April 06, 2001 11:00 pm

By Alice Perry Linker

Observer Staff Writer

Visiting the future from the perspective of the present can be tricky.

Todays research, though, offers a pretty good view of whats to come, says Grande Ronde Hospitals James Mattes.

Speaking Friday to the Rural Health Conference, sponsored by the Oregon Health Sciences University at Eastern Oregon University, Mattes touched on such exotics ideas as robotics, bionics, nanotechnology, DNA chips and cloning, all being intensively studied.

Were in for some amazing surprises, said the Grande Ronde Hospital administrator.

The discoveries, when they come, will change the face of diseases and treatment, Mattes said, and the big three killers, heart disease, cancer and stroke, may no longer be a threat.

Health care, hospitals and medical careers will change, too.

Doctors, instead of doing hands-on surgery, will direct robots, which will lead to procedures that have less effect on the patients body, Mattes said.

In 2020, there will be 200,000 centenarians in the United States, Mattes said.

Longevity may become a problem.

If we alter the killers, what about people with dementia? he said. Quality of life may be an issue.

People will have choices about major physical repairs, such as plaque build-up in arteries, and a person may choose whether to have an efficient removal of plaque, grow new arteries, or have artificial arteries implanted, he said.

Cloning probably will be a major ethical issue in 2020, as a black market for genetic engineering will develop. People will want to clone themselves or a child who has died, Mattes said.

Another ethical problem confidentiality will arise with the assessment of genetic material, Mattes said, because many people will want to decide how and with whom they will share personal genetic information.

A coming change that Mattes said makes him unhappy affects hospitals.

Hospitals will reinvent themselves, he said. Most hospitals will be in regional systems. Stand-alone hospitals probably wont exist.

Mattes foresees that by 2020, hospitals will be emergency and surgical centers.

Hospitals with fewer than 100 beds will become emergency centers and ambulatory care centers, he said.

Using high-speed telecommunications, surgeons and other specialists with be able to confer with far-away patients.

By 2020, the Internet will have impacted the health field, and people will get much of their information online. Diagnostic kits will become commonplace. As a result of information changes, doctors will become interpreters for their patients.

The role of nurses will change, too, Mattes said.

The perception of the nurse as slave will be gone, he said. Nurses will become coaches; help sort through questions. Nurses may coach a team of health care workers. Its a

terrible waste of talent for nurses to do all

the things they do today, but that will change.