The Doctor in Your Pocket

So you go to the doctor's office for an annual exam. You wait half an hour to be seen. Then you sit in the exam room until the doctor gets to you. The doctor breezes in and starts asking questions while she writes your answers into her laptop computer, hardly making eye contact. She looks in your nose, mouth and ears, listens to your heart, takes your blood pressure, etc. And since there are no abnormalities she's out of the room in eight to ten minutes and sends you to a lab for blood work, standard procedure. You wait for the lab results for a week or so and you only get a note from your doctor that they were all in the normal range. Then you and/or your insurance company are billed for several hundred dollars.

Now, what if you only needed the doctor when you have a problem. Instead of going to the doctor's office for an annual exam you have your vitals checked by your cell phone with results to you and your doctor in a matter of minutes. The doctor's office, or a data bank, can track any changes. If you aren't feeling great you can see a nurse practitioner or medical tech, no appointment needed, who has a hand-held scanner that can x-ray, MRI, CT, or ultrasound, if needed, and has another handheld that checks your urine and blood. (You could have those apps on your cell phone if you want, but who wants to use a phone that has body fluids on it!), The results are back within minutes and the interpretations are right there for you to see. The results also go to your doctor and if you need to be examined physically for some reason he/she will make an appointment. But you can be SEEN by the doctor via Skype. Not only is this making medical care more accessible, but it will also ultimately lower costs.

The technology is available now. So why isn't it being used? Think about it. If your section of the labor force was to be reduced by technology, you'd resist, right? Well doctors are mostly stuck in the old way of practicing medicine, the way it has been practiced for hundreds of years. And since the majority of doctors now practicing are over fifty years of age, they are slow to warm to the technology. But a couple of the largest teaching hospitals in our country are using the handhelds with new doctors, so it won't be so long until it is more commonplace to have a doctor in your pocket.

There are already apps available for smartphones that monitor blood sugar, look into your nose, throat, and ears, and track other symptoms. This engages individuals into their healthcare at a greater degree and makes for better compliance to medication and treatment. And the wearable data collectors like FitBit can provide a much wider window of information than that of the monitor of vitals by a doctor visit. They monitor pulse, sleep, physical activity and can monitor blood pressure as well. If you connect that to your medical professional they could get an overall picture of your level of functioning.

Why is that better? Well, if your blood pressure is only high on Monday morning and your doctor appointment is Tuesday afternoon, the doctor - and you - will not know that you have stress related HBP. You could have a stroke or heart attack without warning. Or if your blood isn't tested during a time when something is off you'll never know. You can't actually live at the doctor's office or lab!

And research has shown that an individual's self report of symptoms is more accurate when reported to a computer than when reported to a human face to face. Psychiatrists are beginning to use Skype and computer contact to better track clients status. And it appears to work better with cases of depression especially.

Yes, we can have better, more accurate, and less expensive medical care when we engage patients in their care and when doctors have more data about their patient. That is already here with the use of electronic data collection. CPAP machines can transmit data about the quality of sleep and the efficacy of the individuals use. Electronic scales, blood pressure machines, and thermometers can transmit data via the telephone or wifi to monitor people like my mom, who had a heart condition and was house bound. She experienced that technology more than ten years ago. So imagine how useful it COULD be if it were common practice beyond the elderly.

The newest technologies are making it possible for people in areas of the world that have too few, or no, doctors to get medical care anywhere there is an internet/smartphone connection. They are even delivering medications or blood via drones where the terrain is too rough for usual transport. There are people in undeveloped countries that are getting better, more modern healthcare than those of us in the Western world because they are open to new things that work.

I've mentioned only some of the new developments and if you are interested in learning more specifics, I recommend the book I've taken this information from, as it goes into much more detail about all of this. It is eye-opening.  The Patient Will See You Now, the future of medicine is in your hands, by Eric Topol.

When your health care is truly in your hands, you will have more control over your own body's needs. Not only will your medical records be available at any time, but so will your healthcare. We can encourage the young medical professionals to keep up with all the new developments and compliment their practice with cutting edge technology. And we can stop worrying about a shortage of doctors in the future. We will need fewer doctors but we will need smarter doctors, doctors who can take the amazing amount of data available to make much better decisions about care.

And we will need bigger and better data collection that is secure. This will take time to develop but it is something that will happen. We are on our way to democratized healthcare. The future of medicine truly is in our hands.

The Future Medical Practice Is Here

Your smartphone is your door to your medical care.* We now have technology that will make going to the doctor less frequent and less expensive and far more convenient. Are you aware that in undeveloped countries doctors are few and far between? And medical tests are often out of the question because of lack of access. Yet technology is changing that.

For years technology has made it possible for doctors to see patients via teleconferencing/Skype. It's been used in the U.S. prisons when it isn't practical to take the prisoners to doctors or hospitals.They can now connect with clinics or nurses via the Smartphone anywhere there is wifi.

But technology has taken it way beyond that. They have developed apps that will test blood sugar and other blood tests, pulse, blood pressure, temperature, etc. And the results can be analyzed almost instantly with results to you and your doctor.

There are even apps that will test your genome type and screen for potential genetic disease. And recently I saw an article that explained an app that can change the genetic structure of a cell in order to cure certain cancers!

There are also algorithms that diagnose illnesses with greater accuracy than humans given the same data about the patient. "With demographic, physiologic, anatomic, biologic and environmental data about a particular individual can be used to define one's medical essence."*

And with the proliferation of wearable wireless sensors, like FitBit and others, physiologic data is collected and relayed like a smartphone. By way of electronic monitors Individuals can transmit information from their body to medical professionals [or medical data centers] to monitor heart rate, pacemaker activity, blood oxygen levels, weight changes, blood pressure, respiratory rate, galvanic skin response, eye pressure, blood glucose, brain waves, intracranial pressure, muscle movements, and many other metrics.

"The microphone of the smartphone can be used to quantify components of lung function and analyze one's voice to gauge mood or make the dignosis or Parkinson's disease or schizophrenia. One's breath can be digitized to measure a large number of compounds, such as nitric oxide or organic chemicals, which could enable smartphones to track lung function or diagnose certain cancers.  Beyond all those wearable and non invasive sensors, nanochips are being developed to be embedded in the bloodstream to monitor the appearance of tumor DNA, immune activation, or genomic signals indicative of a forthcoming heart attack or stroke."  It is used to track the progress of chemotherapy in shrinking/eliminating cancerous growths.

We've all seen technological advances in scans of the anatomy of individuals beyond Xray - MRI, CT, nuclear scanning, and ultrasound - that define one's anatomy without surgery. All these scans however rely on access to expensive hospital and clinic-based equipment. There is now an emerging use of pocket devices that obtain high-resolution ultrasounds or X-rays making assessment of individual's anatomy much easier, faster, and cheaper. A smartphone or some other small device can now perform the physical exam of the eyes, ears, neck vessels, heart, lungs, abdomen and fetus, and share share medical imaging that enables the patient to fully review his/her anatomy on a portable device. All this is already available.

So why are you still waiting weeks or months to see a specialist, waiting hours for your turn to see the doctor, paying outrageous amounts of money, to get vague explanations of what is happening in your body?  That's an easy one to answer.

While the technology is changing at breakneck speed, the medical profession is not. They are highly invested in the status quo. Why would they support advances that minimize their control over diagnosis and treatment? Why would they support development of technology that makes them less relevant? For them to change would mean a whole culture change in the field of medicine. While some places in the world are using these technologies where medical care is inaccessible, we in developed countries are being left behind. Hard to imagine that our medical care is less advanced than that of the more undeveloped parts of the world.

But change will not be held in check for long. As we become more aware of what is happening around the world we, as consumers, will demand better care. One reason the change will reach us is that it will be less expensive. Insurance will push for lower costs, as will we all.

We must take ownership of our medical information, as we have every right to our records and to information about diseases. We are smarter consumers now that we have access to the internet's vast body of information on illness and disease. And we have the power as a group to demand easier access and lower prices.

Together we can make lives better with better medical access in all countries in the world. With wifi access spreading everywhere, so then can medical care. The change is happening. Be part of it!
, by Eric Topol.

*The Patient Will See You Now, the future of medicine is in your hands, by Eric Topol