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Posts from the ‘Medicine 2.0’ Category

Defining Digital Medicine: New Paper in Nature Biotechnology

There is a new paper in Nature Biotechnology about defining digital medicine and it’s one of the most comprehensive articles I have ever read about this topic. They also have a figure describing many of the devices currently available for measuring vital signs.

Based on the last segment, new pieces will come soon:

There are many opportunities and challenges that will be clarified as this exciting new field emerges and over the coming year; this column will dig deeper into topics, such as the complexities of data sharing, interpreting data for real decision support, the shifting regulatory landscape, new company opportunities and emerging business models.

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The Medical Futurist on Instagram

As 90% of the hundreds of millions of Instagram users are younger than 35, I made a decision. I think the message that technologies can improve the human touch should reach millennials as well.

So, check out the Medical Futurist on Instagram. Photos and images about future technologies and the amazing innovations I come across worldwide.

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What Comes After The #Wearable Health Revolution?

The wearable health trackers’ revolution has been going on producing devices that let us measure vital signs and health parameters at home. It is changing the whole status quo of healthcare as medical information and now tracking health are available outside the ivory tower of medicine.

A 2014 report showed that 71% of 16-24-year-olds want wearable technology. Predictions for 2018 include a market value of $12 billion; a shipment of 112 million wearables and that one third of Americans will own at least a pedometer.

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Now a growing population is using devices to measure a health parameter and while this market is expected to continue growing, devices are expected to shrink, get cheaper and more comfortable. At this point, nobody can be blaimed for over-tracking their health as we got a chance for that for the first time in history. Eventually, by the time the technology behind them gets better, we should get to the stage of meaningful use as well.

Let’s see what I can measure today at home:

  • Daily activities (number of steps, calories burnt, distance covered)
  • Sleep quality + smart alarm
  • Blood pressure
  • Blood oxygen levels
  • Blood glucose levels
  • Cardiac fitness
  • Stress
  • Pulse
  • Body temperature
  • Eating habits
  • ECG
  • Cognitive skills
  • Brain activities
  • Productivity
  • I also had genetic tests and microbiome tests ordered from home.

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What else exists or yet to come? Baby and fetal monitors; blood alcohol content; asthma and the I could go on with this list for hours.

The next obvious step is designing smaller gadgets that can still provide a lot of useful data. Smartclothes are meant to fill this gap. Examples include Hexoskin and MC10. Both companies are working on different clothes and sensors that can be included in clothes. Imagine the fashion industry grabbing this opportunity and getting health tracking closer to their audiences.

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Then there might be “insideables“, devices implanted into our body or just under the skin. There are people already having such RFID implants with which they can open up a laptop, a smartphone or even the garage door.

Also, “digestables“, pills or tiny gadgets that can be swallowed could track digestion and the absorption of drugs. Colonoscopy could become an important diagnostic procedure that most people are not afraid of. A little pill cam could be swallowed and the recordings become available in hours.

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Whatever direction this technology is heading, believe me, I don’t want to use all my gadgets to live a healthy life. I would love to wear a tiny digital tattoo that can be replaced easily and measures all my vital signs and health parameters. It could notify me through my smartphone if there is something I should take care of. If there is something I should get checked with a physician.

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But what matters is finally I can become the pilot of my own health.

Right now patients are sitting in the cockpit of their planes and are waiting for the physicians to arrive.

Insurance companies such as Oscar Health have touched upon this movement and offer incentives and rewards (e.g. Amazon gift card) if the patient agrees to share their data obtained from health trackers. This way motivating the patient towards a healthier life.

There is one remaning step then, the era of the medical tricorder. Gadgets such as Scanadu that can detect diseases and microbes by scanning the patient or touching the skin. The Nokia Sensing XChallenge will produce 10 of such devices by this June which will have to test their ideas on thousands of patients before the end of 2015.

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I very much looking forward to seeing the results. Until then, read more about health sensors and the future of portable diagnostics devices in my new book, The Guide to the Future of Medicine.

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10 Exemplary Social Media Healthcare Professional Mentors

It’s always an honor being included in lists with such amazing names from Kevin, MD to Larry Chu. An excerpt from the announcement:

What follows are just ten of the exemplary digital opinion leaders (DOLs) creating social media training resources that have been highly shared by other healthcare professionals in the past year. Do you agree with my selection? Please add your suggestions to this list, and I invite you to further enhance this resource through your own opinions and experience.

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10 Things How Artificial Intelligence Could Make Me a Better Doctor

I was watching the movie Her for the second time and I was fascinated again about the scene in which the main character played by Joaquin Phoenix got his new operating system with artificial intelligence (AI) and started working with that. I couldn’t stop thinking about the ways I could use such an AI system in my life and how it actually could make me a better doctor.

Don’t get me wrong, I think empathy and great communication with patients can make a doctor better primarily, but as the amount of medical information out there is exponentially growing; as the time for dealing with patients and information is getting less, it is becoming humanly impossible to keep up with that. If I could devote the time it takes now to deal with technology (inputting information, looking for papers, etc.) to patients, that would be a huge step towards becoming better.

Here are 10 things how AI could make me a better doctor and consequently live a better life.

1) Eradicate waiting time: Not only patients have to wait a lot for their doctors, but doctors lose a lot of time everyday waiting for something (a patient, a lab result, etc.). An AI system that makes my schedule as efficient as possible directing me to the next logical task would be a jackpot.

2) Prioritize my emails: I deal with about 200 e-mails every single day. I try to teach GMail how to mark an e-mail important or categorize them automatically into social media messages, newsletters and personal e-mails, it’s still a challenge. In Her, the AI system prioritized all the 3000 unread e-mails in a second. Imagine that!

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3) Find me the information I need: I think I have mastered the skill of searching for information online using dozens of Google search operators and different kinds of search engines for different tasks, but it still takes time. What if an AI OS could answer my questions immediately by looking up the answer online?

4) Keep me up-to-date: There are 23 million papers on Pubmed.com. If I could read 3-4 papers of my field of interest per week, I couldn’t finish in a lifetime and meanwhile millions of new studies would come out. I need an AI to show me what I should really read that day. Now my curated social media networks do this job, although I’m sure it would be much more accurate with AI.

5) Work when I don’t: I can fulfil my online tasks (e-mails, reading papers, searching for information) when I use my PC or laptop, and I can do most of these on my smartphone. When I don’t use any of these, I obviously cannot work. An AI system could work on these when I don’t have any device in hand.

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6) Help me make hard decisions rational: A doctor must face a series of hard decisions every day. The best we can do is to make those decisions as informed as possible. Some of them are still hard to make. I can ask people of whom I value the opinions and that’s it. Imagine discussing these with an AI system that is even more rational than you are.

7) Help patients with urgent matters reach me: A doctor has a lot of calls, in-person questions, e-mails and even messages from social media channels on a daily basis. In this noise of information, not every urgent matter can reach you. What if an AI OS could select the crucial ones out of the mess and direct your attention to it when it’s actually needed.

8) Help me improve over time: People, even those who work on becoming better at their job, make the same mistakes again and again. By discussing every challenging task or decision with an AI, I could improve my overall well-being and the quality of my job. We could do that with people as well, but let’s be honest, it’s practically impossible.

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9) Help me collaborate more: In Her, the AI collected the letters the main character wrote and compiled them into one manuscript which she sent to a publisher that she thought would be willing to publish it. Similarly an AI could find the most potential collaborators and invite them to work on a paper or study I otherwise work on. This way, opening up my networks even more.

10) Do administrative work: Quite an essential percentage of an average day of a doctor is spent with administrative stuff. An AI could learn how to do it properly and do it better than me by time. It could write down my thoughts and compile them anytime just as if I decided to sit down and write them down saving me an enormous amount of time.

Read more about the use of AI in medicine in The Guide to the Future of Medicine!

The Guide to the Future of Medicine ebook cover

Would you use AI in your work? Please do share! Until then, here is how supercomputers make physicians better:

How mobile is transforming healthcare: Report

The Economist came up with a report about How mobile is transforming healthcare including infographics and analyses. You can download the report here.

According to a new survey, mobile technology has the potential to profoundly reshape the healthcare industry, altering how care is delivered and received.

Executives in both the public and private sector predict that new mobile devices and services will allow people to be more proactive in attending to their health and well-being.

These technologies promise to improve outcomes and cut costs, and make care more accessible to communities that are currently underserved. Mobile health could also facilitate medical innovation by enabling scientists to harness the power of big data on a large scale.

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Shall We Sequence Genomes At Homes? – The Future of Genomics

As a geneticist, talking with George Church or the President of the Personalized Medicine Coalition was a fascinating experience while writing my recently published book, The Guide to the Future of Medicine. This is still one of the most promising fields of medicine but without getting it closer to the general public, genomics will never play a pivotal role in practicing medicine.

Let’s start from the beginning. From the years of 2005, 2006 and 2007, patients have been able to order genetic tests online with 23andme, Navigenics or Pathway Genomics. In 2013, 23andme received a letter from FDA about ceasing marketing of the screening service. Since then, the market has been transforming into something new that could also meet the regulations of the FDA. At least, hopefully.

My Gentle Labs package.

My Gentle Labs package.

I’ve had 3 genomic tests with Navigenics, Pathway Genomics and My Gentle Labs with 3 different results and experience. I thought the direct-to-consumer (DTC) market is just not ready for prime time. I also analyzed my own raw data with Promethease and got to very interesting conclusions about the future of my life. I loved the possibility to get insights about my genome as well, not just measuring my vital signs. Here is my overall experience with genetic testing:

Similarly to how the wearable revolution is transforming into a world of smart clothes, disease prevention and insideables (swallowed sensors), the field of DTC genomics has been changing too. Here are some reasons why.

  • While the cost of sequencing one person’s genome was about $3 billion in 2003, now it’s possible for under $1-3000 (see figure below). The $1000 genome is still not here, but the trends are clear and soon the shipping cost of the sample will be higher than actually sequencing that genome.
  • The number of sequenced genomes is skyrocketing. Illumina said that 228,000 Human Genomes would be sequenced only in 2014 and the predictions for this year are even bigger. Soon we will all have access to our own genomes.
  • It is known that fetal DNA is circulating in the mother’s blood,and it can be separated from her blood to allow analysis of the fetus’s genetic makeup. Imagine the possibilities.
  • Large US hospitals are about to begin sequencing the genomes of healthy newborn babies as part of a government-funded research program called BabySeq. Major diseases could be pointed out and precautions could be made about others far in time.
  • Oxford Nanopore developed the MinION™ portable device for molecular analyses of DNA, RNA and proteins that is driven by nanopore technology. It might be the first step towards sequencing genes at home, despite early criticisms.
  • There are more and more targeted cancer therapies available. As certain tumors have specific genetic mutations such as BRCA in breast cancer or EGFR in lung cancer, among others, they might be sensitive to targeted drugs. Sequencing a tumor’s own genome is becoming a routine step in designing the therapy for cancer patients, although the costs are exceptionally high.
Cost of genome sequencing.

Cost of genome sequencing.

As you can see, examples underscore the notion that genomics could play a very important role in everyday medicine, but numerous steps and elements are needed for that.

  1. Comprehensive and thorough regulation from organizations such as the FDA or EMA about what DTC companies can offer and actually do. Can patients order tests online or only their caregivers?
  2. Innovative companies connecting patients to medical professionals through the genomic knowledge behind cancer and other diseases.
  3. Reliable algorithms that could help use the huge amount of data genome sequencing leads to in analyzing health outcomes. A great example is how Joel Dudley at Mount Sinai Medical Center is working on implementing big data in medical decision making. IBM Watson is also analyzing genomic data to find treatments in brain cancer.
  4. With the widespread of genetic testing and the decline in the cost, it should be a common thing to analyze my genome or get a detailed analysis. Moreover, caregivers should be trained to be able to use that data in patients’ health or disease management.
  5. A better understanding of what genomics can and cannot offer by the general public. Professor Church pointed out to me that without educating people about the pros and cons of the genomic revolution, we cannot make the right steps forward.

It has become clear, seeing the trends, that the technology letting us sequence genomes at home is coming. Although it’s still hard to make good, evidence-based decisions purely based on genetic background; to get reimbursed if genetics-based personalized treatments are cost-effective on the long term (but expensive on the short term); and to interpret the huge amount of data. Cognitive computers are meant to help us with that, but I’m sure ever-improving technologies will provide all of us with our own genomes far before we could do anything with that information.

Read more about the future of genomics in my book, The Guide to the Future of Medicine.

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