Digital Medicine Will Reshape Hospitals

OK, it's a loooong way from today, but the direction sounds right to me. How about you?

... So my iPhone tells me I am having a heart attack.

Do I download an app to fix it, or go to Rapid Oil Change to get a stent put in?

I fail to see how whiz-bang sensors obviates the need for hospitals

I'd agree with ANON above.....self-monitoring might save you going to the doctor, and possibly you could get an electronic prescription for any needed medicine....but if you need to be cut open and fixed, I think the hospital's going to be around for a bit.  Say you're in an accident and broke some bones, or need open heart surgery or even an appendix removed.  How will you do that without hospitals?

David: Where is your sense of adventure, the telly sense robot is going to do the op.

But like you I would opt for the Hospital theatre fully staffed.

You won't need the kinds of mega insitutions we see in our communities today once we get a predictive, personalized health care capability in place.

But yes, "eradicate" is probably too strong a term given the need to set bones and etc.

Rick, you quoted the speaker saying:

"You could know days or weeks before having a heart attack, and get a special heart-attack ring tone that hopefully won't give you a heart attack," he quipped.

Geez, I would be terffied if I get that frigging heart-attack ring tone. Seriously. Then, what am I supposed to do? Call an ER? 

I don't think it's such a long way, actually, at least for the testing aspects of medicine that doctors' offices or hospitals do. Sure, if you need surgery, you'll still need to have someone cut you open. It's the stuff before surgery that could be streamlined considerably.

I totally agree with the notion that medicine is "stuck in the 1960s," although even that has been slowly changing. One reason why medical care is so expensive, and always becoming more so, is that it's not exploiting the digital revolution like other industries have been. Education and medicine are still amazingly labor-intensive. That's what has to change. If the CE industry were similarly still labor intensive, we'd all be living more like in the 1950s.

Hey David. The autonomously driven vehicle will keep you out of the accident. Digital electronics saves the day again!

Rick, the term 'eradicate' is indeed a strong one. The value-add from sensors & monitoring thereof comes from a wealth of data these gadgets can collect and help the physician to make diagnosis and treatment. There are many such monitoring data that are otherwise almost impossible for the physician / med tech to collect in real time, some of it during the occurence of the medical condition itself (for eg., the EEG ichtal data collection in real time that I wrote about last year):

http://bit.ly/HOiz5v

It seems to me that physicians of tomorrow will also become better data scientists, not necessarily by choice!

MP Divakar

An earlier version of this story incorrectly said digital medicine would "eradicate" hospitals and make them "obsolete."

This was an exaggeration of what the keynoter, Eric Topol, said. In a note to me Topol said he believes that with the rise of digital health care "the role of hospitals would be changed/limited to ICUs, operating rooms and procedure rooms."

I was aiming to echo the phrase "eradicate disease" and stretched the speaker's concept to the breaking point. My apologies for the exaggeration.

"In a note to me Topol said he believes that with the rise of digital health care 'the role of hospitals would be changed/limited to ICUs, operating rooms and procedure rooms.'"

True enough, and in fact, that trend has already been happening. Which is why I don't find this all that surprising of change. There are now many tests people can do on their own, even without the assistance of a smartphone, that once required a visit to the doctor's office. And more on the way. Any number of heart and blood tests can be done at home already. Good deal.

But still, much new medical tech is going to hospitals, to improve medical care, but not really geared at reducing labor content. I'm sure the AMA is dragging their collective heels at some of this innovation. I'm looking forward to when you never need to visit with a doctor at all, unless you have to get something physically fixed. You know, much like built-in diagnostics in a car reduces unnecessary downtime AND makes the mechanic's job easier when his intervention is required.

@rick , it might happen faster than we think. Theranos[2] is developing a lab-on-a-chip platform that would enable testing for multiple proteins for cheap(tens of dollars). They already offer some tests to the public probably at walgreen, standard , cheaper blood tests, with only a pin prick o blood .

And the vision of theranos is to offer disease monitoring.

If the protiens that predict heart attacks are known[1] , it might be a relatively short process to get it to market since you don't need to do clinical trials only tests that show your device measures accurately.

I can imagine that people with high risk would go do a biweekly or weekly tests.

[1]An article about eric topol , discovering CEC cells predict heart attack , and there is a protein profile for CEC cells. http://healthland.time.com/2012/03/22/scientists-devise-a-blood-test-to-predict-heart-attack/

[2]Theranos really sounds like a company that can transform healthcare.

The problem with digital medicine, at least this personal sensor push, is that people have to wear the sensors consistently for these benefits to accrue. It makes me think of the scene from Apollo 13 where Tom Hanks gets tired of Houston control commenting on his heartrate and stress levels and he tears off all the sensor leads. I, too, would feel intruded upon if I were telemetering my vital statistics 24/7.

Maybe in a generation or two the technology will be ubiquitous and inexpensive enough that literally everyone will be instrumented in this way. THen hospitals may need to change. But not for quite a while.

"The problem with digital medicine, at least this personal sensor push, is that people have to wear the sensors consistently for these benefits to accrue."

I wouldn't word it that way, Rich. I'd say instead, one ADVANTAGE of low cost personal sensors is that you CAN wear them consistently if there's a benefit to doing so, where in the past this was not typically possible.

But for example, for blood pressure, glucose, cholesterol, etc., no one is mandating that these be monitored constantly. You take the tests whenever it's most convenient for you, and not when most convenient for the doctor. There are many such tests you can administer on yourself these days. In most cases, the results are available immediately. No need to even mail anything to a lab.

@Rich:  A friend told me he was faxing his doctor a handwritten log of his blood glucose levels for three days at a strech. One time he sent a week's worth of data and the doctor told him "I don't need that much information."

So much for continuous real time monitors! ;-)

Same here, sent the doc blood pressure readings taken thrice daily.  Levels all over the map.  Doc said not necessary to record so much.  Looking for a new doc...

Yes, my doctor wants my results put into as few numbers as possible. So, a six-month average is good enough for him. All he wants to know is if my meds are adequate for controlling my blood sugar. I can see how this continuous monitoring might be useful for some critical conditions, but in gereral? And if not generally useful, it wont affect the role of hospitals.

@zeeglen: I love it: The search for a digital doctor. Good luck!

I think the pushback from doctors ("I don't need this much data") is because of a fundamental mismatch in interest between the patient and the doctor. When the patient is sitting in the office they have (or appear to have) the doctor's full attention. It is easy to forget that ten minutes later someone else has their attention. If the doctor is equipped to easily accept the data and automatically do a trend analysis then it becomes useful to them. Otherwise, it is just a neurotic patient that is eating up their time. If we are faxing readings to them they have to absorb a lot of what might be questionable information taken by untrained techs (that would be us). Unless we can get them the information in a useful form they will in most cases resist it.

The potential for digital medicine to detect and illness where people live and work is exciting. Now diagnoses may be made before serious medical damage is done. Furthermore, it cuts costs and potentially detects conditions that only occur in work environments, while sleeping, or under particular stresses that would be missed in a clinical setting.

Quite agree digital medicine is the field where so much can be done for human betterment. But when you try living with technology there are always some limitations. But yes so much can be done an dimproved in healthcare sector with technology.

I work in digital imaging and love how the technology has helped to save lives.  The advantage that we are seeing is that I could have an issue and be in California, but the formost expert on my issue may live in Texas and in a matter of seconds the images can be made available to them for review.  I have implemented systems for the DoD that allows them to do this.  It has exponentially increased their quality of care.

What I like about this is that if you have some issue that requires monitoring you will no longer be tied to a bed in a hospital.  This technology will allow one to live their lives with more than likely some restrictions. 

I see the sensors more than likely being in the form of some jewelry or something like that. 

I would prefer to know I was showing symptoms of a heartattack than to be be driving down the road and have an actual heart attack, thus endangering the lives of others.

I just see some many positives for this, especially in places like the antartic for research expiditions, etc...