#247Health at #Scio13

Jan 08 2013 Published by under [Medicine&Pharma]

I will facilitate a session at Science Online dealing with mobile technology and healthcare (#247Health). Cheaper, faster technology has changed the way we read and communicate and work. Now it can change the way we treat disease and preserve health.

I have posted several times on the use of mobile devices as personal coaches for physical activity and diet (see bulleted list below). This can be useful for maintaining or improving health, as well as the management of some diseases. More than 600 apps for the iOS platform address diabetes management  Some blood glucose meters are now smart phone attachments! Other chronic monitoring can be performed as well, including sphygnomanometers that send their blood pressure reading to an iPhone and heart rate and rhythm monitors.

In The Creative Destruction of Medicine, Eric Topol addresses many of these issues. One problem, though, is that while the technology to monitor a lot of stuff is just around the corner, we still do not know what to do with these reams of data. I have standards to judge a 24-hour ambulatory blood pressure recording; I do not know what to do with a week's worth of round-the-clock values at this time. He envisions a future where we can all have our full genomes sequenced at birth and use the data (and periodic assessments of epigenetic changes and environmental issues) to prevent chronic disease. Right now, you could hand your doctor your full genome sequence, but aside from a handful of genes and variations, we have no idea what it means.

Topol envisions a future where each treatment and recommendation can be tailored to each individual's particular characteristics, rather than our present approach of starting with whatever works in large-scale groups (such as a prospective clinical trial). Unfortunately, we have to collect these massive data sets and analyze them before we can individualize our approaches completely. We have been successful with some aspects of pharmacogenomics as he discussed in his book; I hope that I see further individualization such as he describes during my career.

A short article in this month's The Scientist addresses the movement of lower-cost technology to improve diagnostic testing both for the developed and developing world. Blood tests that require a tube through an analyzer here in the states can be read in 10 minutes on a postage-stamp-sized paper. Perhaps most fascinating to me is the advent of low-cost ultrasonography. Mobisante produces a portable US device that records images on a supplied smart phone. While its $7,500 price tag is quite a bit more than standard medical instruments, it still places this technology in the reach of most medical practices. The device proved its worth assessing trauma after the 2011 Joplin tornado, and it has great potential for the developing world as well. Some medical colleges are teaching their students to use US from day 1 to supplement their physical exams.

Just to show you how cool this is, the demo of this device can be seen here:

 

Healthcare is changing in our brave new world. I can't wait to discuss these frontiers at Science Online on Saturday morning.

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