Have you ever wondered why doctors and hospitals own your medical records? You pay for the visits, labs, scans and hospitalizations but you have no product to show for it. And getting a hold of your data about your body is often exceedingly difficult. The good news: this tight clench of your medical information is about to be released.
That's because you will be generating quite a bit of your medical information via your little mobile devices. The remarkable impact that smartphones have had on our everyday lives is currently being extended to your health care. The range of data that can be captured and processed via a smartphone is mind-blowing. This includes input from sensors -- such as blood pressure, glucose, oxygen concentration in the blood, heart rhythm, lung function and mood.
Virtually all the routine labs can be quickly assayed from a droplet of blood. From a fingerstick, it is now feasible to get your results for various blood chemistries, electrolytes, liver, kidney, thyroid function tests and blood counts. Using a simple smartphone attachment, you can now perform much of a physical exam yourself, including of your eardrum (especially for a child with a possible infection), skin, throat and oral cavity, lungs and heart. It's not just about what's inside you; it's about your environment. There are smartphone sensors to quantify your radiation exposures, the pesticides in your food and the quality of the air you are breathing.
While this may seem daunting to many, there's more help to interpret all this data than you could ever imagine. Computer software algorithms embedded in smartphone apps can analyze the medical data that you generate. Or more likely the data is remotely processed via cloud computing, that can also incorporate medical machine learning about your data. With this, your phone could warn you that your heart or lungs are beginning to malfunction well before you start to have symptoms.
"Your phone could warn you that your heart or lungs are beginning to malfunction well before you start to have symptoms."
There's even the potential link of your smartphone data now to a supercomputer that instantly accesses all of the world's medical literature. This triad of you, your medicalized smartphone and immense computing power is setting up a formidable force to change how health care can be rendered. For those who want to capitalize on this opportunity, it is here now and will be increasingly available wherever there is a mobile signal.
Just this month, there was a report of a study in Rwanda in which a smartphone attachment was used to accurately diagnose HIV and syphilis in less than 15 minutes, for pennies. This concept of having a "pathologist in your pocket" to rapidly make the diagnosis of almost any infection may seem foreign. But it is just one example of how the portability of a little device is bringing advanced medical technology to the hinterlands of the earth.
Notably, all of this data flowing into your smartphone is a challenge to the autonomy of the medical profession, which has deep paternalistic roots that trace back well before Hippocrates (~400 BC). All of this data that was previously unobtainable by you -- now being captured in the context of your daily life -- is more than empowering. This new "bottom-up medicine" forever changes the patient-doctor relationship to a partnership on equal footing.
"Doctors will now be asking for access to the data that you are generating."
The doctor may have hospital and office note records (which you ought to have full access and actually own) but you have much more rich, real-time streaming, granular data about yourself, along with smart machines capable of making many different diagnoses and providing exquisite monitoring equivalent to an intensive care unit when needed. Doctors, still essential for providing treatment and imparting their experience and wisdom, will now be asking for access to the data that you are generating.
This newfound ambition of medical information parity -- both around the world and between doctors and patients -- is exciting in its own right. But there is another dimension to the democratization of medicine that was heretofore inconceivable: the creation of a worldwide health information resource. We're not talking about you Googling your symptoms or side effects of a medication. Instead, this is the potential for something the scale of Facebook with billions of people all across the planet, but medically rather than socially oriented.
So let's say you have a new diagnosis of cancer. It's important to emphasize that, as every individual is biologically unique (even "identical" twins), so is every case of cancer. Your tumor has been sequenced to determine the biological pathways that are responsible for driving it. Now, you and your doctor can find your "nearest neighbors" -- the individuals who match closest to you on every feature, including the cancer DNA sequence. You would learn for your closest matches what treatments were used and what results were obtained.
"This new 'bottom-up medicine' forever changes the patient-doctor relationship to a partnership on equal footing."
This same principle of open medicine can be applied broadly across all conditions, well beyond cancer. So instead of the valuable individual information that is now sequestered and wasted, it could be used to help one another fully inform optimal treatment and even prevention.
Much, if not all, of this potential progress depends on our ability to protect the privacy of each individual's data. While the vast majority of people are willing to share their medical information to help others, that is with the assurance that it will be kept anonymized. Although there have been recent outcries that "privacy is dead" in the digital era, the data brokering of our Google searches and Amazon purchases is altogether different from your medical data being sold or hacked. If we are to actualize this new medicine, decisive safeguards and action will be needed.
Today, via your smartphone and without the need for a doctor, you can have a skin rash or lesion immediately diagnosed, your eyes refracted, your heart rhythm determined and find out whether your child has an ear infection. And instead of waiting weeks for an appointment, you can visit a doctor through your mobile device and not just chat but also exchange your data. What is in store for the future of health care is as far-reaching as the wireless Internet.
For more information, see Dr. Topol's recently-published book, The Patient Will See You Now: The Future of Medicine is in Your Hands.
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