In today's digital age, the adage "an apple a day keeps the doctor away" takes on new meaning. Apple's iPhone offers a range of health monitoring apps, from glucometers to portable electrocardiograms (ECG) set into iPhone cases, that literally put health analysis into a patient's hands.
AliveCor's heart monitor for the iPhone
As health analysis gets mobilized, people may no longer have to come to doctors to get answers about the state of their health -- raising some serious questions for the future of the medical profession.
That's the prediction Dr. Eric Topol, chief academic officer of Scripps Health, made in a recent speech in which he suggested that "Yes" is the answer to the question, "Is your doctor becoming obsolete?" as reported here. "Yes," that is, if the doctor persists in maintaining the asymmetrical model of "paternal medicine" in which the doctor holds the key to nearly all health information, and the patient isn't granted access.
But we stand on the verge of a new model, one that Topol said is analogous to the revolutionary impact of Gutenberg's printing press: the democratization of information that puts the patient on equal footing. "We don't need doctors so much when we have this innovative technology." Mobile monitoring devices will make it possible to pick up on warning signs without physical exams.
Wearable devices transmit biofeedback automatically and are becoming so advanced and compact that they can be printed directly onto the skin in the form of electronic tattoos. These "epidermal electronics" are ultra-thin sensors capable of recording and transmitting the skin's data. Unlike standard tattoos, these wear off after about two weeks due to the skin's exfoliation. But that time is sufficient for the device to "measure things like temperature, strains, and the hydration state of skin." Each of those factors is a key indicator of a person's physical condition. Such devices are useful for more specific purposes, too, like tracking recuperation from a surgical wound.
The computers that analyze the data themselves are on the road to super-portability. The people who brought us the famous supercomputer, Watson, predict it will one day be small enough to fit on a smartphone to serve as a medical expert. The focus so far has been on cancer treatment. Watson can extract data from decades of medical records of 1.5 million patients to present medical personnel with options and outcomes in just seconds. The current goal is to expand Watson's medical knowledge by beefing up its ability to analyze unstructured data, like doctors' notes, medical journals, images, data uploaded by monitoring devices, and even comments posted to web boards.
What all that data reveals is that sometimes less intervention can be better for your health than more treatments. As Topol pointed out, treating everybody the same way is forcing people into holes that don't necessarily fit them: "Mammography done for all women over the age of 40 has net harm. Net harm of almost 200 per every 1,000 women screened. Similarly for prostate PSA, net harm -- 200 per every 1,000 screened," he said.
Screening procedures considered as 100 percent beneficial in the past are coming under scrutiny now and have prompted the American Board of Internal Medicine (ABIM) Foundation to launch the Choosing Wisely campaign with the goal of more efficient and effective medical care. In a U.S. News & World Report piece, one medical professional pointed out that no procedure or medication is without risk, which on an individual level can prove fatal. "On a macro level, the widespread" practice of prescribing antibiotics has given rise to "the evolution of drug-resistant bacteria," noted Michael LeFevre, professor and vice chair of the University of Missouri's department of family and community medicine and co-chair of the US Preventive Services Task Force.
On a macro-economic level, unnecessary procedures cost America as much as $750 billion a year. The Institute of Medicine's report found 30 percent of healthcare expenses in the US in 2009 went toward "needless tests and services, administrative excess, fraud, and other failures that new technologies can help redress."
The latest among these technologies is Fujitsu software meant to measure a person's heart rate in just five seconds, based on face color changes captured by the camera built into mobile devices. As reported here, the company expects to roll this out to market in about a year.
While mobile healthcare analysis undoubtedly offers real value to individuals who stand to benefit from regular monitoring, the question is: Will the advances in these technologies make doctors obsolete? What do you think?
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