The ability to mine useful information from incredibly large amounts of data, to move data around the globe instantaneously, and to remotely operate hardware through robotics all point to time and space becoming a much smaller barrier to the delivery of high-quality healthcare. Similarly, the advances in cellular and molecular biology have great potential for creating devices that are combinations of synthetic materials, inert materials of biological origin, and live biological cells and tissues. The biocompatibility of synthetic materials could be greatly enhanced with appropriate cell growth on their surfaces. Small-diameter vascular grafts lined with endothelial cells could well demonstrate the patencies required of coronary grafts. Tissue engineering could allow the creation of specific organs or their components.
Artificial skin is already available.
The combination of growth factors or genes with appropriate delivery technologies could facilitate angiogenesis and arteriogenesis, and these blood vessels might be grown in a manner designed to sufficiently perfuse the heart or other organs without requiring bypass operations. Some will succeed and many will fail, but new applications will be postulated and attempted. In a free and fertile environment, such developments will happen, but there are scenarios under which many of these changes could well be thwarted. Regulatory bodies, both in the United States and abroad, will need to learn how to deal with products that do not neatly fall into one of the three categories of drugs, devices, or biologics, but which may combine all three. Reimbursement schemes for products will need to mature.