In Focus July 2013

“Nothing about me without me.” How patient-focused technology is democratizing medicine.

e-Health 2013 Special Report

e-Health 2013 explored today and tomorrow in health care—and boy does tomorrow look interesting. It was clear that a rising tide of technology is putting patients’ health in their own hands. 

After announcing $1.6 million toward e-health projects, the Honourable Leona Aglukkaq, Minister of Health, said that innovation “must keep patients in mind.” Technology may, in fact, be doing much more than that.

In patients’ hands . . . literally

Toronto biomedical engineer Dr. Joseph Cafazzo is spurred by the fact that health care technology is needlessly complicated. His team at the Centre for Global eHealth Innovation develops apps that strip down such barriers for patients.

One measures your blood pressure and feeds the results to a BlackBerry. A study showed dramatic improvement in systolic and diastolic levels in users of this app. “This is true patient self-care,” Dr. Cafazzo said.

Another app, called “bant,” helps adolescents manage their type 1 diabetes. Complete with social media and the ability to earn points and compete with others, bant has more than 10,000 active daily users. And Dr. Cafazzo said blood glucose levels have improved dramatically among users.

The centre also created “30 Days,” a simple app to assess your risk for heart attack and stroke. “Breathe” is another, developed for asthma patients. All of this, Dr. Cafazzo said, is just scratching the surface of patient self-care. 

Digitalizing ourselves

In a sometimes startlingly forward-thinking presentation, Dr. Eric Topol revealed where he thinks the future lies. The renowned U.S. cardiologist and technology expert says we are operating in the past and instead should be digitalizing humans for daily care.

Any patient, he believes, should be able to take blood pressure or blood glucose readings through a smartphone. (Apple is, in fact, selling diabetes attachments for iPhones.) Someone with diabetes or pre-diabetes can apply the sensor, get a reading of blood glucose on her phone, then decide if it’s a good idea to eat that muffin. “This really influences your lifestyle,” Dr. Topol said.

How about a sleep study done on a smartphone, with a sensor attached to your finger? Or doing your own cardiogram that spits out a PDF algorithm illustrating your heart rate? “Think of the future: check your email, surf the web and see all your vital signs,” he said. “In real time.”

Dr. Topol said one driver of technology is our genetic information. More and more people are getting their gut microbiomes sequenced to understand their risks for many types of disease. Genomics could reveal who is likely to respond to certain drugs, eliminating experimental prescriptions and wasted money. Genomics has already found biological pathways that trigger cancers, moving away from the organ-specific cancer train of thought. 

He said a huge new view is slowly taking hold. “Why see a dermatologist or an optometrist, or send your child to a pediatrician, when add-ons to your phone can easily diagnose issues? 

“Is your doctor becoming obsolete? A question you’d never consider until this profound technology has come along. Why do we need hospitals? They are for sick people. Why go there if you can monitor your health right in your own home?” 

Rise of social media and other peer-to-peer patient health care possibilities

Dr. Topol believes that “democratization of medicine” is taking shape and that consumers can start launching a patient revolution. One phrase that received much attention at e-Health summarizes his patient-centred approach: “Nothing about me without me.” 

That revolution would include a kind of communal health care, via social media and peer-to-peer channels. Toronto physician Dr. Michael Evans heads a team of patients, researchers, filmmakers and social media experts. “The biggest workforce in health care is patients,” he said.

To that end, he works to engage patients rather than educate them. His biggest splash was a budget-less video called “23½ Hours,” which asked “What’s the biggest thing we can do for our health?” On YouTube, it has 3.5 million views. His team created eight more videos, each showing the reach and power of social media. This has flowed into a “medical school for the public” YouTube channel, which has more than 7 million views. 

“This is peer-to-peer health care,” Dr. Evans said. “Stories trump data. Relationships trump stories. Individuals trump organizations.”

Or, as Dr. Topol put it, “There needs to be a changing of the guard in medicine.”

CIHI proudly co-hosted e-Health 2013 in Ottawa from May 26 to 29.