The Real Way to Reform Health? Wireless Technology
The calorie counter from a San Diego-based company called PhiloMetron is just one of the many new high-tech devices that could help us take better care of ourselves.
As you probably know, the health-care reform legislation that President Barack Obama signed into law on Tuesday is really more insurance reform than actual reform of our health-care system. What actually could make us live healthier lives -- and save money in the process -- is combining the use of wireless technology, such as the calorie counter, with our greater understanding of genetics, or what makes us predisposed to certain diseases, says digital health pioneer Eric Topol (pictured).
This will lead to improvement in care because patients will be monitored and treated on a more personalized basis, predicts Topol, chief medical officer of the West Wireless Health Institute, a La Jolla, Calif.-based non-profit focused on developing wireless technologies for use in medicine.
Transforming How Doctors Practice
"We have to get away from the population medicine we use today," says Topol, speaking at the Burrill Consumer Digital Health Meeting in Burlingame, Calif. "We give the same dose of drug and use the same devices and screenings on the same patients. Focusing on the individual and using the tools that we have, whether they are sensors, phenotypes [the expression of certain traits depending on genetic and environmental factors] or whole-genome screening, will get us to the medicine of the future."
Just as Apple's (AAPL) iPhone and Amazon's (AMZN) Kindle are changing the way we communicate and entertain ourselves, new wireless sensors and other gadgets are transforming how doctors practice medicine, says Topol, who is also director the Scripps Translational Science Institute, a La Jolla, Calif.-based outfit focused on using clinical research to improve patient care. The time is now, says Topol, a cardiologist by training who is also chief academic officer at Scripps Health, the San Diego health system part of Scripps.
The world currently has 4 billion cellphone users. The advent of smartphones, smart sensors, pervasive connectivity and broadband 3G are also speeding changes in medical practice, he says.
"These five forces have crated a perfect storm for the medical world to exploit some opportunities here," says Topol.
A 21st Century Stethoscope
Topol says he now uses his smartphone to look up prescription drug information while consulting with patients, saving him from having to go to his computer or flip through a book. Using an application developed by San Antonio-based AirStrip Technologies, Topol can now monitor a patient's vital signs including heart rhythm, heart rate, blood pressure and oxygen saturation on his cellphone.
"You can do this from anywhere in the world," says Topol. "I think this is one of the many ways that we will be able to follow patients."
While many of the technologies that Topol discussed at this conference, sponsored by San Francisco life sciences investment bank Burrill & Company, are in various stages of development, some are already on the market. One is GE Healthcare's (GE) Vscan handheld ultrasound machine, which is being billed as a 21st century stethoscope. Shaped like a clamshell telephone, the Vscan provides resolution as good as the typical echocardiogram machine found in hospitals.
"Why would you need a stethoscope if you have ultrasound imaging?" asks Topol. "You can never get this information from listening to a person's heart." Vscan can also be used to check up on fetal health in remote locations.
Even though all these medical doodads hold a lot of promise, they do face challenges. Among them is the fact that it may be harder for doctors to get reimbursement for new technology such as the Vscan, which is priced under $10,000. Compare that to under $50 for a stethoscope.
Physicians Are Averse To Change
What's more, physicians are notorious for being averse to change. "Physician acceptance and physician adaptability is arguably the most difficult thing to achieve," says Franklyn Prendergast of the Mayo Clinic.
But the potential for many new devices to make doctors' jobs easier -- and to help patients live longer -- may force the issue, experts say. San Diego-based Sotera Wireless is working on a sensor that could capture blood pressure and oxygen saturation through a wrist transceiver, obviating the need for a clumsy blood pressure cuff. The benefit? A patient's blood pressure could be monitored anywhere and continuously.
"It's not just because high blood pressure is the most difficult disease to manage and diagnose," says Topol. "The variability in blood pressure has been shown to be more important" than the actual reading, he says.
How would such devices save money? The iRhythm monitor for irregular heart rhythm, which can be taped on like a Band-Aid, could be used for a week at a cost of about $100, says Topol. Using the traditional Holter monitor -- recognized by all its electrodes that must be attached to the chest -- to observe cardiac arrhythmias can run in the thousands for two days, he says.
Shifting To Digital Medical Era
Topol maintains that we are moving from the "digital lifestyle era to the digital medical era." There are pills in development with digestible RFID chips that will notify caregivers whether a patient has taken their meds. The scanning of an individual person's whole genome, a process that once cost millions, may soon be in the hundreds of dollars, leading to a better understanding of what medicines work best on which individuals.
Meantime, products like the iShoe sensor, which detects deteriorating balance in elderly adults, could help the 40% of U.S. seniors who fall in their homes every year to better avoid injuries.
While there have been many advances, researchers are still working on developing a monitor that would allow diabetics to measure their glucose levels continuously without having to break the skin. "The holy grail of wireless needs is the non-invasive glucose monitor," says Topol. With health reform now underway, perhaps researchers will find a little more support in their quest.