to the fields of medicine, biomedical sciences, bioengineering, food technology, biochemistry, biophysics, and other disciplines of biology and medicine [ 10 , 11 , 12 , 13 ].

Forty years of revolutionary interaction among biology, medicine, and nanotechnology have led to present-day nano-biotechnology, which is now showing progressive application in multiple aspects of the medical field [ 14 ]. From disease detection to treatment, many medical issues such as disease diagnosis, drug discovery, personalized medical procedures, cancer treatment, pharmaceutical discoveries, as well as the latest medical tools and procedures, are now improving on the uses of nano-biotechnology [ 15 ]. Similar to regular vaccination approval, nano-based medicine and nanovaccines are also obtaining regular medical approval with the passage of time. Various nanotechnology-based diagnostic kits such as nanosensors, nanoparticle-based imaging agents, nanoparticle-based PCR Assays, Lab-on-a-Chip devices, along with modern drugs and medicines such as nanoparticle-based drug delivery vehicles, liposomal formulations and polymeric nanoparticles, Nanomedicines (such as Abraxane (nanoparticle albumin-bound paclitaxel) and Doxil (pegylated liposomal doxorubicin)), nanotechnology in gene therapy, nanoparticle-based vaccines, and antimicrobial agents, etc. are being commercialized for research and clinical usage [ 16 ].

Nanomedicine is a broad-spectrum field of science and technology that unites multiple streams of medical applications such as disease treatment and diagnosis, disease prevention, pain relieving technologies, human health improvement medicine, nanoscale technology against traumatic injury, and treatment options for diseases [ 12 , 15 ]. Thus, an interdisciplinary approach is being adopted to apply the outcomes of biotechnology, nanomaterials, biomedical robotics, and genetic engineering combined under the broad category of nanomedicine [ 17 ]. On a broader level, nanoscaling of medical technologies provides efficiency, a rapid response rate, and functional effectiveness in most biological and chemical processes used to manufacture medical materials. Thus, research provides constant hope for the upcoming new applications of nanomedicine [ 12 , 18 ].

In this review article, comprehensive analyses have been carried out to examine the application of nanotechnology specifically in the field of medicine. The most advanced form of nanotechnological applications have been highlighted with a slight emphasis on the previous uses of nanotechnology in the past few years of the 21st-century. Some modern medical applications, such as diagnostics, nanomedicine, regenerative medicine, and personalized targeted therapies, have also been included to bring into account the latest nanomedical applications.

2. Results and Discussion—Applications of Nanotechnology in the Medical Field

2.1. applications of nanotechnology in diagnostics.

Diagnostic sciences are now using nanodevices for early and rapid disease identification for further medical procedural recommendations. It also utilizes nanotechnology for the predisposition of disease at the cellular and molecular level to develop insights into treatment options [ 16 ]. Nanotechnology has the potential to revolutionize the field of healthcare diagnostics by improving the accuracy, sensitivity, and speed of medical tests [ 18 ]. One of the profound applications includes nanoparticle-based diagnostic imaging, in which nanoparticles can be attached to specific biomarkers to enhance imaging modalities such as magnetic resonance imaging (MRI), computerized tomography (CT) scans, and positron emission tomography (PET) scans, making them more sensitive, accurate, and specific [ 19 ]. Similarly, nanotechnology-enabled point-of-care diagnostic tests can quickly and accurately detect infectious diseases, cancers, and other illnesses, enabling timely treatment and prevention [ 9 , 19 ].

Biosensors are yet another dimension of application in which nanotechnology has enabled the development of highly sensitive biosensors that can detect even low levels of biomolecules in bodily fluids such as blood and urine, facilitating early detection and disease management [ 20 , 21 ]. Similar applications come in the form of microfluidic devices that incorporate nanomaterials and can be used to isolate and analyze specific cells, proteins, and genetic material, providing rapid and accurate diagnosis of diseases [ 19 , 22 ]. Another use may involve nanopore sequencing, which is a novel technology that uses nanopores to detect the sequence of DNA or RNA molecules, allowing for rapid and accurate diagnosis of genetic disorders such as cancer and genetic diseases [ 23 ].

Recent advances show that nanomedicine can be used in in vitro diagnostics sciences to increase the efficiency and reliability of disease apprehension [ 24 ]. This is achieved via nanodevices at the subcellular level, with samples prepared from human tissue, cell culture, body fluids, etc. [ 19 , 25 , 26 ]. In in vivo diagnostics, the nanomedicine approach is being used to develop devices capable of working, responding, and modifying within the human body with the sole purpose of early diagnosis of any irregularities in the human body that could lead to toxicity or tumor development events [ 22 , 27 ]. A few types of nanoparticles that are currently in use for diagnostic purposes include paramagnetic nanoparticles, nanocrystals, quantum dots, nanoshells, and nanosomes [ 28 , 29 ]. Overall, nanotechnology has enormous potential in healthcare diagnostics and is expected to play a significant role in the development of personalized medicine.

2.2. Nanotechnology and Lab-on-Chip Technology

Nanotechnology and Lab-on-Chip Technology have revolutionized the field of healthcare by offering innovative solutions for disease diagnosis, personalized treatment, and drug delivery [ 15 ]. The combination of these two technologies has led to the development of advanced diagnostic tools that are faster, more accurate, and more cost-effective than traditional diagnostic methods [ 30 ]. Lab-on-Chip technology is making progress in different fields of science; for example, it is being considered for use against viral and cancerous diseases [ 15 , 24 ]. The whole process revolves around analyzing genetic information at the cellular level [ 30 ]. Advanced procedures of gene sequencing and body fluid sampling have further assisted in revolutionizing nanotechnology in service of cures for diseases that were previously unimaginable [ 31 , 32 ].

Together, these two technologies have led to the development of Lab-on-Nanoparticles, which are small devices that can perform multiple functions, including diagnostics, drug delivery, and monitoring of various health conditions [ 31 , 32 ]. These devices are made up of nanoscale materials that can detect and respond to changes in the body, allowing for real-time monitoring and personalized treatment [ 26 ]. One of the significant applications of nanotechnology and Lab-on-Chip Technology in healthcare is cancer diagnosis [ 20 , 21 ]. Nanoparticles can be designed to target cancer cells, allowing for early detection and treatment [ 33 ]. Lab-on-Chip devices can also be used to diagnose various health conditions, including infectious diseases, genetic disorders, and metabolic disorders [ 32 , 34 ].

The use of nanotechnology and Lab-on-Chip Technology in healthcare has also led to the development of advanced drug delivery systems [ 31 ]. Nanotech systems such as nano-Liposomes can target specific cells or tissues in the body, enhancing drug efficacy and reducing side effects [ 28 , 35 ]. Moreover, viral detection is considered a feature that will be linked to future generations of nanoscale diagnostic devices. Such devices are expected to enable the detection of the release of medications in the organs of the body, which will help in the calculation of treatment efficiency and efficiency rates [ 36 ]. In simple terms, nanotechnology is trying to increase the pharmacokinetic and pharmacodynamic properties of drugs to stay longer inside the body, work faster and more efficiently, and at essential sites [ 37 ].

2.3. Applications of Nanotechnology in Pharmaceutical Sciences

A brief overview of nanotechnological applications in pharmaceutical sciences has been covered in the following section with a diagrammatic representation in Figure 1 .

Applications of nanotechnology in pharmaceutical sciences.

2.3.1. Nanoscience and Drug Dose Specifications

Nanoscience has revolutionized the pharmaceutical industry by enabling the production of improved therapeutic drugs with enhanced efficacy and lower toxicity. Nanoparticles can improve the pharmacokinetics of drugs by increasing their solubility, stability, and bioavailability [ 38 ]. They can also target specific tissues and cells, reducing side effects and enhancing their efficacy [ 25 ]. The nanoscale size and unique physicochemical properties of nanoparticles demand precise specifications in terms of drug dose and administration [ 39 , 40 ]. The dose of nanoparticles depends on various factors such as their size, shape, surface properties, and the method of administration [ 40 ]. For instance, oral administration may require a higher dose to achieve the same effect as intravenous administration due to the differences in absorption and biodistribution [ 40 , 41 ].

Furthermore, nanoparticles have complex pharmacokinetics and dynamic behavior in vivo, requiring a careful consideration of their dose regimen [ 40 ]. Researchers need to determine the optimal dose range, frequency, and duration of nanoparticles to achieve their therapeutic goals while minimizing adverse effects [ 41 , 42 ]. In the past, medical studies have resulted in very advanced treatment options; however, there is still a gap in effectively neutralizing drug overdoses. The use of nanoparticles as absorbents of toxic drugs is a feature being taken into account to create a rich method of drug absorption in the medical sciences [ 40 , 41 , 42 ]. The design of nanosponge-type substances is on the way to absorb unnecessary toxic dosages of drugs in blood to reduce the side effects of drug overdoses and treat ailments from body fluids [ 43 ]. Such antiviral drug absorbents have been introduced by researchers that work as nanoscale molecules to render anticancer and antiviral nucleoside analogs by linkage with squalene [ 44 ]. These nano-assemblies work as superior anti-cancerous molecules to treat human cancer cells that have yet to be developed beyond in vitro studies [ 45 ]. In summary, the development of nanomedical products requires careful consideration of the dose and administration of nanoparticles to ensure their efficacy and safety. The nanoscience community must collaborate with regulatory agencies to develop guidelines for nanomedicine testing to ensure their safety and efficacy.

2.3.2. Nanotechnology and Drug Delivery Technologies

Nanotechnology has revolutionized the field of drug delivery by providing an effective and targeted delivery of drugs, minimizing side effects, and increasing the therapeutic efficacy of drugs. The application of nanotechnology in drug delivery involves the use of nanoparticles that are designed to carry drugs and deliver them to the desired site of action [ 46 ]. The use of nanotechnology in drug delivery has several advantages. First, it allows for targeted and controlled delivery of drugs to specific sites in the body, such as tumors, inflamed tissue, and infected areas [ 46 ]. This reduces the amount of drugs required and minimizes side effects. Secondly, nanoparticles can improve the solubility and stability of drugs, making them more effective in treating diseases [ 47 ]. Thirdly, nanotechnology can increase the bioavailability of drugs by enhancing their absorption and distribution in the body. This allows for lower doses of drugs to be used, resulting in reduced toxicity [ 48 , 49 ].

Drug delivery technologies are also being given full consideration to be modified as per the new rules of nanoscaling. Some kinds of medical nanorobots are in line to be used for medicine delivery [ 32 ]. These materials swim across veins and carry drugs to specific sites. These aspects are being used for antitumoral responses of drugs [ 48 ]. Scientists are even working on performing wireless intracellular and intranuclear nanoscale surgeries against multiple malignancies and diseases [ 46 , 48 ]. Marvelous scientific arrangements are being carried out in the form of manufacturing and testing mechanical red blood cell technologies called respirocytes. Nanorobotics share the potential to deliver 200+ times more oxygen to body tissues as compared to natural red blood cells [ 49 , 50 ]. This could make one think about the potential of nanotechnology to be utilized for the diagnosis and treatment of various blood-linked disorders and their cure in the future [ 50 ]. In conclusion, the application of nanotechnology in drug delivery has revolutionized the field of medicine. It has provided an effective and targeted delivery of drugs, minimized side effects, and increased the therapeutic efficacy of drugs. The future of drug delivery lies in the continued development of nanotechnology-based drug delivery systems.

2.3.3. DNA Nanotechnology and Drug Delivery System

DNA-based drug delivery devices have been introduced in the past few years, such as DNA guns and DNA vaccines. Based on similar principles, an emerging field of DNA nanotechnology is being introduced in the nanomedicine industry [ 51 ]. These medical tools allow for the self-assembly of nanostructures and molecules that ultimately enhance drug targeting and reduce the toxicity associated with these drugs. With such technology, toxicity measures can be easily dealt with in diseases such as cancer, where the major issue is the drug toxicity associated with chemotherapeutic drugs [ 24 , 51 ].

The latest advances in research indicate that modern programing optimization and in silico approaches are being adopted to design DNA nanostructures with precise size, structure, surface chemistry, and functioning properties against specific diseases [ 22 , 52 ]. The effort is also to create personalized targeted drug therapies using nanotechnology-based DNA medicine [ 51 ]. Efficient drug biomolecules, such as doxorubicin and CpG oligonucleotides, have been successfully amalgamated with DNA-based nanostructures to increase cellular intake efficiency [ 53 ]. The future holds the potential to create RNA-based medication using principles similar to those employed in DNA-based medication [ 54 ].

2.3.4. Nanobiotechnology and Gene Therapy

Nanobiotechnology and gene therapy are two fields that often intersect in the development of innovative therapeutic approaches for the treatment of various diseases. In gene therapy, DNA molecules are introduced into the patient’s cells to replace defective or missing genes, with the aim of treating genetic disorders and other diseases [ 55 ]. One application of nanobiotechnology in gene therapy is the use of nanoparticle-based delivery systems to transport therapeutic genes to target cells [ 41 , 56 ]. These nanocarriers protect the DNA molecules from degradation and enhance their ability to penetrate the cell membrane, increasing the efficacy and safety of gene therapy [ 53 , 56 ].

Other nanobiotechnology approaches that support gene therapy include the development of gene editing technologies that use nanoscale tools to precisely modify DNA sequences and correct genetic mutations [ 57 ]. Additionally, nanoparticle-based sensors can be used to monitor gene expression and other molecular events in real-time, providing valuable information for personalized medicine [ 32 ]. Modern therapeutic concepts including gene therapy and molecular DNA-based therapies are already being practiced in healthcare and the arrival of nanotechnology has forwarded further advances in it [ 58 ]. Since the very basis of working gene therapy is at the molecular level of disease prevention and genetic adjustments, nanoscale technology plays a vital role in gene therapy [ 58 ].

Gene therapy processes are being modified to attach different kinds of biodegradable and non-biodegradable organic and inorganic particles fabricated with nano-assemblies. These structural combinations help bind DNA and access it across cellular surfaces [ 59 ]. Moreover, polymer-based nanoparticle mixtures are also prepared for intravenous drug injections. These modified technologies are a gateway to further advances in nanogenetic therapies [ 60 ]. Overall, the integration of nanobiotechnology and gene therapy is expected to lead to advanced treatments for a wide range of diseases, including cancer, genetic disorders, and infectious diseases.

Gene Therapy Approaches via Polyplex Micelles

Polyplex micelles are a type of nano-sized structure that are formed by the self-assembly of cationic polymers with nucleic acids, such as small interfering RNA (siRNA) or plasmid DNA (pDNA) [ 61 ]. These polyplex micelles have attracted significant attention for their potential in gene therapy and as drug delivery systems. In the context of tumor treatment, various polyplex micelle-based strategies using siRNA and pDNA have been studied. siRNA is an RNA molecule that is used to specifically target and knock down the expression of disease-related genes [ 62 , 63 ]. Plasmid DNA (pDNA) is a circular DNA molecule that can carry therapeutic genes to the target site. Polyplex micelles can encapsulate siRNA or pDNA within their core, protecting them from degradation and facilitating their delivery to tumor cells [ 63 , 64 ]. Additionally, the cationic nature of the polyplex micelles allows for electrostatic interactions with the negatively charged cell membrane, promoting their uptake by tumor cells [ 64 ].

These polyplex micelle-based strategies have been investigated for the treatment of various tumors, including pancreatic adenocarcinoma [ 63 ]. Pancreatic adenocarcinoma is a particularly challenging type of solid tumor resistant to many conventional treatment options. By using polyplex micelles, siRNA or pDNA can be delivered specifically to the tumor cells, enabling targeted gene therapy or enhancing the efficacy of chemotherapeutic drugs [ 64 ]. Thus, nanotechnology, specifically polyplex micelles, offers a promising approach for delivery of siRNA or pDNA to tumors such as pancreatic adenocarcinoma. These micelles can protect genetic material, promote cellular uptake, and potentially enhance the effectiveness of treatments for intractable solid tumors [ 65 ].

2.3.5. Green Nanotechnology-Driven Drug Delivery Assemblies

Nanomedicines are largely produced through chemical and physical methods of downgrading particles up to micro- and nanoscales. However, with the concerns of environmental and toxic health impacts, nanomedicine is now employing the concept of green chemistry and green engineering into the manufacturing of nanobiomedicine [ 66 ]. The purpose of this green technology is to create eco-friendly nanoassemblies with less environmental and health-related negative impacts [ 66 ]. Subsequently, the combination of green nanoassemblies with drugs, vaccines, or diagnostic markers will be the next step to propel the field of green nanomedicine. Many inorganic nanoassemblies have been introduced to the market and manufactured on the principles of green engineering and nanotechnology [ 67 ]. Some examples may include gold and silver nanoparticles, quantum dots, organic polymeric nanoparticles, mesoporous silica nanoparticles, dendrimers, nanostructured lipid carriers, solid lipid nanoparticles, etc. [ 66 , 67 , 68 ].

These nanoassemblies are attached with drugs, DNA molecules, or specific enzymes, proteins or peptides for further handling in nanomedicine purposes [ 66 ]. However, the need is to establish research studies that demonstrate the difference and effectiveness level of nanomedicine produced using normal bioengineering against that of manufacturing of nanomedicines through the elaborative principles of green bioengineering [ 66 , 67 , 68 ]. This will allow scientists to opt for the best manufacturing conditions for nanoassemblies in the future.

2.3.6. Nanotechnology—Antiviral and Antibacterial Applications

The causative agents of viral, bacterial, and other microscopic diseases work at the microscopic level; therefore, the best way to fight against them is at the nanoscale. Nanotechnology is thus the gateway to the cure and diagnosis of a wide range of viral, bacterial, and fungal diseases [ 69 ]. Although traditional Greek medicinal practices have been using metals such as silver to cure diseases for a long time, an updated version of nanoscale-based material conversion has been shown to improve the efficiency of such traditional and modern medication options [ 70 ]. One such study carried out by Nycryst Pharmaceuticals (Canada) showed that nanosized silver particles are more reactive to cure burn or wound as they easily penetrate the skin at some small scale [ 71 ].

The genomic and proteomic fields are already contributing much to the elucidation of molecular insights into disease, and with the assistance of nanotechnology, new opportunities are being put in the hands of researchers to create powerful diagnostics tools with the power of genetic elucidation of irregularities at the level of the gene [ 72 ]. Research indicates that soon, nanotechnology-based diagnostic and treatment options will be available for preventive and regenerative medicine with targeted and personalized therapy potential against pathogenic and pathophysiological diseases [ 70 , 71 , 72 , 73 ]. All these benefits are coupled with the cost-effective and time-saving aspect of this new technology.

2.3.7. Barriers Associated with Nanoparticle-Based Delivery Efficiency and Clinical Translation

There are several barriers or issues associated with nanoparticles in terms of delivery efficiency and clinical translation. The accumulation of nanocarriers in organs of the reticuloendothelial system, especially the liver, poses a significant challenge for clinical translation as it captures a majority of the injected dose, hindering the delivery of an adequate dose to the targeted disease site and potentially causing toxicity concerns [ 74 ]. Researchers have developed various approaches to address this issue, including preconditioning macrophages with chloroquine, saturating the reticuloendothelial system organs with drug-free nanocarriers, and transient stealth-coating scavenger cells to enhance the efficiency of drug-loaded nanoparticles reaching the diseased tissue [ 75 , 76 , 77 ]. Additionally, the incorporation of targeted cellular on the surface of nanocarriers such as those applying the “do not eat us” strategy, helps evade capture by the reticuloendothelial system, improving the accumulation of nanodrugs at the desired site [ 73 , 76 ].

On the other hand, surface shielding of nonionic hydrophilic polymers such as PEG on nanocarriers reduces cellular uptake and endosomal escape, resulting in poor delivery efficiency despite improving colloidal stability and stealth in a biological environment [ 77 ]. To overcome this “stealth dilemma,” targeting ligands are strategically placed at the distal end of the PEG segments to facilitate specific ligand receptor-mediated uptake [ 78 ]. Another strategy involves wrapping anionically charged polymers on positively charged mRNA-polyplexes to promote endosomal escape by converting them into positively charged polymers in response to the acidic pH of the endo/lysosomal compartments [ 79 ].

The use of messenger RNA (mRNA)-loaded lipid nanoparticles is limited by their hepatic protein expression, even when administered locally through intramuscular and intratumor injections [ 80 ]. Minimizing the off-target hepatic expression would be advantageous for protein replacement therapies and cancer immunotherapies. One approach involves incorporating microRNA target sites in therapeutic mRNAs to selectively prevent their expression in the liver [ 80 ]. Some other generalized barriers associated with nano-based drug delivery mechanisms are included in Table 1 . It is important to note that although nanoparticles face these barriers and issues, significant advancements are being made in addressing them, bringing us closer to their successful clinical translation.

Barriers associated with nano-based drug delivery.

2.4. Applications of Nanotechnology in Regenerative Medical Sciences

2.4.1. nanotechnology and bone regeneration technology.

Nanotechnology is the science of creating and manipulating materials at the molecular and atomic levels. Bone regeneration technology creates new bone tissue, or helps existing bone tissue heal, with the use of materials that promote bone growth [ 81 ]. Nanotechnology is increasingly used in bone regeneration technology to create better, more precise and targeted materials for promoting bone growth [ 80 ]. For example, researchers are exploring the use of nanoparticles to deliver drugs or other molecules that promote bone growth directly to the areas that need them, improving the effectiveness of the treatment [ 80 ].

Nanoparticles can also be used to create scaffolds that mimic the structure of bone, which can help guide new bone growth and aid in bone regeneration. Additionally, advances in 3D printing technology that uses nanoscale materials can be used to create highly precise and customized implants for bone regeneration [ 81 ]. Bone weakening and dysfunction is a widespread problem and this has been marked by nanotechnologists as an issue of the utmost importance when linking nanotech to medicine. Some studies are being carried out regarding bone formation and structuring with the help of nanotechnology [ 80 , 81 ]. Scientists are trying to develop bone graft substitutes in the form of nanostructured materials with similar properties to be accepted by body and organ tissues. If these studies succeed, they will bring a new wave of regenerative technology to cure damaged bones and broken muscular fragments [ 82 ].

Principle investigation on biomineralization is being carried out to reduce the particle size of bone materials that could be coupled with its crystalline properties to be embedded into collagen fibers [ 80 ]. The purpose is to create a penetrating composition in damaged bone areas with specific mechanical properties to revolutionize the field of osteology and bone tissue engineering [ 80 , 81 ]. Similar studies are being carried out to make artificial joints, nanoscale collagen-mimicking coatings for knees and hips that act to stabilize the process of bone formation by osteoblasts [ 83 , 84 ]. Overall, the use of nanotechnology in bone regeneration technology holds great promise for improving the outcomes of bone repair and regeneration, including faster healing times, improved bone strength, and reduced complications.

2.4.2. Nanotechnology and Regenerative Medicine

Regenerative medicine is an interdisciplinary field of medical applications in which the benefits of cell therapy and tissue engineering methods are well fabricated to device mechanisms for the treatment, maintenance, improvement, and reparation of damaged and dead cells, tissues, and organs [ 73 ]. Previously, it was difficult to deal with the body at the cellular level but with the emergence of nanoscale technology, a huge opportunity has become available in the form of regenerative medicine to interact with cells and their components so that the linked cellular responses and extracellular material production can be controlled [ 80 ]. Tissue repair has been greatly upgraded with the powerful tissue regeneration abilities of nanoassemblies. These technologies are being directed for cellular adhesion, migration, differentiation, and other mechanical aspects that initiate tissue regeneration [ 85 ].

Exploration in the field of nanomedicine is going on to manufacture nanoscale materials, such as gold and silver nanoparticles, dendrimers, nanorods, carbon buckyballs, nanoshells, nanocubes, and many other forms of nanoparticles [ 73 , 79 ]. Each is specific to its linked properties, which can be directly utilized in targeted tissues and organs. Multiple research groups are working worldwide to explore the diagnostic, therapeutic, anti-viral, antifungal, and most importantly anticancerous properties of these nano-agents [ 70 , 72 , 86 ]. Progress shows that soon, a world of nanotechnology will bring a revolution to the treatment options for incurable diseases such as cancers, for which early diagnosis through nanotechnology is already on board and has been successfully explored [ 73 , 86 ].

2.5. Applications of Nanotechnology in Surgery

A brief overview of nanotechnological applications in surgery is covered in the following section with a diagrammatic representation in Figure 2 .

Applications of nanotechnology in surgery.

2.5.1. Surgical Nanorobotics and Nano-Bioelectric Medicine

Surgical nanorobotics involves the development and use of tiny robots or nanorobots that can perform surgical procedures with high precision and efficiency [ 87 ]. These nanorobots can be guided to specific locations within the body using advanced imaging techniques, and they can then perform tasks such as delivering drugs, removing tumors, or repairing damaged tissues. Nano-bioelectric medicine, on the other hand, involves using electrical signals to stimulate the body’s healing processes [ 88 , 89 ]. This emerging field focuses on the use of nanoscale technologies to access and control the electrical activity of cells and tissues in order to treat a wide range of medical conditions, including chronic pain, wound healing, and heart disease [ 90 ]. Both surgical nanorobotics and nanobioelectric medicine have the potential to revolutionize the field of medicine and improve patient outcomes. However, there is still much research needed to fully explore the potential of these technologies and ensure their safety and efficacy [ 88 ].

Programming, engineering, and biological fields are working inter-connectively to develop a surgical nanorobot that works through the vascular system. These small-scale devices are manufactured with the multipurpose function of searching diagnostics and treatments against lesions and pathogens [ 87 , 88 ]. These robots work at a minute scale that can be used to cut even a single dendrite and neuron at the cellular surgery level without causing harm to other neurons bound in a complex network. These experiments have been confirmed in animal models where a nanoscissor action has been governed by these nanorobotics [ 91 ]. The results have pushed scientists to perform further experiments before optimizing surgical conditions on diseased patients. A new wave of bioelectric medicine is also in the market which adheres to biological components for more effective diagnostic and therapeutic therapies. This nanobioelectronic is being employed in cancerous diseases, cardiovascular disorders, and other malfunctions in the human body [ 92 ]. However, many improvements are needed to successfully apply this technology in a clinical setting for multipronged complex diseases.

2.5.2. Implantable Medical Nanogenerators

Nanogenerators, as the name indicates, are a class of self-powered and implantable medical nanosensors. They work on the principle of conversion of mechanical energy from body movement into an electric spark [ 87 ]. As the body converts chemical energy from glucose, muscle converts this energy to mechanical energy and in turn these nanogenerators convert it into electric energy which can be used to charge and power implantable nanodevices that are aggressively being manufactured for medical purposes nowadays [ 88 ]. Implantable medical nanogenerators (IMNGs) are miniature devices that use mechanical energy from body movements to generate electrical energy [ 87 ]. They can be implanted inside the human body and used to power various medical devices, including pacemakers, neurostimulators, and drug delivery systems [ 93 ].

IMNGs are made up of thin layers of materials, such as piezoelectric materials, which convert mechanical energy into electrical energy. These materials generate electric charges when they experience mechanical stress, such as bending or pressure [ 87 ]. They can also be designed to harvest energy from other sources, such as temperature changes or fluids in the body [ 88 ]. IMNGs have several advantages over traditional batteries used to power implantable medical devices. They can eliminate the need for battery replacements, which can be invasive and costly. They can also improve device reliability as battery failures can cause serious medical problems [ 93 ]. Additionally, IMNGs are environmentally friendly since they do not require the disposal of toxic batteries [ 94 ].

Despite their potential benefits, there are still challenges to overcome in developing IMNGs. The devices must be durable enough to withstand the harsh conditions inside the body, including high temperatures and corrosion from body fluids [ 95 ]. They must also be small enough to be implanted inside the body without causing discomfort or obstruction [ 94 , 95 ]. Overall, IMNGs hold great promise for improving the safety, reliability, and convenience of implantable medical devices in the future. Therefore, researchers are continuously working toward their development to make them practical for human use.

2.5.3. Nanotechnology and Anesthesia Induction

Anesthesia induction is a critical step in dental surgeries and other sensitive medical procedures, such as brain surgeries. For such anesthesia induction procedures, researchers are working on nanorobotic suspension mixtures that make a colloidal suspension with millions of nanoscale active analgesic nanoparticles [ 96 ]. These nanoparticles work on patients’ gingival and other sensitive portions and penetrate deep up to the level of loose tissue. This passage of nanomaterials is conducted via the combinational principles of chemical and temperature gradients and positional navigation that are monitored and controlled by onsite nanocomputers [ 97 ]. This nanoscale anesthetic action helps to carry out the desired effect, attained quickly with an even distribution of anesthetic in the projected organ such as the dental surface. The sensitivity action can also be controlled for a particular tooth for which surgical action is required. After the completion of surgeries, nanorobots are controlled via nanocomputers to restore tooth sensitivity to normal [ 98 ].

2.6. Applications of Nanotechnology in Dentistry

Nanodentistry is a separate branch of nanomedicine that involves a broad range of applications of nanotechnology ranging from detection to diagnosis, to cure treatment options and prognostic details about tooth functions [ 99 ]. A wide spectrum of oral health-related issues can be dealt with using nanomaterials [ 100 ]. These nanomaterials derive their roots from tissue engineering and biotechnologically manufactured dental nanorobotics [ 100 , 101 ]. Some recent advances under oral nanotechnology may include treatment options such as anesthesia, dentition renaturalization, hypersensitivity cures, orthodontic realignment problems, and modernized enameling options for the maintenance of oral health [ 99 , 102 ].

The nanoscale technology used for such functions are named mechanical dentifrobots. They work to sensitize nerve impulse traffic at the core of the tooth in real-time calculation and hence could regulate the tooth tissue penetration and maintenance for normal functioning [ 103 ]. The functioning is coupled with programmed nanocomputers to execute actions from external stimuli via connection with the localized internal nerve stimuli. These mechanistic insights could help dental surgeons suggest a strategic treatment option that may be conducted directly via in vivo nanorobot action using acoustic signals, as elaborated earlier [ 100 , 101 , 102 , 103 , 104 ]. Some of the applications of nanotechnology in the field of dental science have been compiled at the end of this section in Figure 3 .

Major applications of nano-dentistry.

2.6.1. Nanotechnologies, Tooth Repair, and Hypersensitivity Treatment

Scientists are further working to use nanotechnology for the creation of dental cures and treatment strategies. This may include the stimulation of the natural biomineralization process or the utilization of nanomaterials for artificial tooth development with sensitivity programed by nanorobotics [ 100 , 105 ]. They are trying to develop the hardest tissue enamel by using nanoscale manufacturing of nanorods derived from calcium hydroxyapatite crystals to help regulate the function of teeth. Additionally, reconstructive dental nanoparticles are utilized to offer patients a rapid and long-term cure against hypersensitivity [ 106 ].

2.6.2. Tooth Repositioning and Renaturalization

Repositioning of the tooth is a matter of greater concern for patients as it sets the basis for further cure or disruption of dental health in case of maladjustment. Orthodontic nanorobots could be used in this case to manipulate tissues in such a way that a smooth painless straightening, rotation, and repositioning of the tooth could be attained [ 107 ]. Moreover, with time, customers are more interested in improving the aesthetic standing of their physical appearance, and so the concept of dental esthetics has emerged. In this regard, nanotechnology is considered to perform actions such as excavating dental amalgams or remanufacturing teeth alongside fillings, crowns, and other such modifications [ 107 , 108 ].

2.6.3. Nanotechnology and Dental Durability

Much more effort is being put into securing dental durability and the appearance of teeth in normal dentistry practices. Nanotechnology provides a more secure and long-lasting solution in the form of nanostructured dental materials with carbon nanotubes that provide fracture-resistant properties [ 109 ]. Additionally, simpler dentifrobots are being incorporated into mouthwashes and toothpastes to replenish dental surfaces on a routine basis for cleaning and continuous calculus debridement [ 110 ]. These dentifrobots have the ability to highlight and destroy specific pathogenic bacteria from the mouth and retain the useful oral microflora in a healthy balance [ 111 ]. All these benefits delay the conventional causes and processes of dental decay with the remedial disappearance of oral diseases, especially in the early years [ 100 , 112 ].

2.7. Applications of Nanotechnology in Oncology Field

2.7.1. nanotechnology and cancer treatment strategies.

In the world of medicine, complex and incurable diseases such as cancer are always given a special focus to find treatment and early diagnosis options for these modalities [ 113 ]. Nanotechnology is providing a good opportunity for researchers to develop such nano-agents, fluorescent materials, molecular diagnostics kits, and specific targeted drugs that may help to diagnose and cure disease in a better way in the future [ 114 ]. Scientists are trying various protocols to conjugate already available drugs with nanoparticles to enhance drug specificity and targeting in organs [ 113 , 114 , 115 ].

Nanomedicine acts as the carrier for hundreds of specific anticancerous molecules that could be projected at tumor sites. Moreover, the tumor imaging and immunotherapy approaches linked with nanomedicine must also be kept in mind when diving deep into nanomedicine and cancer links [ 34 ]. The effectiveness of nanomaterials in cancer therapies has pushed scientists to replace traditional cancer therapy approaches with targeted therapies that may be utilized alone or in conjugation with already available anti-cancerous drugs [ 16 , 34 ]. The focus is also being drawn toward lessening the impact of chemotherapeutic drugs by increasing their tumor-targeting efficiency and improving their pharmacokinetic and pharmacodynamic properties. Similarly, heat-induced ablation treatment against cancer cells alongside gene therapy protocols are also being coupled with nanorobotics [ 52 ].

Some other cancer treatment options, in the form of enhanced tissue imaging and tumor microenvironments, as well as adjustment by the release of nanoparticle-bounded drugs, are being practiced in the oncology field [ 59 , 116 ]. These nanomedicines hold the potential to overcome drug solubility, instability, and resistance issues. Various nanomedicines that act as anticancerous medicines are being researched, while some have been approved by the US Food and Drug Administration (FDA) and European Medicine Agency (EMA) [ 117 ]. These anticancerous drugs may utilize the “Enhanced Permeation and Retention Effect” (EPR effect) and/or active targeting of nano assemblies such as liposomes, albumin nanospheres, micelles, and gold nanoparticles [ 118 ]. Some of the applications of nanotechnology in the oncology field are discussed in the following section and a summary ( Figure 4 ) is shown at the end of this section.

Applications of Nanotechnology in Oncology field.

2.7.2. Nanotechnology in Cancer Diagnosis

Cancer diagnosis is the most observable problem in cancer patients. Cancer largely remains uncured due to late detection in the third or fourth stages. To fight this cause, nanotechnology is being employed to allow early detection of tumors in organs [ 16 ]. Nanotechnology provides a very sensitive and specific multiplexed measurement capacity to detect cancer biomarkers in extracellular settings and in vivo bioimaging techniques [ 19 ]. Nanotechnology has enormous potential in the field of cancer diagnosis. Nanoparticles are incredibly small and can penetrate cell walls and the blood–brain barrier. This makes them ideal for delivering drugs and other therapeutic agents to cancer cells. They can also be used to detect cancer cells and identify the location and nature of the disease [ 119 ].

One of the most promising areas of nanotechnology in cancer diagnosis is the development of targeted nanoparticles. These are nanoparticles designed to adhere specifically to cancer cells, allowing them to be easily identified and targeted by doctors. This could result in more accurate early detection, better monitoring of cancer progression, and faster diagnosis [ 120 ]. Another promising application of nanotechnology in cancer diagnosis is in the development of biosensors. Biosensors are small devices that can detect specific biomarkers in a patient’s blood or other bodily fluids. These biomarkers can be indicative of cancer and could be used to detect cancer at an early stage [ 92 , 93 ].

In conclusion, nanotechnology has enormous potential in the field of cancer diagnosis. With targeted nanoparticles and biosensors, it could help in the development of a more accurate, non-invasive and effective way to diagnose cancer. However, the challenges pertaining to such diagnostic kits remain and the need is to overcome these challenges and update the nanotechnology-based diagnostic methods for cancer and other disease diagnostics and prognoses in the future [ 19 , 120 ].

2.7.3. Multifunctional, Multimodal, Theranostics-Based Anticancer Therapy

Multifunctional theranostics therapy is an emerging field in cancer treatment that combines multiple modalities into a single treatment approach. This approach aims to both diagnose and treat cancer using nanomaterials. Nanomaterials, such as nanoparticles, are highly versatile due to their unique properties at the nanoscale [ 121 ]. They can be engineered to have various functionalities, such as imaging capabilities, drug delivery systems, and targeted therapy agents. By using these multifunctional nanomaterials, theranostics therapy can provide simultaneous cancer diagnosis and treatment [ 122 ]. In parallel, the term multimodal refers to the combination of multiple treatment modalities in a single therapy [ 123 ]. In the context of theranostics therapy, multimodal treatment can involve different approaches, such as chemotherapy, radiotherapy, and immunotherapy [ 124 ]. These modalities can be incorporated into nanomaterials used for therapy, allowing for targeted delivery and enhanced efficacy. The theranostic approach also enables real-time monitoring of treatment outcomes [ 124 ]. By incorporating imaging agents into nanomaterials, clinicians can track the distribution and effectiveness of the therapy. This information helps guide treatment decisions and allows for adjustments to optimize patient outcomes [ 123 ]. Thus, the combination of multifunctional and multimodal theranostics therapy using nanomaterials holds great promise in the fight against cancer. It offers the potential for personalized and targeted treatment, improved efficacy, and reduced side effects compared to traditional cancer therapies [ 121 , 125 ].

2.7.4. Targeted Nano Drug Delivery Technology for Cancer Therapy

Targeted nano drug delivery technology for cancer therapy is a form of treatment that uses nano-sized particles to deliver drugs specifically to cancer cells in the body. These nanoparticles can be engineered to selectively bind to cancer cells, allowing the drugs to be delivered directly to the tumor site, while minimizing damage to healthy tissues [ 5 ]. The development of targeted nano drug delivery systems has several advantages in cancer therapy. Firstly, it can enhance the efficacy of the drugs by increasing their concentration at tumor sites. This is especially important for drugs with low solubility or high toxicity as it allows for higher doses to be delivered directly to the cancer cells [ 24 ]. Additionally, targeted nano drug delivery systems can help overcome some limitations of traditional chemotherapy, such as poor drug bioavailability or resistance. By encapsulating the drugs within nanoparticles, their stability and solubility can be improved, leading to better drug delivery and higher therapeutic effects [ 5 , 126 ].

There are various types of targeted nano drug delivery systems being explored, including liposomes, polymeric nanoparticles, dendrimers, and carbon nanotubes. These nanoparticles can be functionalized with ligands or antibodies that specifically bind to receptors or proteins overexpressed on the surface of cancer cells [ 127 ]. This targeting moiety allows for the selective binding and internalization of nanoparticles into cancer cells, enabling efficient drug delivery. Furthermore, targeted nano drug delivery systems can also be combined with imaging agents, enabling real-time monitoring of drug distribution, tumor targeting, and uptake [ 24 , 128 ]. This helps in tracking the therapeutic response and adjustment of treatment protocols as needed [ 128 ]. Overall, targeted nano drug delivery technology has the potential to revolutionize cancer therapy by improving the efficacy and safety of drugs, minimizing systemic side effects, and enabling personalized medicine approaches. However, further research and development is still needed to optimize these systems and ensure their clinical translation [ 128 , 129 ].

2.7.5. Nanotech Based Magnetic Drug Delivery Technology and Cancer Therapy

Nanotechnology and magnetic drug delivery technology are both innovative approaches in the field of medicine that improve drug delivery and enhance treatment effectiveness. Magnetic drug delivery technology utilizes the application of an external magnetic field to guide drug-loaded nanoparticles to a specific site within the body [ 130 ]. Magnetic nanoparticles can be functionalized with drugs and then injected into the bloodstream. By applying a magnetic field externally, the nanoparticles can be directed toward the desired location, such as a tumor [ 131 ]. This approach allows for more precise drug delivery, minimizing systemic exposure and reducing side effects [ 39 ]. Similarly, by engineering nanoparticles, researchers can create drug carriers with unique properties that are not in conventional drug delivery systems [ 130 , 131 , 132 ]. These nanoparticles can be functionalized and designed specifically to target diseased cells or tissues, improving drug concentration at the desired site and minimizing off-target effects [ 131 ].

Additionally, nanoparticles can protect the drug payload from degradation, resulting in improved stability and prolonged drug release. Thus, the combination of nanotechnology and magnetic drug delivery technology has shown promise in several areas of medicine [ 130 ]. For example, in cancer treatment, magnetic nanoparticles can be used to deliver chemotherapy drugs directly to tumors, increasing drug concentration at the tumor site and reducing toxicity in healthy tissues. This approach can enhance treatment efficacy while minimizing adverse effects [ 133 ]. Furthermore, magnetic drug delivery can also be utilized in targeted therapy for other diseases, such as neurological disorders. Nanoparticles loaded with neuroactive drugs can be guided to specific regions in the brain using externally applied magnetic fields, allowing for more targeted treatment and potential reduction in systemic side effects [ 133 ]. Thus, the integration of nanotechnology and magnetic drug delivery technology has the potential to revolutionize drug delivery by improving targeting, reducing side effects, and enhancing treatment outcomes. Ongoing research and development in this field hold great promise for the future of medicine.

2.8. Other Applications of Nanotechnology in the Medical Field

2.8.1. applications of nanotechnology in medical machinery.

As nanotechnology is making progress in the field of medicine and biological sciences, eyes are on the board as to how this technology will bring revolution to medical machinery [ 25 ]. It is predicted that soon, micro and nanoscale materials will be integrated with useful robotic characteristics that may include nanoscale manipulator arms, sorting rotors, reagent purification kits, and super diagnostic surfaces that will be modeled to respond to particular disease diagnostics and treatment. These nanomaterials and robotic connections are assumed to be controlled via nanocomputers [ 25 , 134 ].

Nanocomputers are expected to control, activate, deactivate, and deter the response rates of nanomechanical devices [ 134 ]. They will be programed to execute specified medical and dental operations with a connection to a wider network of interconnected nanocomputers, such as programmed nanomachines and robotics, which have the potential to allow physicians and clinicians to perform precise medical procedures at a subcellular level [ 135 , 136 , 137 ]. Furthermore, these robotic elements are expected to work in gerontological and pharmaceutical research phases, diagnostics, and dentistry [ 138 ].

2.8.2. Nanotechnology and Veterinary Medicine

In addition to the application of nanomedicine to humans, beneficial applications of nanomedicine are now being used on animals. Multiple variations of nanovaccines and nanoadjuvants have started their way into veterinary sciences [ 11 , 139 ]. The previously used animals’ therapeutic, diagnostic, treatment, and veterinary vaccinations along with disinfection, breeding, reproduction, and nutritional concerns are now being modernized using the concept of nanotechnology [ 139 ].

Nanotechnology has the potential to revolutionize the field of veterinary medicine, offering new diagnostic tools and treatment options for animals. In the area of diagnostics, nanotechnology can improve the accuracy and sensitivity of diagnostic tests used to detect various diseases [ 140 ]. Nanoparticles can be engineered to bind to specific biomarkers in the body that are indicative of disease, allowing for early detection and treatment [ 140 ]. In the field of therapeutics, nanotechnology can improve drug delivery systems, enhancing drug efficacy while minimizing side effects. Nanoparticles can be designed to improve drug solubility, stability, and specificity, ensuring that drugs reach their intended targets and remain active for longer periods of time [ 139 , 140 , 141 , 142 ].

Additionally, nanotechnology can be used to develop novel vaccines and immunotherapies, as well as new tools for regenerative medicine. For instance, nanoparticles can be used to create scaffolds for tissue engineering and repair, promoting the growth of new tissue and accelerating healing processes [ 73 , 85 , 86 ]. The use of such small-scale nanomedicine shows a direct impact on public health due to the interconnectedness among humans and animals within the same living environment. The effort is going on to increase meat and milk production, leading to a reduction in vaccine residues and drug resistance problems in veterinary medicine [ 142 , 143 ]. Moreover, this medicinal revolution remains cost-effective and helps to minimize the amount of discarded milk and meat products. In addition to that, in modern pet care, nutritional and hygienic products are also being introduced in the market under the genesis of successful practices in nanotechnology [ 143 ]. Overall, nanotechnology offers exciting possibilities for improving animal health and welfare and has the potential to revolutionize veterinary medicine.

2.8.3. Nano Sensors, Nano Microbivores and Chemical Warfare Technology

Nanosensors refer to small devices that can detect and analyze chemical or biological agents at the molecular level. They have various applications, including monitoring air quality and detecting pathogens in food and water [ 12 ]. Nano-microbivors, on the other hand, are small (microscopic) organisms that can consume or break down contaminants such as organic chemicals and heavy metals in the environment [ 17 ]. They can be used for bioremediation purposes and for treating contaminated soil and groundwater [ 144 , 145 ]. There is an interlink between these concepts, in that nanosensors and nano-microbivors can be used in the detection and remediation of chemical warfare agents [ 146 ]. For example, nanosensors can be developed to detect the presence of chemical warfare agents in air or water, while nano-microbivors can be used to break down or detoxify these agents in the environment [ 146 , 147 ]. In this way, these technologies are important tools in ensuring national and global security.

A new wave of nanosensors is being developed to be utilized for military purposes against detection of airborne and released chemical agents that could be easily exhaled and inhaled with toxic outcomes [ 12 , 17 ]. Phagocytes have a cellular clearing digestive function; based on this principle, artificially designed nanoscale microbiomes are being used in studies to clean the bloodstream by digesting toxic pathogens [ 146 ]. They perform this function in a very limited time as compared to other medication options without causing any toxicity or septic shock conditions. A similar principle of action will be utilized to detect the amount of inhaled prohibited drugs such as marijuana, banned substances, and alcohol concentrations in individuals, against which the use of such substances is strictly prohibited in patients [ 148 ]. Such advanced technologies may take the place of traditional procedures, which are extensive and time-consuming diagnostic procedures.

2.8.4. Nanomedicine and COVID-19

During the COVID-19 pandemic, nanomedicine has played a crucial role in developing diagnostic tools, treatment strategies, and vaccine delivery methods. The link between the coronavirus and nanoparticles based on size and function is relatively straightforward. In terms of size, both the virus particles and nanoparticles are tiny particles with a size on the nanoscale [ 149 ]. This small size allows them to interact with each other on a very tiny scale. Similarly, in terms of functional similarities, nanoparticles can be engineered or designed to have specific functions. For example, some nanoparticles can be coated with molecules that make them stick to viruses such as the coronavirus [ 150 ]. This function is essential because it allows nanoparticles to “grab onto” the virus. Thus, in the context of the coronavirus, scientists have explored how nanoparticles can be used in various ways including detection, treatment, and protective responses. Nanoparticles can be designed to bind to specific parts of the coronavirus. When they attach to the virus, they can change color or emit light, making it easier for scientists and doctors to detect the presence of the virus in a sample, such as a patient’s blood or saliva [ 151 ]. Similarly, nanoparticles can also be used to deliver medicines directly to the virus or infected cells. Think of nanoparticles as tiny delivery vehicles that can carry antiviral drugs right to the site of infection, potentially making treatments more effective [ 152 ]. In addition, regarding the protective technologies against COVID-19, Some masks and face coverings have been designed with nanoparticle coatings that can trap and neutralize viruses, including the coronavirus, when they come into contact with the mask’s surface [ 149 , 151 ]. Furthermore, nanoparticles have been used to create highly sensitive and specific diagnostic tests that can detect SARS-CoV-2 in patient samples [ 149 ]. Nanoparticles have also been used to develop therapeutics that can directly target the virus, as well as improve the delivery and efficacy of existing drugs [ 149 ].

In addition, nanotechnology has been used to improve the stability and efficacy of vaccines, as well as develop new delivery methods such as nasal sprays and microneedle patches [ 149 , 150 ]. These approaches can help increase vaccine accessibility and effectiveness, particularly in resource-limited settings. The breakthrough and rapid responses coming from nanomedicine can be ascertained by the fact that nanotechnology is also being utilized for vaccine drug manufacturing technologies against COVID-19 [ 151 ]. Since nanomedicine has already proven its benefits for disease diagnosis, treatment, and prevention, it is being employed to tackle the pandemic. Now, nano-based technology is on hand and is being considered for utilization in manufacturing antiviral technology to integrate into personalized medical equipment and to manufacture nano-based drugs [ 150 , 151 ]. The sole purpose is the greater safety of medical workers and to save patients suffering from the impediments of the coronavirus with more sensitive medicine and machinery.

In this regard nanomaterials, such as quantum dots, are being introduced into biosensors for diagnostics experiments and other nanoassemblies, such as liposomes, polymeric and lipid nanoparticles, metallic nanoparticles, and micelles, which are being utilized for antiviral drug encapsulation and drug conjugation [ 150 , 151 , 152 , 153 ]. The great benefit would be increased pharmacological impact and more efficient drug targeting. Studies are showing that these antiviral properties of nanoparticles function by blocking the binding, entry, and replication of coronavirus in the body [ 154 ]. With this technology, the toxicity linked to normal body cells owing to nanoparticle application is the major factor of concern and thus needs to be investigated and improved for future applications [ 155 ]. Overall, nanomedicine holds great promise in the fight against COVID-19 and could potentially revolutionize the way we diagnose, treat, and prevent infectious diseases in the future. Figure 5 below shows the link between nanoparticles and coronavirus in terms of the chemistry of the structure, size, and functionality that could be used as an exemplary overview as to how nanotechnology could be majorly utilized to discover antiviral treatments in the future. Commercial applications of nanotechnology in medical field are summarized in Table 2 .

A link between coronavirus and nanoparticles based on size and function.

Examples of nanotechnological applications and their commercialization in the medical field.

2.9. Toxicology and Safety Analyses of Nanotechnologies

The side effects of nanotechnology are of great concern for humans, animals, and the overall environment. While the toxicity attached to these assemblies is poorly understood, the scientific community remains unsure as to what level they can extend the applications of nanotechnology, especially in medicine, which is quite a sensitive domain of healthcare [ 142 ]. In previous years, some nano-based products were introduced but later pulled back from the market owing to the reported side effects in the general public. The risk assessment of nanomedicine is thus a critical topic and needs to be assessed soon [ 145 ].

The need is to prioritize experiments for nanoparticle safety, dosing adjustment, and usage. The miracles of nanotechnology itself can be used in sensors and markers for biological, chemical, and environmental remediations [ 162 ]. Toxicity profiling of consumer products should be specifically carried out. Skin care and dental products containing different nanomaterial liposomes, cubosomes, solid lipid nanoparticles, and dendrimers must be specifically assessed, and their side effects must be determined so that more modified, effective, and harmless nanoemulsions can be introduced and utilized in the future [ 163 ].

Similarly, the issue of bioaccumulation and persistence is attached to nanotechnology. Nanomaterials have the potential to persist in the environment for extended periods and accumulate in living organisms [ 162 , 163 , 164 ]. This can lead to potentially adverse effects on both human health and ecosystems. Additionally, in healthcare settings, medical professionals who handle nanomaterials may be at risk of potential exposure through inhalation, dermal contact, or ingestion. Safe handling practices and adequate protective measures must be implemented to minimize exposure risks [ 165 ]. Moreover, the use of nanomaterials in medical applications also raises ethical considerations regarding informed consent, privacy, equity of access, and potential impacts on vulnerable populations. There is a need to address these ethical concerns to ensure the fair and responsible use of nanomaterials in healthcare [ 166 ].

To ensure the safe and sustainable use of nanomaterials in the medical field, several measures can be implemented, such as rigorous and comprehensive risk assessments, which should be conducted to evaluate the potential hazards and risks associated with specific nanomaterials before their deployment in medical applications. Similarly, adequate regulatory frameworks should be in place to ensure the safe production, handling, and utilization of nanomaterials [ 142 , 166 ]. This includes the evaluation of their safety, labeling requirements, and monitoring of their effects in healthcare settings. Additionally, standardized testing methods should be developed to assess the safety and efficacy of nanomaterials for medical use. This includes standardized protocols for toxicity testing, characterization, and quality control. Furthermore, strict control measures should be implemented to minimize occupational exposure to nanomaterials [ 165 ]. This includes the use of engineering controls, personal protective equipment, and employee training programs. Moreover, transparent communication about the potential risks and benefits associated with nanomaterials is essential for establishing trust among stakeholders, including healthcare professionals, patients, and the general public [ 165 , 166 ].

The need is to prioritize experiments for nanoparticle safety, dosing adjustment, and usage. The miracles of nanotechnology itself can be used to produce sensors and markers for biological, chemical, and environmental remediations [ 166 ]. Toxicity profiling of consumer products should be specifically carried out. Skin care and dental products containing different nonmaterial liposomes, cubosomes, solid lipid nanoparticles, and dendrimers must be specifically assessed, and their side effects must be determined so that more modified, effective, and harmless nano-emulsions can be introduced and utilized in the future [ 145 , 166 ]. Overall, by evaluating potential risks, implementing appropriate regulatory measures, and promoting responsible use, nanomaterials can be safely and sustainably utilized in the medical field for improved diagnostics, drug delivery, and disease treatment.

2.10. Future Prospects Regarding Nano-Medical Applications

Nanomaterials hold significant promise for various biomedical advancements and industrial applications. However, their unique physicochemical properties raise concerns about their potential impact on human health and the environment. In order for medical nanomaterials to enter the market, there are many obstacles to overcome, such as FDA certifications and permits, as well as safety and ethical concerns. In recent years, regulatory bodies worldwide have focused on developing appropriate frameworks to ensure the safe and responsible use of nanomaterials. Such an issue should be addressed more intensively in the coming years of nanotech research. Review papers, in this regard, should aim to provide researchers, policymakers, and industry professionals with a comprehensive understanding of the recent regulatory affairs surrounding nanomaterials. By critically examining the current state of nanomaterial regulation, this paper highlights the need for harmonization and collaboration among regulatory agencies worldwide. Regulating industrialization affairs surrounding nanomaterials in medical sciences involves several steps. It is important to note that these steps provide a general framework, but the specific details and processes may vary depending on the jurisdiction and specific requirements of each country or region. A general outline of the process is provided in a table format ( Table 3 ) below. Steps needed to regulate the industrial affairs of nanotechnology are shown in Table 4 .

FDA approved and commercialized nanomedicines.

Steps needed to regulate industrialization affairs surrounding nanomaterials in the medical sciences.

3. Materials and Methods

A comprehensive search strategy was adopted for this systematic review to include data from diverse, recent, and the most cited sources of study.

3.1. Search Strategy

Data were collected via a systematic literature search through various online sources including Google Scholar, PubMed, NIH (National Library of Medicine), Web of Science, European database, Springer, and Embase databases. Since the study was focused on the applications of nanotechnology in medicine and healthcare, the major research items were “nanotechnology”, “nanobiotechnology”, “nanomedicine”, “nanotechnology and medical applications”, “nanotechnology and diagnosis”, “nanotechnology and treatment”, “nanotechnology and drug-delivery”, and “nanotechnology and healthcare and esthetics”, among other similar search terms. After a thorough analysis of titles and abstracts of publications related to applications of nanotechnology in the medical and healthcare industry, the data was selected to be part of this study. Only studies published in the English language were included in this study. Moreover, only data from 2010 onwards were included in the article.

3.2. Inclusion and Exclusion Criteria

Multiple types of sources were used, including data from research articles, book chapters, review articles, case reports, clinical trials, and case studies published starting beginning in 2010. Studies with incomplete citations and published before 2010 were excluded from the study.

4. Conclusions

The future of nanotechnology in healthcare and medicine holds immense potential for revolutionizing the way we diagnose, treat, and prevent diseases. Nanotechnology involves the manipulation of materials at such a small scale where the properties of materials significantly differ from their bulk counterparts, allowing for precise control of their physical, chemical, and biological properties. This opens up new opportunities for developing novel therapies, targeted drug delivery systems, and sensitive diagnostic tools. In addition to drug delivery, targeted delivery, improved drugs, limited dosages, and reduced systematic side effects, nanoparticles can also be used to enhance the efficacy of existing drugs by improving their solubility, stability, and bioavailability. Additionally, nanotechnology-based sensors and devices can monitor patient health in real-time, enabling early detection and personalized treatment plans. In the future, nanotechnology may even enable the development of nanorobots that can navigate through the bloodstream to target and destroy cancer cells or deliver payloads of drugs to particular tissues.

The broad spectrum of nanomedicine covered in this article may be lacking in various other aspects of nanomedicine still in the research pipeline. The vision of nanotechnology might seem heretic and abstract, similar to the in silico experimentation and computational bioinformatics field that was criticized a few years back. However, the field of nanobiotechnology is rapidly appearing as a cutting-edge technology of the 21st century, with diverse implications in science and technology. The theoretical knowledge is there, and applied research is ongoing to make it more progressive. It is predicted that soon, nanotechnology will not remain an option but rather be compulsory in the medical industry. As soon as the cost associated with technology becomes accessible, it is predicted to affect our dentistry, healthcare, and human life more profoundly than in the past. The major need is to curtail the toxicological concerns and risks that are attached to high doses and the excessive use of nanomaterials in drug and treatment regimes. This is important if scientists want to enable the successful operation of nanotechnology in medicine. Overall, the future of nanotechnology in healthcare and medicine holds great promise for improving patient outcomes and revolutionizing the way we approach disease prevention and treatment.

Funding Statement

K.M.’s work was supported by the United Arab Emirates University UPAR-Grant#G3458.

Author Contributions

Conceptualization, S.M., K.M. and Y.W.; methodology, S.M., K.M. and Y.W.; validation, S.M., K.M. and Y.W.; formal analysis, S.M., K.M. and Y.W.; resources, K.M. and Y.W.; data curation, S.M., K.M. and Y.W.; writing—original draft preparation, S.M., K.M. and Y.W.; writing—review and editing, S.M., K.M. and Y.W.; supervision, Y.W.; funding acquisition, K.M. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Not Applicable.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

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