Democratizing Health Care Via Smartphone
Jan 07, 2016
Having a medical app on your smartphone is not just a cute gadget anymore, according to Scripps cardiologist Eric Topol — it’s part of a revolution: the democratization of medicine.
Topol spoke with Aspen Idea and Atlantic editor Corby Kummer during the Spotlight Health portion of the 2015 Aspen Ideas Festival, demonstrating and discussing some of the best recent medical advances in smartphone technology. Now that people can create their own cardiograms, monitor their glucose, interpret skin rashes, and check for ear infections — all with devices that relay information to smartphone apps to interpret — patients are able to take more control of their health care, and medicine is slowly moving toward what Topol believes is a long overdue bottoms-up approach.
“This is kind of a Gutenberg moment in medicine,” he said, referring to the 15th century printing press that changed the world by democratizing information. Topol explained that up until now, medicine has been practiced from the top down, with the all-knowing doctor in charge of every step, from diagnosis and monitoring to treatment to medical records.
He pointed out the waste in the current way of doing things, including $3 trillion spent on health care in the United States (more per capita than any industrialized country), half of all prescriptions not being followed, and how 80 percent of the time, the leading drugs simply don’t work in those individuals.
Individualized medicine — which includes patients being able to come into a doctor’s office with their own data and trusting technology to do the interpretation it is now capable of — is part of the answer, according to Topol. “Our lives were changed totally by smartphones in every sector of our world, except for health care and medicine — and that’s about to go through radical change.”
He gave as an example a consumer-grade otoscope that magnifies the ear drum, transmitting the picture to the cloud to determine whether it harbors an ear infection or not. The algorithm the program uses is more accurate than most pediatricians’ interpretations, said Topol. There’s also a prescription reminder and adherence tracker app, as well as a wearable glucose monitor that sends a warning via cellphone app if one’s blood sugar is too low.
Here, Topol demonstrates the cardiogram app and explains why it’s a good thing.
“That’s the thing that is so transformative, because the doctor-patient relationship was about doctors’ orders and doctors having control and autonomy,” said Topol. “And now what we’re talking about is a co-pilot, a type of partnership relationship, where the patient is armed with their data.”
Naturally, many in the medical establishment are suspicious of patient-generated data and are fighting what they see as loss of control. But Topol argues that shifting routine monitoring and diagnostics to the patient's control will make overworked doctors’ lives simpler, allowing them to be more involved with treatment and data oversight. And with more reputable tech firms investing in the medical space, many of these devices and apps are rigorously reviewed and FDA approved.
All of that, along with other medical advances such as genome sequencing and blood and saliva tests for an increasingly broad range of conditions, points to an inevitable shift from the paternalistic, doctor-centered way of practicing medicine, said Topol. But it will most certainly need a nudge from consumers and, perhaps more importantly, large employers who manage health insurance for their employees.
Topol concluded: “Everything we do is not individualized, but we can get there, because we have the ability now to construct a Google medical map of each individual: physiology through sensors, anatomy through scans, external features, phenomes, DNA sequence … . You can even use sensors to quanitfy your environment. So we have this new capapbility in medicine that we never had before to have this high-definition human being and to get out of this waste, this ridiculous way of praticing medicine all these years, which is mass medicine.”
Watch the full session here.
By Catherine Lutz, Guest Blogger