May 30, 2013
For all the misconceptions–both positive and negative–about what’s now known fondly and acridly as Obamacare, one thing that is clear is its focus on shifting the U.S. health care system from one in which doctors and hospitals are rewarded for ordering tests and procedures to one built more around preventive care and keeping people healthy.
As is often the case, technology is racing ahead of policy, finding ingenious ways to use little sensors or Big Data to devise early warning systems for health trouble. In fact, it’s fomenting medicine that’s not just preventive, it’s predictive.
Follow the behavior trail
One of the more innovative approaches is a mobile app called Ginger.io, from a company of the same name. It’s based on the idea that changes in a person’s behavior–perhaps something as seemingly mundane as a lull in making phone calls–may tip off the start of a spin into bad health or depression.
That may seem a bit of a leap, but research has found that people with chronic medical conditions, such as pain or diabetes or mental illness, tend to withdraw if their health deteriorates. They stop reaching out to friends and family, don’t go out as much, and lose interest in taking care of themselves. Often, that’s when they quit taking their meds.
So the app tracks how frequently someone uses his or her phone, how often they move and if they do go out, where they go. If it notices a change in patterns, particularly too much isolation and too little activity, it sends an alert to a designated person. It might be a doctor, it might be a family member.
Ginger.io has been described as a human “Check Engine” light in that it’s designed to flag potential trouble before a person breaks down. One of the app’s advantages is that it keeps a precise record of what a person has been doing or not doing, rather than depending on the often unreliable or skewed memories of patients.
A number of U.S. hospitals are now testing it with patients who have opted into the alert system, but it’s still not clear how effective it can be. There’s no way to tell, for instance, if a person’s been inactive because he’s depressed or just has a bad cold. Will doctors and nurses end up wasting time and money on waves of false alarms?
There’s also the question of whether patients, even though they’ve chosen to use the alerts, will start to feel they’ve given up too much privacy. For now, though, they seem to like the access the app provides to caregivers. They feel like doctors and nurses are actually keeping an eye on them.
The doctor will text you now
At the same time, patients are more in control of their personal health data than they’ve ever been. Increasingly, it’s in their smartphones, not locked away in a doctor’s office or a lab somewhere. And that, predicts Dr.Eric Topol, is going to forever change the role of doctors. They’ll still advise and treat patients, of course, but less as an authority figure and more as a collaborator, says Topol, the chief academic officer of Scripps Health and author of “The Creative Destruction of Medicine.”
As he told Forbes in an interview earlier this year:
“We are ending the era of medical information asymmetry, with most of the information in the doctor’s domain. The consumer is now center stage–he or she will drive this new medicine with a rebooted model of physician partnership. It is the consumer’s data, the consumer’s smartphone, and the consumer’s choice of who, when and how to share.”
Topol is equally evangelisitic about predictive medicine, although his focus is on early warning systems based on biology rather than behavior. He’s convinced that it won’t be long before scientists will be able to send tiny sensors into our bloodstreams that will be able to detect the first molecular signal of a heart attack or the development of the first cancer cell.
And yes, your smartphone will be the first to know.
Thoroughly modern medicine
Here are other recent health tech innovations:
- Tracking ticking brains: The Defense Department is doing a trial with a company named Cogito Health using software that tries to measure whether a soldier may be developing PTSD by identifying if he or she is withdrawing or becoming more manic.
- Stop making sense: Recently purchased by United Healthcare, a Boston firm called Humedica crunches the Big Data of patients’ electronic records so hospitals can get a much clearer idea of how often different treatments actually help people get better.
- So quit blaming the cat: An app named Asthmapolis uses a sensor attached to an inhaler that tracks where a person is and potentially what triggers are around when they have an asthma attack. And it saves that info on the smartphone.
Video bonus: Dr. Eric Topol went on “The Colbert Report” not long ago and actually managed to get in a few words about the future of medicine. He also examined Stephen Colbert’s inner ear. It’s not pretty.
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