A Blog by Jonathan Low


Mar 19, 2015

You're the Doctor Now and the Smartphone Is Your Clinic

One of the features of the digital economy is that you are expected to do more yourself.

From banking to diagnosing computer problems to bagging your own groceries, businesses are always trying to transfer costs to the customer.

While frequently annoying - what was that service I was supposed to be paying for? - there may be aspects of this DIY process that work in consumer's favor. And medical care may be one of them.

Given the hassle and expense of seeing an actual doctor, drop-in clinics with names like MedExpress are siphoning off an increasing amount of business. But even they may be disintermediated by smartphone apps which give you the ability and the cost-savings. For more serious problems, there are more traditional options, but given the societal focus on self-reliance, turning that power to one's own advantage just makes sense. JL

Ariel Schwartz reports in Fast Company:

Point-of-care (POC) testing includes any tests performed outside of a lab - everything from glucose monitoring and infectious disease testing to blood chemistry analysis and cholesterol measurements. By 2018, the market is expected to grow to $24 billion in the U.S. alone.
Perhaps this sounds familiar: you spent 45 minutes waiting for a doctor's appointment, only to be seen (and if you're lucky, diagnosed) in five. Why, you might wonder, did you need to go into the office at all? In many cases, you probably didn't. As doctors and patients become more comfortable with telemedicine, and as DIY medical tools get more advanced, the number of visits you make to the doctor could decline dramatically.
Instead of trekking to those annoyingly short visits, you'll have much of the equipment you need to make a diagnosis at home.
Diagnostic testing is a huge business, worth billions of dollars. One of the fastest-growing segments of that business is the point-of-care (POC) testing market, which includes any tests performed outside of a lab—including at-home testing. POC testing can include everything from glucose monitoring and infectious disease testing to blood chemistry analysis and cholesterol measurements. The global POC market was worth $13.8 billion in 2011. By 2018, the market is expected to grow to $24 billion in the U.S. alone.
CellScope's Oto HOME, an otoscope (that fun medical device used to look inside ears) designed for at-home use, is a harbinger of things to come. The startup recently started selling the $79 otoscope, available now in California, with an eye towards kids with chronic ear infections. "That's 4 million kids per year. When we talk to parents of these kids, they say, 'We’d do anything to have a device like yours,'" says Amy Sheng, the cofounder of CellScope.
The Oto HOME is similar to an analog otoscope, but it has a few digital twists: the device hooks up to a smartphone and captures video as the parent peers into their child's ear. A software algorithm guides parents to point the camera toward the eardrum. That video, along with any additional symptom information, is sent to an in-state physician that's signed up to Cellscope's telemedicine service. Parents receive a diagnosis a few hours later. If necessary, the physician will provide a prescription.
Ear infections are an easy starting point for at-home diagnosis—they are simple to spot just by looking into the ear. CellScope's next focus, skin concerns, also lends itself to picture and video-taking. Generally, says Sheng, "a lot of weird insect bites, ear infections, eye infections—they can often be diagnosed with a visual." She notes that there are already consumer versions of common devices that doctors use, like thermometers and blood pressure cuffs. New additions like the Oto make it that much easier to do at-home diagnosis. "I can imagine in the future consumers having a bunch of these devices in a kit," she says.
If the Qualcomm Tricorder X Prize's vision pans out, that toolkit will include some serious multi-use tools. The $10 million competition challenges teams to correctly diagnose 15 diseases—including diabetes, stroke, anemia, and pneumonia—in 30 patients in three days using a mobile platform. The teams (winners will be announced in 2016) have come up with devices that track vitals like respiration rate and blood pressure. One of the finalists, Scanadu, has created a device that measures temperature, heart rate, oxygen levels, blood pressure, and the patient's electrocardiogram reading when placed on the temple for a few seconds (Scanadu is still waiting for FDA approval).
Grant Campany, senior director of the Qualcomm Tricorder XPRIZE and the Nokia Sensing XCHALLENGE, predicts that devices like the Scanadu, with the ability to do "multiple condition analysis and validation" could be available by 2018. But single-use smartphone tools, like the Oto and the AliveCor heart monitor, are already hitting the market. Now it's just a matter of getting more doctors onboard—and in some cases, they're loath to adopt new at-home POC technology for fear that it will generate more work and create legal risks. In the case of devices like the Oto, however, participating physicians can at least reap financial rewards from their extra work.
"There are so many things lacking right now that prevent physicians from having direct access to patients in the field and home," Campany says. "This could provide physicians with additional tools that they can use to leverage their own reach. It provides the opportunity for patients themselves to be partners in the process."


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