Mobile Technology Could Put Health In Hands of Patients

Author

Pearl, Robert

August 22, 2013

If health care is the new gold rush, then it’s no surprise Silicon Valley’s high-tech companies, entrepreneurs and recent MBAs hope to strike it rich on the heels of U.S. health care reform.

A growing number of today’s technological gold-seekers want to help patients manage chronic disease. Specifically, they are interested in home monitoring devices – wireless trackers that can send thousands of electrocardiogram (EKG) tracings, blood sugar levels or other bodily statistics directly to health care professionals.

While home monitoring devices may have a glittering future, some of today’s tech companies are chasing fool’s gold.

That’s because some promoters of home monitoring technology believe doctors will carefully scrutinize each EKG or blood sugar reading and use the information to tailor perfect regimens for their patients. This is not how medicine works.

Let me explain the problem using an analogy. Imagine a skilled skier out on the slopes, ready to make the most of her day. How does she determine the right gear and skis to wear?

Knowing the shape of every snowflake on the mountain doesn’t help much. Instead, she needs to know which of several possible snow conditions to expect. Deep powder requires wider skis. Icy moguls demand sharp edges. Figuring out which of several snow patterns is present gives her the information she needs.

The same is true for home monitoring. Looking at thousands of EKG tracings won’t add much value either. In fact, putting all that information into an electronic medical record (EMR) only makes it more difficult for doctors to identify other, more vital pieces of information. Instead, doctors need to understand which of a few possible patterns are happening to determine the appropriate course of action.

But in addition to the logistical issues, there are regulatory ones, as well. When medical information is sent directly to the physician or imported to the patient’s medical record, the tracker becomes a “medical device” and must be approved by the Food and Drug Administration (FDA).

Imagine if these regulations applied to a bathroom scale. Of course, there is no regulatory oversight necessary if a doctor instructs a patient to monitor his own weight. But if that same patient’s weight is sent directly to his physician, the scale would need to be approved by the FDA – adding significant cost to device manufacturers, consumers and the health care system.

So, given these obstacles, is there any real gold here for high-tech companies?

Yes, I believe the conditions are ripe for a multibillion-dollar market. Up to half of all U.S. adults have a chronic condition and more than half of all adults use smartphones. Both numbers are growing rapidly. Therefore, the concept of patients measuring and tracking physiological statistics via smartphones is promising.

Already, there’s the iBGStar Blood Glucose Monitoring System ($71.99 to $99.99), a blood glucose meter that attaches to an iPhone. There’s the AliveCor Heart Monitor ($199), a device that also snaps onto an iPhone and traces EKGs. Other smartphone attachments serve similar purposes for chronically ill individuals.

But most patients won’t buy or use multiple home monitoring attachments, especially when the cost for each add-on totals $100 to $200. Meanwhile, health insurers would likely cover costs only for the handful of patients who have the highest probability of being admitted to a hospital.

Perhaps the best place to search for health care gold is inside the smartphone itself.

There’s opportunity on the horizon for tech companies to develop and launch a smartphone device that has all the necessary monitoring capabilities built in, priced at or slightly above the cost of a “regular” phone.

Now, imagine an app for this device that collects and analyzes the health data gathered. Instead of sending data directly to a doctor or EMR, the device prompts the patient to notify a physician when patterns fall outside of previously established parameters.

A doctor might want to be notified by one patient when blood pressure readings exceed 160/100 a certain number of times a day. And for another patient, the trigger would be glucose levels exceeding a particular value for two consecutive tests.

The point is doctors don’t need thousands of data points to deliver the best care. They simply want to know when certain predetermined boundaries are violated or when a new, worrisome trend develops.

Lawyers would need to figure out whether this consumer controlled approach could eliminate the “medical device” label and mitigate the cost of FDA approval. Regardless, embedding home monitoring devices into a smartphone helps personalize medicine and represents the future of chronic disease management. It’s convenient, the data belongs to the patient, and the analytic process can happen around the clock.

Once multipurpose home monitoring tools become affordable, they will be standard practice for how doctors manage patients with chronic disease. The price point challenge for any new technology is getting to scale. When smartphone manufactures are convinced enough people will buy their products, they will price them accordingly.

If today’s Silicon Valley forty-niners can solve the logistical and regulatory challenges of embedding home monitoring devices into a smartphone, they will increase patient engagement and clinical outcomes. The gold rush is on and the spoils could go to whoever gets there first.

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