Saturday, February 22, 2014

Brave New World for Empowered  Patients

The brave new world of digital medicine is coming about by  the convergence of three rapidly evolving technologies – IT, or informational technology, involving wireless signaling, cloud computing and most particularly, the spread of even more sophisticated smartphones; medical applications of nanotechnology; and the progressively lower cost and availability of genome sequencing.

Robin Cook, MD, and Eric Topol, MD, “How Digital Medicine Will Soon Save your Life, “ Wall Street Journal, February 23-23, 2014

Don’t get too far ahead of the parade that people don’t know you’re in it.

John Naisbitt, Mindset!  2007

Amidst all the health care turbulence,   the disastrous rollout of, the politic turmoil over ObamaCare,  the  call by Larry Kudlow for a three year moratorium on the health law,  there is another school of thought:  that somehow medical innovation will save the day and the health system and  patients empowered by all knowing, all connective smart phones,  will  step in and save the day – and the health  system.

Don't Count on It Soon

Don’t count on it in the near future.   As Doctor Topol, a cardiologist  at Scripps Clinic in San Diego noted in his book, The Creative Destruction in Medicine (Basic Books, 2013),  it sometimes  takes 17 years for big innovations to filter down  to the level of  practicing physicians.  This may not be true in the age of instant messaging as indicated by Facebook’s acquisition of for $19 billion,  but  other factors  ought to be considered.

·         Unanticipated consequences mostly related to privacy.

·         Misuse of information by hackers and identity thieves

·         Patients overwhelmed with too much information.

      To these factors I would add the sluggishness of state and federal bureaucracies to process, understand  and pay for medical and technological innovations. 

       Nevertheless,  as Doctors Cook  and Topol  speculate and project: 

·         “Digital medicine will soon save your life.”

·         “In the very near future, your avatar doctor may be able to warn you days in advance that you are going to have a heara heart attack by sensing circulating  in your blood stream and sending you to your cardiologist  or to the ER.”

·         Regardless, digital medicine is coming over the next few year with the force of a hurricane  whether we doctors – and we patients – are ready or not.”

       How Soon Is "Soon"

These statements may  all may be true – but how “soon” is “soon”,  what is the “very near future,” and  how long are “the next few years”?   

It may be that “when you wake up with chest pain, your smartphone rads your ECG. If  it’s a heart attack, it calls an ambulance and sends your data ahead  to the ER.” 

 I hope so and I pray so, but I’m not holding my breath waiting for it to happen “soon.”

In the meantime,  it may be worthwhile for physicians and patients  to heed the slogan of the Army Corps of Engineers in World War II,  “The impossible we do immediately,  miracles take a little longer.”

Tweet:  Patients empowered with smartphones  may transform “sick care” to “health care,”  to immediately save lives, but it will take a few years  for this to become a reality.

No comments: