Sunday, September 8, 2013

Now, Instant Diagnosis on  Drop of Blood
Our whole society is instantaneous.
Bryan Cranston (born 1955), American actor, writer, director
And once you get instant communication with everybody, you have economic activity that’s far more advanced, far more liquid, and far more distributed for everybody.
Marc Andreesen (born 1971), American entrepreneur, founder of Netscape
We live in an age of instantaneity. It is the age of Twitter, Facebook, social media, mobile devices,  smartphone,  Wikipedia,  instant news,  instant destruction of established businesses, instant communication at all levels of society,   and now instant diagnosis.

We may soon know what diseases we have or are likely to get even before we know we have them and before they get us.
According to a September 7 interview by Joseph Rago, a member of the Wall Street Journal editorial board , with Elizabeth Holmes,  a 29 year old Silicon Valley entrepreneur who founded Theranos, a health care business,  in 2003, it is now possible to provide more than a thousand laboratory and genetic test results from a single drop of blood, instantly, more accurately, and more cheaply  than before. We can get results within hours rather than days or weeks and establish an instant diagnosis.
If this instantneity works out as predicted,  it could upend the entire medical laboratory industry. The 6.8 billion tests now perfomred  now accounts for 2.0% to 2.5% of all health care spending and drives 7 to 10 of clinical decisions.

For perhaps the first time, we may be able to increase quality while decreasing cost.
Ms. Holmes envisions a Theranos clinic coming soon to a pharmacy near you. The company is launching a partnership with Walgreens for in-store sample-collection centers, with the first one in Palo Alto and expanding throughout California and beyond. Ms. Holmes's long-term goal is to provide Theranos services "within five miles of virtually every American home."
Ms. Holmes claims Thernaos technology testing could cut laboratory test costs in half and save Medicare $61 billion  and Medicaid $8 billion over the course of ten years.   The new  nanotechnology might may  eliminate the need for phlebotomies andblood drawing stations  and put thousands of medical technologists, pathologists, and medical labs out of business.

It might also reverse a current trend – that new medical technologies may increase quality but they also increase costs.    The promise here is that new technologies would not only increase quality but decrease costs and speed diagnosis in the process.
As a veteran clinical pathologist who co-owned a medical diagnostic laboratory. I am of  three states of mind about all of this. 

One, I think it is theoretically possible and could instantaneously generate instantaneous clinical diagnoses,   before a disease became manifest. 

Two,  I would like to see the technological and diagnostic accuracy validated before leaping to any conclusions.  

Three, if validated this would be an example of the power of digital technologies to produce the “creative destruction” of an established medical industry.  

This is not as far-fetched as it might seem.  After all,  Internet- related “instantaneities” have already undermined or rendered obsolete many newspapers,  encylopedias, retail stores,  and other businesses dependent on print and foot traffic.   Why not medical laboratories, too?

Tweet:  It may now be  possible to create instant diagnoses from  a single drop of blood within hours at ½  the price and in far less time than currently required.

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