Healthcare Analysis: Doctor vs. Device


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
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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Ariella Brown,

Ariella Brown is a social media consultant, editor, and freelance writer who frequently writes about the application of technology to business. She holds a PhD in English from the City University of New York. Her Twitter handle is @AriellaBrown.

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Re: Yes but...
  • 4/24/2013 11:29:33 AM
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@Maryam yes, if the project achieves its goals, the researchers will not only learn a lot more about heart disease, but people will learn how to better manage their own health. And, ultimately, they do hope to cut back on those emergencies. 

Re: Yes but...
  • 4/24/2013 11:25:39 AM
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 Ariella it sounds like great research and I do agree it will help patients and hospitals. Hopefully it will help reduce the overload many ERs have for patients with chronic illnesses and help impact the overall health of patients.

Re: Liability Still A Medical Stumbling Block
  • 4/23/2013 12:21:04 PM

@tinym My sentiments exactly. People delude themselves into believing the lunch is free for them, assuming that the check will always be paid by someone else. It comes as a surprise to some that, they too, will be forced to pay for their own lunches -- and at premium prices, too.

Re: Liability Still A Medical Stumbling Block
  • 4/23/2013 12:11:33 PM
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@Ariella agreed! Whatever metric they're using is very wrong and they get a totally different government plan anyway. None of the healthcare stuff makes sense to me. It's as though this stuff was thought up like fiction and forced on the whole nation when it absolutely will not work out. If you can't pay for traditional insurance you certainly shouldn't be forced to contribute to a higher-priced government plan. Everyone will end up paying. There is no such thing as a free lunch, right? First rule of 12th grade economics...

Re: Liability Still A Medical Stumbling Block
  • 4/23/2013 10:11:38 AM
NO RATINGS

@tinym Yes, you have to not only provide your own health history but offer what you know of your families. The role of genetics is one of the things they really want to investigate. 

I laughed at your " I wish there were an app to make lawmakers read these bills before signing off." How about an app to give them a reality check about real people's income,living expenses, and what businesses can afford?

Re: Liability Still A Medical Stumbling Block
  • 4/23/2013 9:01:00 AM
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@Ariella Ah, I forgot you didn't have smartphone.

Yeah, the new healthcare laws will force everyone to pay for insurance of some kind. My employer-supported plan went up ahead of the new requirement almost two years ago. We got a comparison chart of the existing plan and the new government plan - the government plan was going to cost a significant amount more. That was crazy. I wish there were an app to make lawmakers read these bills before signing off.

I want to sign up for the heart study but I'm actually a little worried about data breaches. The university will have a lot of personal info.

Re: Liability Still A Medical Stumbling Block
  • 4/23/2013 8:46:22 AM
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@tinym I didn't join. I don't use a smartphone, and the assumption in place for the apps is that the particpants do have one. 

Regarding the group that don't pay for insurance, as I understand it, they will be compelled to, regardless, under the new healthcare laws. 

Re: Liability Still A Medical Stumbling Block
  • 4/22/2013 9:57:12 PM
NO RATINGS

@Ariella I really enjoyed this post. The new face of healthcare assistance is ever-changing and fascinating. Thanks too for linking to the eHeart study. I think I might write about it too. Did you join the heart study?

Re: Liability Still A Medical Stumbling Block
  • 4/22/2013 9:49:18 PM
NO RATINGS

You forgot the third group that can't afford to pay for insurance so they pay out of pocket a few times a year when they get really sick and have to go to a doctor. They don't want to use state-funded healthcare so they pay when the go instead of year 'round too.

Re: Liability Still A Medical Stumbling Block
  • 4/22/2013 4:47:31 PM
NO RATINGS

Broadway, - Laughing at the whole concept of old-fashioned medical care. its interesting to think that some people actually pay for medical care out of pocket. considering how few they are though, i'm certain they will not dictate the trend in the future of medical care. They will be the outliers.

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