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Calling Dr. Algorithm

Richard Adler | Oct. 15, 2014
Technology is poised to make big changes in the delivery of healthcare.

Back in 2007, I wrote a paper titled Health Care Unplugged: The Evolving Role of Wireless Technology that was published by the California HealthCare Foundation.It turned out to be the first publicly available report on what soon came to be known as "mHealth" -- the use of lightweight, wearable devices to track and support patients' health. These devices were made possible by continued progress in making medical sensors smaller, cheaper and more sensitive, along with the growth of high-speed wired and wireless networks that would enable healthcare providers to track their patients' health remotely.

The need for such technology was being driven by the aging of the population, which was shifting the focus of care from the episodic treatment of acute health problems (such as infections or injuries) to the ongoing management of chronic conditions. Given that doctors can see any one patient for only a few hours per year, the primary responsibility for caring for chronic conditions inevitably falls on the patients themselves (and their families). If they are to be successful in providing self-care, they need help in monitoring their health status and getting professional help when needed.

mHealth has emerged as one of the hot areas of healthcare in the past few years. The development of the technology has occurred mainly in the areas of wearable activity trackers (like the Fitbit and the Jawbone Up), which have been adopted by several million people to help them improve their fitness, and the growth of health apps for smartphones, which now probably number in the thousands.

Smartphone makers have also developed mHealth offerings. Earlier this year, Samsung unveiled its line of Gear Fit devices, which monitor workout activity, heart rate and sleeping habits. And Apple recently announced its iPhone Healthkit platform, which promises to increase the usefulness of mobile health apps by integrating inputs from many separate sources (including data from external devices like a scale or a blood-pressure cuff) in a single friendly interface. With the continued innovation in smartphones, it's very likely that some or all functions of the tricorder may simply be another built-in capability of our omnipresent mobile phones.

Connected health. When a sick patient needs to see a doctor, time is often a critical factor. (For example, there is a "golden hour" for stroke victims, which means that appropriate treatment needs to begin within 60 minutes in order to maximize the chances of successful recovery.) But too often, access to doctors -- and particularly to specialists -- can be a difficult challenge.

Telemedicine -- the use of teleconferencing and other network links -- to connect doctors and patients has been in use for several decades, but mostly on the fringes of healthcare (such as remote rural areas). With the growth of broadband networks, the cost and complexity of supporting telemedicine have declined, while the Affordable Care Act has created new incentives to improve the efficiency of healthcare delivery.


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