Good Dr. Algorithm, or the future of telemedicine

Imagine that every housewife will have a cheap, easy-to-use portable gadget that can automatically measure vital signs (blood pressure, oxygen level in the blood, heart rate, respiration rate, temperature); diagnose many serious diseases (including anemia, diabetes, hepatitis A, pneumonia, tuberculosis and stroke), and will also be able to instantly send the collected information to a professional nurse if necessary.



Sounds like science fiction? In fact, this device is inspired by truly science fiction, or rather, the “tricorder” used by the crew of the Enterprise in the 23rd century in the Star Trek universe.



But it seems that we will not have to wait several centuries to make the medical scanner a reality. In 2011, the X Prize Foundation announced Qualcomm Tricorder XPrize , a $ 10 million competition to “stimulate innovation in creating accurate diagnostic technologies to help consumers independently and reliably diagnose their health.” Ten teams from six countries have already been selected as finalists for the competition. devices that would accurately determine the five main vital signs and 13 health conditions. At the end of 2015, the finalists will be tested by consumers and the winner will be announced in January 2016. The US Food and Drug Administration is promoting the X Prize Foundation initiative to speed up the approval process, which will be important before the finished device hits. To the market. If the competition continues to be successful, the tricorder-like device may be on the shelves by the end of the 2010s.

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Health destruction

The race to develop a working tricorder is just one small aspect of a lot of the larger movement of integrating modern technology into medical care. Despite the fact that in the last 10–20 years, many other areas were almost destroyed with the advent of modern technology, health care remained relatively untouchable. Unfortunately, the US healthcare system (despite claims that “it is the best in the world”) has big problems: Although the cost of providing medical care per capita is the highest in the world, the US lags behind many other countries in terms of key indicators health, such as life expectancy and infant mortality rates.



But lately there have been some encouraging signs of progress. Instead of focusing on the treatment of specific diseases, innovations are designed to improve the efficiency of overall medical care. To make you understand what is happening today, let's briefly look at three areas: “mobile healthcare” and remote patient monitoring; attempts to link physicians and patients electronically; and the use of advanced computational techniques to help physicians with complex medical decisions.



In 2007, the California Health Foundation published an article entitled Health Care Unplugged: The Evolving Role of Wireless Technology . It for the first time openly discussed a phenomenon that will later become known as “mobile health” - the use of lightweight, wearable devices to monitor and support patient health. These devices are made possible by the continued progress in reducing medical sensors, reducing their prices and increasing sensitivity, along with the growth of high-speed wired and wireless networks that allow physicians to monitor the health of their patients remotely.



The need for such technology is caused by the acceleration of aging of the population, which has led to a shift in the priority of medical care from the “point” treatment of certain diseases to the long-term follow-up of chronic diseases. Given that doctors see one patient for only a few hours a year, the main responsibility for caring for chronically ill patients inevitably falls on the patients themselves (and their families). If patients want to help themselves with high quality, they need precise control over their health and professional care when necessary.







Mobile healthcare has become one of the hottest topics in healthcare in the past few years. The development of technology has occurred mainly due to wearable fitness trackers (such as Fitbit and Jawbone Up), which are already used by millions of people to increase the effectiveness of sports, and the growing popularity of mobile applications for personal health care, of which there are probably thousands.



Smartphone makers have also shown interest in developing applications to support health. This year, Samsung introduced its Gear Fit lineup, devices that track sports activity, heart rate and sleep habits.



Apple recently announced the iPhone Healthkit , which promises to increase the usefulness of mobile applications by integrating data from many sources (including data from external devices, such as blood pressure meters) into one convenient interface. In connection with the development of smartphones, there is a high probability that some or even all the functions of a tricorder may simply be built into our ubiquitous mobile phones in the not too distant future.

Live Medicine

When the patient needs the help of a doctor, time is often a decisive factor (for example, there is a “golden hour” for stroke victims, that is, it is necessary to provide appropriate assistance within 60 minutes, otherwise the chances of a successful recovery can be significantly reduced). However, it is often quick to get qualified help, access to doctors - and especially to specialists - becomes a difficult task.



For several decades, telemedicine has existed - the use of teleconferencing and other networking capabilities for communication between doctors and patients. However, this type of patient-doctor interaction was practiced mainly on the outskirts, where health care is developed, to put it mildly, not very well (for example, in remote rural areas). With the expansion of broadband networks, the cost and complexity of supporting telemedicine has decreased, while regular health care reforms create new incentives to increase the effectiveness of medical care.







In fact, telemedicine is becoming very popular. For example, the American company with the talking title Specialists on Call (SOC) uses high-quality teleconferencing systems to enable small hospitals to get quick access to various specialists from other institutions, such as cardiologists or neurologists. This service is extremely useful for patients who urgently need specialized assistance. This way of interaction is also useful for physicians themselves, since they can fully realize their skills, remotely communicating with a much larger audience of patients. And yet, despite the popularization of telemedicine, there are still a number of regulatory and political barriers that impede the promotion of such opportunities for patients.

Smart healthcare

Our knowledge of health care is accumulating rather quickly, thanks to the substantial growth of research programs around the world. For example, the use of genomics and proteomics (understanding the mechanisms of diseases at the molecular level) opens up new exciting prospects for the development of highly personalized medical procedures.



But this growth of scientific knowledge also creates a problem for those who directly provide medical services. The total amount of information about new drugs and methods of treatment that enters medical institutions doubles every five years, while the number of employees for processing this information does not increase. This means that, basically, in a clinical setting, the relevant information is not taken into account and, as a result, the quality of medical care varies greatly, often staying very far from ideal. According to RAND Corporation , in the United States they can’t get half of what patients really need in terms of treatment, while they don’t need 20% of the treatment.







Can digital technology make healthcare smarter? The facts available to date are very encouraging. A number of interesting experiments are underway, and the most famous of them, a kind of “face” of advanced intelligent medical technologies, is the cognitive computing system Watson from IBM. After winning Jeopardy! in 2011, Watson was involved in working on more serious problems, including health care.



Over the past few years, IBM and their partners have been engaged in Watson medical “education”, which includes more than 600,000 different medical articles, more than 2 million pages from medical journals and the ability to search for 1.5 million hospital records of patients.



You can also mention the joint research project Sutter Health and Geisinger Health System , whose goal is to identify early signs of cardiovascular diseases, and WellPoint and Memorial Sloan-Kettering Cancer Center attempts to improve cancer treatment procedures by analyzing big data. According to WellPoint’s head physician Samuel Nassbaum, Watson has the potential to increase the proportion of good decisions in cancer treatment from 50% to at least 90%.



Other approaches are being explored to improve the “intelligence” and reliability of health care. For example, Clinical Excellence Research Center, in collaboration with the Stanford University Artificial Intelligence Laboratory, is developing a visual control system in places such as intensive care units to ensure that all critical requirements are properly performed by doctors and medical staff.

Correct policy

The combination of high-speed Internet, smart devices and smart medicine has an incredible potential to change the very principle of medical care. In order to speed up this change, you need to carefully weigh all possible risks and take steps to modernize the laws. Technologies that seem incredible now may become part of public health sooner than we imagine. Mobile medical devices will become the standard for virtually all patients at risk. While programs like SOC are now focused on hospitals (partly because of all the same policies), telemedicine services will continue to move steadily further in our homes. For example, the US Veterans Health Administration already uses relatively simple technology to monitor the health status of about 100,000 sick veterans and people with disabilities at home each day. In the end, telemedicine will provide medical care where and when it is needed.



Who knows, probably, in the foreseeable future, the idea that doctors can diagnose and treat patients on their own, without the help of high technologies, will seem as outdated and even barbaric as conducting operations without anesthesia and using antibiotics.