Future Wireless Medicine 
Compiled by Walter Sorochan, Emeritus Professor San Diego State University
and based on work by Dr. Eric Topol, Scripps Health, San Diego, Ca.

Posted April 24, 2012.

topol healthwirlesscvd We are on the verge of a revolutionary transformation in medical practice in which recent technological and scientific advances will enable medicine to be personalized and provide better health care.  This trend is headed by Dr. Eric Topol, a cardiologist, geneticist and an innovator in wireless medicine at Scripps Health and Scripps Research Institute in San Diego. He points out his new book, “The Creative Destruction of Medicine,” that: "Medicine has operated by a one-size-fits-all" rule that ignored biochemical differences in patients.  Like prescribing the same dosage of medication for most people.  We now have tools that let doctors be precise and perform more individualized medicine.  New advances and thinking in medicine will also give people more control and responsibility for their own health while at the same time, sharing more personal information with doctors. 

 This article briefly summarizes the new medical frontier. 

Most of the information herein is based on Dr. Topol's research and innovation that he presented in interviews and speeches.  Additional commentaries about health care practices are included by author Sorochan that may be changed by wireless medicine. 

Here are two U-tubes that feature Dr. Eric Topol of Scripps Health. Dr. Topol introduces his ideas about futuristic medicine in the first U-tube that is 4.5 minutes long:

 

The second U-tube is a TedMed 2009,  17 minutes long presentation.  Dr. Eric Topol shows you how doctors can use smartphones to monitor a patient's vital signs and chronic conditions. At a TEDMED presentation, he highlights several of the most important wireless devices in medicine's future: 

 

Both U-tubes do an excellent job of presenting Dr. Topol's view of future medicine.  Below is Dr. Topol's future of medicine in text format for your convenience.

 Our existing health care system needs a facelift!   Dr. Paul Jacobs, Chairman and CEO of Qualcomm, isn't much of a fan of the traditional medical system, which he complained is "inefficient, bureaucratic, and at worst even inaccurate."  He points to the fact that it typically takes 21 days in the U.S. to just get a doctor's appointment, and then another 2 hours in the waiting room to see the doctor. As an alternative, Qualcomm is pushing mobile self-diagnosis devices, which will help remove some of the reliance on unreliable medical professionals.  Mick: Qualcomm prize Jacobs 2012 

ge_vscanDr. Topol focuses on wireless technology to jump start the new medical revolution. Winslow: wireless medicine 2012   Wireless sensor technology now makes old fashioned monitoring tools like the stethoscope, computer displays and monitoring heart functions somewhat obsolete.  The stethoscope, for example can be replaced by a small, mobile ultrasound device [ image on left ] that allows the doctor to see a patient's heartbeat instead of just listening to the heart.  The ultrasound device allows the doctor to have more detailed and instant information about the patient; allowing the doctor to make better decisions about the patient.  Many monitoring devices that are locked down in the examination room can be replaced by mobile wireless cell phones that display remotely what the office computer does now. Instead of waiting for an appointment to travel to the doctor's office, patients, from their homes, can use wireless phones to display their body symptoms and connect this data instantly to their doctors.  This allows the doctor to perform instant and rapid analysis of the patient's condition and prescribe medical therapy. This is an example of instant and efficient medical therapy.  "The average appointment lasts seven minutes in the U.S. And usually the patient is waiting for an hour. So it's a very inefficient system." Winslow: wireless medicine 2012  Wireless smartphones will change the way doctors interact with patients.  Reed: Topol creative medicine 2012

The new frontier in medicine puts together DNA information, using biosensors to collect additional body information and connecting all this information in a digitized manner that can be displayed on a smartphone.  Biosensors can measure any physiologic metric — blood pressure, temperature, glucose, oxygen concentration in the blood — and send the data wirelessly through smartphones to doctors. That means doctors can have a comprehensive view of a patient that doctors can use to assess and manage disease, and that patients can use to help maintain their health and direct their own care.  This makes for smart medicine.   Winslow: wireless medicine 2012   Reed: Topol creative medicine 2012

 Examples of Topol's medical technology:  Here are a few examples of wireless medical technology can change medical practice and provide faster and better health care:

health checkup health heartmonitor   Stethoscope   and traditional ultrasounds replaced by Vscan: [ made by GE Healthcare and illustration on right side ] –-- a pocket size visualization tool. Roughly the size of a smart phone, Vscan houses powerful, ultrasmart ultrasound technology that can be used in virtually any clinical, hospital or primary care setting. By giving doctors a view into the body from the palm of a hand, Vscan has the potential to redefine the way doctors examine patients and ultimately improve patient care.  Dolan: digital medicine gadgets 2010   Imagine paramedics using a Vscan in an emergency situation and communicating with an EMR physician!  Vscan makes the stethoscope obsolete.

health holtermonitor health patch mom2  Holter heart monitor   [ on the left ] replaced by PiiX(TM) made by Corventis and illustrated on right side] is an unobtrusive, water-resistant, patient-worn smart bandage that adheres to the skin and automatically collects and transmits physiological information, including ECG, heart rate, heart rate variability, respiration rate, fluid status and activity. Corventis’ Avivo(TM) Mobile Patient Management System is an integrated system that combines the patient-friendly PiiX with advanced algorithms, wireless capabilities and a comprehensive web-based infrastructure to provide clinicians focused insight into the cardiac health status of patients, anywhere across the globe.  Dolan: digital medicine gadgets 2010 

 Prescription medicine:   is another area that Topol identifies as ripe for change.  He cites studies showing that popular medications such as Lipitor and Crestor have been proven to benefit only one to two percent of patients taking them who do not already have heart disease. When it becomes possible to predict in advance which patients will benefit from these medicines, a large part of the $26 billion spent annually on them could be saved, to say nothing of preventing their sometimes serious adverse effects.

Rosen: Topol's future mwireless medicine 2012

Plavix, a drug given to prevent blood clots (on which $9 billion was spent in 2010), is another example. It is now known that at least 30 percent of people are unable to convert it into its active form due to genetic mutations. Not only does giving it to someone who cannot metabolize it place that person at risk for developing a dangerous blood clot, it, too, wastes resources."  Rosen: Topol's future mwireless medicine 2012

The examples cited by Topol about drug medications illustrates that wireless, personalized medicine is at odds with the century old population-based practice of medicine.  Much of the waste in this nation’s $2.7 trillion health-care system is related to prescribing drugs that don’t work effectively because not enough is known about the individual patient.  Meanwhile, many traditionalist physicians are reluctant to embrace such a wholesale shake-up of the way they work. The entire health care system needs to shift gears from a symptom treatment system to one dealing with treating the cause.  Rosen: Topol's future mwireless medicine 2012

 Patient Feedback and convenience:  As a patient, you can get an add-on to a smartphone which does eye refraction and then texts [the prescription] to get your glasses made. Or you can get your skin lesion scanned and get a text back quickly that there's nothing to worry about. If you're a dermatologist, you will be able to take a DNA sequence, check for skin problems on your smartphone and get instant data feedback to help you advise your patient. Minimize patient travel and appointment hassels. Winslow: wireless medicine 2012 

As a person, you can press a button on your phone and you can get all of your blood pressures graphed, digitized, and archived in your phone and then send it to either your doctor or save it on on your personal computer.  Diabetics can monitor glucose readings every 5 minutes around the clock. Doctors can also to do remote monitoring and save patients the expense of travel and time. Reed: Topol creative medicine 2012 

 Lack of monitoring patient therapy:    Doctors assume that the therapy they give their patients is working.  They do not monitor patient progress.  And their contact with the patient is so limited [10 minutes per office visit ] that they really know very little about their patients; outside of blood chemistry.  Patients are seldom if ever asked about their diet and what they eat! 

But the big missing link in medical practice today not monitoring patient progress.  This is especially true when doctors do not hear from their patients for months and months.  The assumption appears to be that as long as patients do not call back, the therapy is working.  This is totally absurd!  For example, the patient's biochemistry may change due to the ingestion of supplements, food and exposure to environmental toxins; and no effort is made to find out if the previous drug medication fits the patient's changing biochemistry. Doctors often renew the patient's medical prescriptions without the doctor checking the patient's biochemistry to determine if there is a need to adjust the therapy.  Most doctors neglect to contact the patient a week or month later to find out whether the prescribed therapy is helping the patient.  This lack of patient monitoring can be changed with smartphone technology helping the doctors to monitor daily patient status.   [ Sorochan ]

 Is the public ready for smart medicine?   The general public is much more informed about medicine and health today than they were 30 years ago. A major reason is the availability of the information on the internet. Yes, the information is a mixed bag but the general public has become pretty sophisticated in using the internet free library to search for good health-medical information.  The point being made is that the public today has access to medical information and is not as reliant on doctors as in the past.  Most doctors are not are aware that many of their patients are often more knowledgeable about their health condition and availability of medical options than their doctors are.  Hence a huge credibility gap! 

Another example that today's out-dated medical practice is not working very well is the popularity of unconventional medicine.   Patients now are turning to their online networks for virtual peers to get guidance about medical conditions.  Many patients trust these virtual peers they've never met more than their doctors. Reed: Topol creative medicine 2012  Millions of health informed patients find that the medical health care they get is not working and are now by-passing the advice of their doctors.  Much of medical therapy is out-dated, is not working and patients have become aware of this.  Such awareness has motivated many of them to take back some of the responsibility for their health that they gave to doctors .  Many are beginning to medicate themselves, and to look after their own well-being through preventive habits of exercising and better nutrition.  Others are applying grandma's home recipes of traditional home care when grandma could not afford health insurance and grandma did not have the money to visit a doctor when sick.  But grandma had "old fashioned good common sense" and that is what many persons today are beginning to use while the medical system wallows in continuing crisis!  [ Sorochan ]

 The medical system needs to change:    There is reluctance on the part of the medical establishment to embrace technologies that are available today and which could redefine how society approaches healthcare.  Reed: Topol creative medicine 2012  Topol points out that the big challenge for wireless medicine is convincing the medical community that it needs to change the way it delivers care and that wireless health technology is the key to making that change.  Topol perceives that medical change and acceptance of such change by the medical establishment will come sooner if there is demand and support from the people consumers.  Patients and doctors will need to partner health care.  This approach will set off a whole different way of practicing medicine in the future.  There will be fewer medical gods in white cloaks!  Reed: Topol creative medicine 2012

Reference: 

Dolan Brian, "World Renowned Physician and Thought Leader Dr. Eric J. Topol to Highlight Digital Medicine Revolution at International," Mobile Health News, Computer Electronic Show, Las Vegas, January 8th, 2010.   Dolan: digital medicine gadgets 2010

Mick Jason, "Qualcomm Announces $10M USD Tricorder X-Prize," Daily Tech, January 11, 2012.   Mick: Qualcomm prize Jacobs 2012

Reed John C., MD, PhD; Eric J. Topol, MD., "Topol on The Creative Destruction of Medicine," Medscape Internal Medicine, April 13,2012.   Reed: Topol creative medicine 2012

Rosen Dennis, "‘The Creative Destruction of Medicine’ by Eric Topol," Boston Globe, February 13, 2012.  Rosen: Topol's future mwireless medicine 2012

West Wireless Health Institute, "Dr. Eric Topol eBook Launch: Creative Destruction of Medicine," December 5, 2011.  West Wireless Health Institute 2011 

Winslsow Ron, "The Wireless Revolution Hits Medicine," The Wall Street Journal, April 16, 2012'   Winslow: wireless medicine 2012