Science

Dr. You: The Democratization of Diagnoses

Julian Smith Writer

Futuristic handheld medical devices give everyday people, especially those in the developing world, unprecedented access to medical information to help make informed decisions about their health.

When Dr. “Bones” McCoy first used a medical tricorder on Star Trek in 1966, the idea of a handheld medical device that could scan and diagnose a patient on the spot was pure science fiction.

Recent leaps in technology are starting to turn this fantasy into reality.

Available devices or some that are in the works use smartphones to perform ECGs and help diagnose skin conditions. Other standalone devices make it easier to bring advanced medical care to remote areas.

“Mobile phones provide the perfect platform for healthcare,” said Erik Douglas, founder of the medical device company CellScope. “They are always with us and make it easy to connect to care any time.”

sick person

These smartphone-enabled healthcare platforms became possible when certain computing technologies advanced to where they are today.

The advent of gigahertz computing performance in mobile devices in the late 2000s was a major turning point in mobile health, said Sailesh Chutani of MobiSante, makers of portable ultrasound machines. Essentially this turned mobile phones into powerful portable computers. Advances in fields as diverse as wireless sensing, artificial intelligence and molecular biology have also helped make tools smaller and easier to use, and orders of magnitude cheaper.

This confluence of technology advancements is opening new possibilities for digital-health startups, many of which vie for funding by participating in worldwide competitions that offer huge prizes for health and wellness innovation.

wrist blood pressure machine

Since 2012, the Nokia Sensing X Challenge has awarded millions of dollars in prize money to companies pushing the envelope in personal digital health. The most recent winner, the Cambridge, MA-based DNA Medicine Institute, is working on a portable universal blood sensor.

The Qualcomm Tricorder X Prize will award $10 million for the first device that can accurately diagnose more than a dozen conditions, from hepatitis A to strokes. Hundreds of teams are expected to compete in 2017 competition.

“This is definitely a big shakeup” in the medical world, said cardiologist Eric Topol, the author of The Creative Destruction of Medicine and The Patient Will See You Now. A visit to the doctor’s office as a starting point for medical care is something he sees slowly but steadily becoming optional.

The shift in power from doctor to patient is causing “tremendous unrest” in the medical community, Topol said. Some doctors worry about patients being overwhelmed with reams of new information but having little knowledge or experience to make sense of it.

“Since before Hippocrates, doctors have had all the data,” he continued. “Medicine has been their domain.”

New tools could mean fewer in-person visits, which would save patients money but might result in subpar care.

doctors with medical devices

Nonetheless, the benefits of democratizing diagnoses could be profound in countries with aging populations and soaring healthcare costs like the U.S.

In the developing world, the impact could be even greater. Making fast, quick and effective medical care more widely available would save lives in poor countries, where many people live far from the few doctors and available medical centers. This has inspired frugal innovations like the LifePhonePlus in India. The device allows people to take an ECG, monitor their blood-glucose levels and seek a specialist’s advice without traveling anywhere. The device was designed 2013 by researchers from Intel Labs who knew affordable mobile technology could help 70 percent of the 1.2 billion Indians living in rural areas, where going to the doctor’s office can take days and often costs more than a family earns in a week.

“Smart and connected technologies are powering the democratization of access to medical devices,” said Kay Eron, GM Health IT & Medical Devices markets at Intel. “Smaller, mobile and wireless devices make it possible to distribute care to wherever the patient needs it. In rural and emerging markets in particular, putting quality medical devices into the hands of field workers can give them much greater data-driven insight into how to provide the best care for that individual.”

However long it will be until patients can order a medical tricorder on Amazon, the technology is changing how people use the data available to them. As Topol said, “It’s a unique time in medical history.”

High-tech medical devices

Some Trek-worthy handheld medical devices are already available.

Dexcom’s G5 Mobile Continuous Glucose Monitoring System ($1400) tracks blood glucose levels every five minutes, allowing diabetes patients to adjust insulin doses and head off hyperglycemic or hypoglycemic events. A small sensor attached to the body with adhesive measures glucose levels in the interstitial fluid space just below the skin surface.

A transmitter on top of the sensor sends data via Bluetooth to a mobile receiver or a smartphone running a Dexcom app, which can issue alerts if levels are too high or low. Family members can also track patients’ levels, and the data can be viewed in cloud-based reports.

The AliveCor Mobile ECG ($99) turns a smartphone or tablet into a heart health monitor. The FDA-approved device uses an app and a special case with two stamp-sized electrodes to record the heart’s electrical activity and whether any heartbeat irregularities are present. The data is recorded and stored for free — 5 million have been already — and the first one comes with an assessment by a cardiologist.

Instead of having to go to a doctor’s office in person, parents can use the CellScope Oto ($79) to send images of suspicious skin and ear conditions to a board-certified pediatrician. The diagnostic quality magnifying device, developed at UC Berkeley, attaches to the phone’s camera and uses a free app called Seymour.

For $10, patients are guaranteed a doctor’s response and recommendation plan in under two hours. The company’s first version could detect pathogens like tuberculosis and malaria from blood samples. It was tested in Uganda, Vietnam and India.

Many more devices are coming down the pike, often awaiting FDA approval. The mobile medical device company Scanadu is developing two smartphone-based units, both of which are currently seeking FDA clearance.

The Scanadu Urine uses an app and a smartphone camera to analyze a disposable paddle after it is dipped into a urine sample. The system will check for several health conditions, based on color changes in the paddle and is designed for maternal and women’s health.

The Scanadu Scout is so promising it raised $1.66 million in an Indiegogo campaign whose goal was $10,000. A small sensor unit measures blood pressure, temperature, heart rate and blood oxygen level, all from touching a patient’s left hand and temple at the same time. It’s currently being tested in more than 70 countries.

Introduced at CES 2016, the Omron Project Zero Wrist Blood Pressure Monitor is the first sphygmomanometer small enough to wear on the wrist, yet still as accurate as the inflatable upper-arm cuffs. The gizmo is the size of a fat watch and will also track physical activity and sleep quality. It will also sync with an app that lets physicians remotely monitor patients for hypertension.

Eye care is a serious issue in the developing world, where ophthalmologists and their complex, expensive diagnostic tools are in short supply. The Portable Eye Examination Kit (PEEK) could change that, using a camera lens adapter and mobile app to diagnose eye problems anywhere.

Patients take a vision test while the phone’s camera captures high-resolution images of the retina. Doctors can use the data to check for glaucoma, cataracts and other eye conditions, and contact info and GPS data for every patient makes follow-up treatment easier.

As technology continues to advance, giving more people access to devices that used to be affordable for a select few, healthcare science fiction slowly becomes a helpful, much-needed reality.

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