Despite the passage of the Affordable Care Act, healthcare in America is far from functional. Aided by doctors, pharmaceutical companies push drugs that merely mask symptoms, and the insurance industry laughs all the way to the bank. New technology, including the ubiquitous smartphone, promises to disrupt this vicious cycle, making medicine cheaper, safer, and more personal.
Dr. Eric Topol is a professor of genomics and endowed chair in innovative medicine at the Scripps Research Institute. After over a decade at the Cleveland Clinic, during which time it achieved a #1 ranking in heart care, Topol started to realize that the centuries-old approach to medicine wasn't working. Tired of watching his colleagues utilize one-size-fits all medicine, prescribing dangerousdrugs like Vioxx simply because they were the latest craze, he searched for a better way. The answers he found weren't in stuffy medical journals or a laboratory, but rather in his own pocket.
In his book, The Creative Destruction of Medicine: How The Digital Revolution Will Create Better Healthcare, Topol marvels at the way smartphones facilitate connection, learning, and sharing, while medical technology has remained behind a veil of expensive secrecy. Current-day medicine is designed for groups. It's expensive and wasteful, blindly prescribing a barrage of tests and procedures without truly taking into account each patient's history and needs. Thanks to the digital technology we already own, Topol envisions a world where visits to a doctor's office are few and far between, where the digitization of our entire physical, emotional and even genetic history allows customized diagnoses, and perhaps most importantly, where high-cost treatments are replaced by inexpensive apps we download and use like medicine.
In this interview with MSNBC, Topol demonstrates how a device designed for his iPhone allows him to virtually eliminate the formal cardiogram, saving time and his patients thousands of dollars. The prototype device designed by Oklahoma City-based AliveCor has two built-in sensors connected to an app. It allows the doctor to step out from behind the chart, discussing the readings and results almost instantly. Patients with access to similar apps on their smartphones can take their own readings at home while the doctor watches remotely and in real time. They're comforted by ongoing follow up care without the trouble or cost of an office visit.
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"Wireless medicine is allowing patients access to high quality medical knowledge, diagnostic information, and the ability to monitor their health in a more convenient way," explained Ravi Komatireddy a physician and clinical scholar in Wireless Medicine at the Scripps Translational Science Institute who workds closely with Dr. Topol. "Ultimately, these devices could lead to more empowerment, engagement individualized medical approaches. As physicians we want patients to feel more engaged and involved in their own healthcare - wireless health devices may be the perfect tools to help achieve this."
If you're wondering how less time in a doctor's office can result in higher quality health care, just think about how much you love playing games on your phone. Angry Birds is hardly on par with a cardiogram, but it's got one big advantage over your doctor's advice about heart health: you're interested in it.
The vast majority of medical therapy, especially the management of chronic disease, depends upon adherence to therapy and positive behavior change. "Medicine for high blood pressure isn't effective if people don't take them; and, it's very difficult for patients to adhere to therapies for various reasons that include prohibitive costs, low engagement, and lack of immediate perceived benefit, among others," said Komatireddy. "However, its amazing how 'engaging' digital devices and apps are for all of us. Many smartphone apps are used everyday to help us organize our lives, communicate with others, and find information." Mobile apps deliver the instant gratification and sense of control we crave. If a medical app were able to show small but daily decline in cholesterol or blood pressure, it becomes an instant incentive to continue positive changes.
Though it's a bit counterintuitive, wireless medicine can also eliminate that "just another chart" feeling most of us get when visiting the doctor's office. This feeling largely stems from the fact that doctors don't have individual information about YOU, or the time to gather it. Knowing the intricacies of your specific medical problems, your physiology, your habits and lifestyle, your genetic makeup, and how you react to different types of treatment are critical to treating you effectively as a unique individual.
"Achieving this level of context has been challenging for two reasons," said Komatireddy. "First, its traditionally been difficult to understand patients and their medical problems outside the hospital and clinic, where they spend the vast majority of their time. Second, even if we have access to this information it's difficult to communicate it to medical professionals in the typical 15-minute time frame of an average outpatient clinic appointment."
According to Topol and his colleagues, smartphones, wireless sensors, and medical apps have the potential to record and convey information about our physiology and health to healthcare professionals in a much more targeted, and concise way--not to mention at a fraction of the cost of traditional office visits, tests, and lab analysis. The interaction between patient and doctor can be more immediate, convenient, and relevant to our own individual lifestyles and how we prefer to manage our health problems.