Clean bill of health soon just a touch screen away
Eight years ago, Dr Jeff Goldsmith presented health care executives with a fictional scenario in which a man awakes one morning in 2013 and puts his hand on a touch pad.
The device at his bedside uses an infrared sensor to capture a video of the blood pulsing through his capillaries and sends its molecular movie to his doctor's office. There, software immediately spots abnormalities among the man's white blood cells.
The patient had developed leukaemia. Technology, however, had caught the disease at its earliest stage. The man, in Goldsmith's happy ending, is cured in less than a month.
Goldsmith, who, as founder of Health Futures, is one of America's top health industry analysts, says his digital diagnosis tale first struck many in the medical field as far-fetched. Back then, touch screens were primitive and costly. The iPhone was just a dream in some Apple laboratory. No one had heard of an app, let alone one that could detect disease.
Now, the future Goldsmith imagined is coming true - fast. Around the globe, doctors, researchers and entrepreneurs are churning out at a dizzying pace software and devices that promise to prevent deaths, prolong lives and change our relationship with the family doctor.
Indeed, they may change our relationship with our own bodies.
A group of young scientists from the US recently unveiled LifeLens: a smart-phone application that can with a drop of blood placed on an external adaptor identify malarial cells before a patient develops the full-blown disease.
Meanwhile, the CardioSentinal, developed here in Hong Kong by the Digital Life Research Centre at Hong Kong University of Science and Technology, could give you a heart examine from the comfort of your own home - or from across the globe.
The device is about the size of two fingers and can easily fit in a pocket. It uses a series of sensors to monitor your heart's electrical activity, detects any problems and sends a report via smart phone to your cardiologist.
HKUST researcher Dr Qian Zhang, said the software would be intelligent enough to determine whether you just woke up or finished working out. If there's a question, the device will provide a platform for communication with the patient.
'Well, you are now in an abnormal stage,' Zhang said a doctor might ask, 'What are you doing right now?'
This kind of doctor-patient exchange might strike some as cold. But it's just the beginning, and health care prognosticators like Goldsmith envision great patient benefits to having a 'doctor on your desktop' whom you can query any time.
They imagine fewer hospital visits, shorter stays, better diagnoses and digitalisation to such an extent, that if you get sick while on holiday in Thailand, the local doctor can view your Hong Kong health records on his tablet computer.
Every doctor's office could have a genomics machine to tailor medical treatments to your particular genetic make-up - part of a personal health database that you can take with you wherever you go.
Dr Albert Yu Cheung-hoi, who heads Hong Kong-based biotech company Hai Kang Life, imagines that one day, flu-sufferers might be able to walk into a 7-Eleven, tap a few points on a touch screen and walk out with a personalized prescription.
'Every person is different, so they respond differently to medication,' Yu said. Technology will make it possible to separate those differences.
What will all this innovation mean for the old-fashioned bedside manner? Will doctors retreat into their computer screens, responding only to a machine's analyses?
Avoiding that, experts say, may require doctors - and the medical education system that trains them - to change as fast as the technology.
'You can't just memorize a textbook anymore,' said Dr Daniel Kraft, who explores the technological potential of medicine at the FutureMed programme at Silicon Valley's Singularity University.
'There's an almost overwhelming amount of potential information,' Kraft said. 'Doctors have to use technology to make sense of that information and put it in context of that individual patient.'
Dr Atul Gawande, a well-known physician and writer, told graduates during a commencement address at Stanford University's School of Medicine that they should be prepared to confront a new concept of what it means to be a doctor.
'This can no longer be a profession of craftsmen individually brewing plans for whatever patient comes through the door,' Gawande said. Stanford, perhaps to drive home the point of technology's central role in those changes, gives each medical student an iPad on their first day.
Experts say the future is not just a product of technology but also the way people bring these technologies to life. That means doctors, patients, their friends and their families.
Such change is already visible in the increase of social-networking sites revolving around health care. Websites such as PatientsLikeMe allow an online community of patients to discuss their symptoms while sharing insights and advice with strangers who have had similar experiences.
Social media sites, like Facebook, Google+ and Twitter, allow users to keep in touch and track their loved one's health from afar.
Perhaps, like the Weasleys' clock in the Harry Potter series that tracks where each family member is, one day, you will receive an alert when some family member has taken ill on the other side of the world.
Kraft, the Silicon Valley researcher, jokes about friends Twittering each other to help with weight loss. That sort of group motivation is an important part of health care's future, too, he said.
'A lot of our medical issues are not from our genes but from our habits,' Kraft said. 'Technology can track our habits, how many calories we're consuming, how much we're moving.'
The future of health care is not only about prevention - catching diseases before they can harm - but also about changing behaviour to prevent disease from occurring at all.
Experts question how we can change unhealthy behaviour - people still smoke despite the gruesome images of damaged lungs on cigarette packs - but technology could achieve more impact through digital simulation.
'You could have a virtual representation of you and what you're going to look like or what may happen if you don't change your lifestyle,' Kraft said 'You may be less likely to indulge in harmful habits.'
People could have their own medical doppelganger - or health avatar, to borrow a term from video games - that stares at them from their own smart phone each the morning. Faced with such an image, people might find the will to change their behaviour on their own.
The technology is coming, but the choice to participate will likely remain up to us. Goldsmith calls it an 'electronic safety net.'
While he makes a living dreaming up visions of health care's future, Goldsmith himself admits to being a little old-fashioned. He still uses a paper calendar and does not run his day through Microsoft Outlook.
'A lot of people won't want to friend their doctors [on Facebook], they'll want to see him in their office,' Goldsmith said. 'Maybe I want to see my doctor in person. Or I can Skype him if I don't have time. That's going to be up to me.'
The true test of these technologies, Goldsmith said, is whether doctors will get to spend more time with patients because they have saved time on everything else. Right now, doctor's spend more than half their time filling forms, researching, inputting information, tasks which are fast becoming automated.
'People don't go into medicine to sit in front of a computer,' he said.
In some ways, Asia, with its fast-growing economies and relatively undeveloped health care network and regulatory structure, could be the first to experience the next technological revolution in health care.
'China and Asia is where it's going to be happening,' Goldsmith said. 'Not having a huge installed base of large hospitals and specialists is an advantage, not a disadvantage. You have the freedom to create something new. We [in America] are held back by what we've already done.'
Face of future health care
Remote monitoring of mental state will enable families and psychiatric teams to keep track of those with illness
Nose and throat
GPS will track when and where you had your last asthma attack, sending the information to your doctor
Talking computer program will remind you about taking medication and record your verbal responses using voice recognition and natural language processing technology
A 24-hour monitoring system will track your heart's electrical activity and diagnose heart attacks by studying fatty-acid-binding proteins
Clothes equipped with biosensors will measure heart rate, respiration rate and temperature during physical activity