Weigh In: What’s the Next Revolution for Medicine?

By Lisa Raffensperger | August 27, 2014 9:00 am

smart-phone-medicine

Medicine looks incredibly different than it did a century ago (which I think we can all say thank goodness for that). From new technology such as MRI scanners and antibiotics, to improvements in logistics, such as widespread immunization programs and organ-donation schemes, medicine seems to be constantly modernizing.

But for every revolution in medicine that’s complete, there must be a dozen more that haven’t even started. Quick lab diagnostics are great — now how do we make those affordable for clinics in rural Africa? Patients are gathering their own genetic and lifestyle data — now how can doctors use that to improve their medical care?

Shake It Up

Over the last couple of months here at Citizen Science Salon, we’ve featured ten different projects in the “Exploring a Culture of Health” series, brought to you by SciStarter, Discover, and the Robert Wood Johnson Foundation. These projects aim to shake up medicine as we know it.

Some of those were directed at medical professionals. We asked nurses to share their on-the-job workarounds; we encouraged medical staff to imagine a better doctor’s office experience; and we solicited ideas for how charts and graphs could better communicate complex health ideas.

Other questions were posed to organizations, such as hospitals, governments and schools. We challenged orgs to think up ways to reuse wasted supplies, to ensure privacy for patient-supplied data, to improve their community’s overall health, and to provide support to kids who’ve faced childhood trauma.

Finally, the blogs posed questions to all of us as patients. Would you use a free online course to learn more about a health condition you or someone close to you had? Would you volunteer personal information to help scientists study a disease you have? Would you use an app to track your daily habits and report them to your doctor?

Your Turn

We live in an interesting time, where data is paramount and whole industries are built on its sharing. Our smart phones sync with wearable sleep-trackers and pedometers, and we can share that data socially. Wired clothing and smart contact lenses are in development to provide even more real-time vitals. These devices for the moment are for personal use, but someday doctors could, with your permission, also view these feeds and use them to help improve your health.

What are your ideas for how smart gadgets could make people’s lives healthier? Maybe a new app or a new device? Perhaps a reformed approach to medical charts that could integrate user-generated data? Maybe ways to use social networks to encourage healthier behaviors? Or maybe something we haven’t even thought of before now…

We want to hear your ideas. Leave them in the comments below, or email them to editorial@discovermagazine.com. The most inspiring ideas will be featured in an upcoming print issue — and may just bring about yet another exciting revolution in healthcare.

 

Image adapted from kimberrywood / Shutterstock

CATEGORIZED UNDER: Health & Medicine, top posts
  • Lisa Raffensperger

    Another interesting question is how to design apps that produce useable data in the first place. This recent Wired article (http://www.wired.com/2014/07/medical_apps/) describes how many apps make medical claims that are untested.

    On the flip side, though, are these apps – to help doctors quickly identify pills on the fly, to input symptoms and get a list of possible diagnoses – which are clearly a huge benefit to medicine! And maybe even patients themselves? http://online.wsj.com/news/articles/SB10001424052702303376904579137683810827104

  • http://www.mardixon.com/ Mar Dixon

    Wearable Tech such as Google Glass have so much potential when it comes to improving health and well being. Along with providing access to some simple features such as calls using only voice control (important for those with arthritic hands) to the advance features that can come from biometrics, wearable tech can be a massive game change.

    What would happen if the wearable tech (watch, glass, etc) can indicate high blood pressure or warn you of other potential health issues?

    I’m not into fitbit or other apps that tell me how many steps I walk (my aching legs do just fine in providing that information) but if I’m already wearing a device and it can intelligently data gather a baseline of who I am and detect changes that are potential issues, how fantastic would that be?

    • Lisa Raffensperger

      That’s true, gathering this info over time does allow the app itself to detect changes and recommend ways to address them, even if the info isn’t being shared with your doctor. Would you want your doctor to have access too? Would you share these health data on social networks designed to foster some friendly accountability?

    • http://home.uchicago.edu/~jsradford/ Jason Radford

      Just wanted to share this relevant prototype http://www.popsci.com/scitech/article/2008-07/fancy-pants-may-prevent-falls. Please forgive the style if it’s not yours. They’re from Virginia Tech.

      As for a substantive question, what kind of feedback would you like? As I see it, much of the “smart”-ness of a system will be in generating interactions with the user based on long-term data and recent trends (i.e. running for the first time in 6 months). So, what kinds of local knowledge would you want. Maybe like a recommended exercise plan if you decide you want to work out more? Or, maybe some stretch recommendations if it notices an tightening calf?

  • http://home.uchicago.edu/~jsradford/ Jason Radford

    Your personal smart device becomes your everyday health provider: measuring sleep, diet and exercise, mood, and a dozen other micro-variables and providing you feedback and encouragement to eat better, exercise more, and have more fun. It shows you improvements in your nutrition, resting heart rate, miles run, and hours of sleep. You check your stats everyday and feel healthy, happy, and good-looking.

    Your doctor uses your data to monitor your and your community’s health. Medicine is no longer about diagnosis, but early detection and many diseases
    like cancer or AIDS are now curable or manageable because you use the app. In addition to medical support, you also get discounts on things like health, life,and disability insurance. You get bonuses for healthy living from your company and even tax breaks for using the service. To verify your health, you give these institutions access to your data and every mile you run or stair you climb is that much more money in your pocket. The app will remind you of that everyday if you’d like.

    Data breaches are rare, but like breaches today, common enough that you believe they don’t really effect you. And, you believe these organizations will protect their consumers. What can a hacker do with someone’s heart-rate anyway? Plus, it’s not like whomever has your data, if your data was even a part of the data that was compromised, has access now. Ultimately, it’s not like you’re going to stop using the app. You’d never give up all the good things it brings. You’ll continue to use it like everyone else and carry on.

    This health app is so fundamental to how you live your life, your everyday routine, the money you make, how you feel about yourself; that you secretly judge anyone who’s still not using it and make assumptions you know you probably shouldn’t about people who look a little overweight. You marry someone who uses it or finally talk them into using it because we all want to be better, happier people. You raise your family with it. You teach your children how to be healthy and the rewards of trying to be a better person. Within a generation, this healthy app is as taken for granted as the internet itself. It’s a crucial part of the ecology of smart systems your family interacts with on a daily basis. It, along with many other services, empowers the internet of things to enervate your life. To help you be a better person, everyday.

    Underneath all of this, there is still drama and darkness and damage. But don’t worry. There are apps for them too. And we humans are resilient.

    • lump1

      This sounds plausible. I will add that your doctor will have constant access to all this data and will be able to catch potential problems early, schedule you for regular appointments, call you on your cell if if there are signs of trouble and you might need an ambulance, etc. Oh, and also, your doctor will be something like IBM’s Watson.

      • Lisa Raffensperger

        That’s an interesting thought – and I think what you’re referring to is IBM’s stated intention to deploy Watson-style analysis drawing on deep data to connect networks of symptoms and medical history and give a treatment recommendation. (more here: http://www.businessinsider.com/ibms-watson-may-soon-be-the-best-doctor-in-the-world-2014-4) It’s like how we presently use online symptom-checkers – only way, way more powerful.

    • Lisa Raffensperger

      That’s a compelling vision of the future! It’s true that health apps that serve a simply monitoring function aren’t nearly as much of a concern in terms of hacking as, say, an app that was synced to a pacemaker or an insulin delivery system. Do you think those two kinds of medical devices will stay separate, though, or will they eventually converge into one kind of health app that both monitors health and controls it?

      • http://home.uchicago.edu/~jsradford/ Jason Radford

        That’s a wonderfully sharp question and one I hadn’t considered – linking intervention devices as opposed to just sensors to automated systems. Right now, you can still hack an old, wirefree pacemaker with magnets or switch someone’s insulin for something else. Frankly, I think we would turn down such an integration if it helped people. For me the question is not what hacking becomes possible with new technology (a lot of terrible kinds is an assumption I make), but who does it and for what? What does it take for us to build a society capable of being so thoroughly vulnerable?

  • Ike Carpenter

    Because smart phones have become an integral part of most peoples’ lives, not only as a communication vehicle, but as a channel for accessing and sharing information and other resources, it is natural that they are playing a bigger and bigger role in individual health and wellness, and the treatment of disease, from data collection, to education, to treatment collaboration, to reporting. One of the big reasons this is happening is through the availability of platform and data APIs that make it easy for suppliers of information, products, and services to integrate their offerings into the resources that patients and providers are already consuming. We are already seeing smart phones track heart rate and steps through their cameras and accelerometers, and measure blood sugar levels, blood pressure, and more, through the same port on the smart phone that other companies use to capture credit card data. Through APIs (web services that let different programs share data and functionality) , these same smart phones can access data captured through other devices (like smart scales that capture weight and body fat and put it on the cloud where can be accessed through the smart phone), via numerous apps and phone-centric web applications. While this is great, the big opportunity lies beyond capturing the data. The big opportunity lies in communicating it the person’s care providers, and other people in their “network of care” to provide “actionable insight” into the need/opportunity to intervene either to address a deficiency, or encourage effort and acknowledge achievement. In addition, through APIs, that data will get captured into the individual’s health record (eventually provided by the government.. sorry to all of the EMR/EHR vendors out there) where it will not only be easily accessible by the individual’s providers in the future, it will also become part of the individual’s “personalized health algorithm” ( think if it as a person’s “daily health index”) that will be accessible at the touch of a button on the person’s smart phone. And while we’re on the subject of data, let’s not forget the “big-data” opportunity. By capturing personal health information in real-time (much of which will come from smart phones and linked devices), from millions of individuals, we’ll gain insights into healthcare opportunities, options, and outcomes that we’ve never had before. Insight that can inform healthcare policy, best practices, and research.

    In addition to APIs, there are health platforms that are leveraging smart phones to help care providers extend their care beyond the office visit. Companies like Patients Matter (https://www.PatientsMatter.com) are helping care providers (via their smart phones) to easily provide health education recommendations to those the serve. These recommendations are then easily accessible to the recipients of those recommendations (via their smart phone), so they can be accessed at a time and place that is convenient to them. Furthermore, as the recipient accesses each recommendation, their activity is tracked. This compliance information is available to the care provider (via their phone, of course) which helps to inform them as to what to do next. By extending treatment from a series of disjointed visits into a “continuum of care” between the provider and recipient, both parties benefit.
    Health platforms like Patients Matter also encourage care collaboration. And I am not just talking about collaboration between care providers… the collaboration I am referring to extends to supporters, suppliers and payers. Using their smart phones, supporters share recommendations that they have received ,with others who might benefit. Suppliers are also providing smart-phone-centric applications that capture data that will help them to tailor the solutions they provide to each consumer (for example, individuals can already order daily vitamin packs that are formulated and packaged specifically for them), and payers will (eventually) dynamically adjust benefits and premiums based on each individual’s contribution (i.e. effort) towards caring for themselves, and caring for others.

    All of this becomes more and more possible through the ubiquitous presence of smart phones in our lives. Those devices whose purpose has already evolved beyond letting us talk, text, and post what we had for breakfast. They are now becoming devices that empower us to care for ourselves and care for others. In the end, this is where healthcare change must come from…. from the premise, and promise that “care comes first”!

    • Lisa Raffensperger

      Those are really great insights. I like the idea of a “continuum of care” – that’s definitely one of the promises of this new area, but I haven’t heard it described so succinctly.

      Would a “personalized health algorithm” essentially be a daily guide to health goals, based on all your recent metrics? E.g., it would tell me, Today you need to eat 4 servings of vegetables (you only ate 1 yesterday) and, come on, take the stairs this time ok?

      • http://www.PatientsMatter.com/ Ike Carpenter

        Lisa – Thanks for the comment about “continuum of care”. In my opinion, it can be applied to describe many aspects of health…

        Lifespan: continuum of care from cradle to grave

        Personal Health Challenge: continuum of care from wellness to prevention (like vaccines) to sickness

        Provider Interactions: continuum of care
        beyond the office walls

        Provider Networks: continuum of care created by collaboration between providers

        Personal Network Of Care: continuum of care
        that captures all of the above, and pulls in Suppliers, Payers, and Supporters (family and friends).

        Regarding your question about “personal health
        algorithm”. The answer is “yes!” And there is
        more! (If you buy now… you will two sets of knives… sorry… couldn’t resist:-) What I mean by “more” is that:

        It can be used to guide you beyond providing “real time” direction. It can also be used as a measurement over time to guide you on changes that need to be made like:

        “your % body fat has increased over the last 30
        days… time to exercise more/eat less each day”

        – or –

        “Your average resting heart rate has increased
        10%. And we see that you have not cut back on your aerobic exercise. You might want to visit your Dr.”

        And the “personal health algorithm (PHA)” can
        be used to help others determine how best to interact with you as your:

        Supporter: “Ike, I see that your overall PHA
        is going up… Great job”

        Care Provider: “Your score has gone down since your last visit… let’s look at what you’ve been doing differently. (And then the PATIENT pulls out their “activity” chart)

        Payer: “Congratulations! Your PHA score
        qualifies you for a discount”

        Of course, all of this requires the capture of information (which smart watches
        can help with), and the integration of all of the disparate solutions (which APIs can do). In my opinion, the only way we can do that, is to have
        it be driven by the one party who should be the most interested – the individual! This will happen when the pain of change becomes less than the pain of keeping things the same. Personally… I think we’re getting there!

  • Massimo Giulianelli

    Information gathered with personal devices to monitor vital parameters should be used by researchers to conduct large scale research, provided privacy is guaranteed. This could change studies on large popuations allowing medicine to highlight differences between them.

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