Revolutionizing the Practice of Medicine

Thanks to the CommNexus Healthcare Communications SIG for sharing video and presentations from the “Revolutionizing the Practice of Medicine: a look at how MD Revolution and it’s technology partners have created the medical practice of the future today” event that was held on Tuesday, June 19, 2012:

My notes from watching the video:

Kevin Patrick, Professor, Family & Preventive Medicine, Director, Center for Wireless and Population Health Systems, Editor-in-Chief, American Journal of Preventive Medicine, coFounder, Santech Inc.

A great start to his presentation with an explanation of how excited he and his colleagues are about mHealth (from 4 min):

we’re particularly interested in this use of mobile technology I think this is something that is many of of us who have been involved in this field for many many years – more than I care to admit sometimes – are more excited about this potential than anything we have seen come along there is an enormous potential

I love the 8th slide in his deck that suggests the current sickcare system is just like rearranging the deckchairs on the Titanic as it’s a good reminder that 100 years ago as the band played on the bridge there were engineers busy using the newly invented Marconi wireless tech to save hundreds of lives…

In the Q&A at the end Kevin also gave some great answers:

QHow would you define differences between mobile health, telemedicine and telehealth?

Ahaving been involved in telemedicine for 25 years, when at the university of Utah we were sending information out to Nevada supporting Physicians, out there, that was telemedicine, telehealth. Mobile health is much much different. Mobile is the ubiquitous computing with the notion that all the things people are wearing and potentially on the go all the time
and my sense is that Telemedicine is in decline as far as a term
and it’s (now) much more the mobile, that’s my read of the zeitgeist right now. Telehealth might be getting a bit of a niche in terms of homecare or the particular things that might be stuck up for the care of specific chronic diseases, i’m sure these are in fashion in different parts of the country and different parts of the world but mHealth is where it’s at for most of us now

Related: my definition of mHealth.

Q “(1hr:09:30) this is a very important scientific and technological advances and I commend you for that so excuse my contrarian question, we have a lot of information whenever i go to my primary care physician and it’s excessive, way too much information, we know exactly what’s relevant for our patient today so are you really really sure that all this information is in the long run going to reduce healthcare costs?

AI like to use a metaphor we’re at a point now where our eyes are right up next to the book and we’re looking at the letters and we have the ability now to scale back and see the letters and the words and the sentences and then hopefully the paragraphs and the meaning that actually comes from this data so we’re at a point now where we have to step back and look at all this data at a very different scale and very different level of enquiry… …clearly it’s noisy now, there’s a lot of things going on, but this is just a time of churn and i think this will settle into something that will be much more powerful for clinicians and patients

I think Kevin’s provided a great answer to a question that I’m regularly asked. Up close most data is overwhelming until you work out how to process/filter it. Taking even simple tech like the mobile connected care monitor from SendTech and where someone will see just noise others will see potentially life saving signals eg. a few data points in the night may signal nocturia/nocturnal polyuria which is the biggest risk factor for hip fractures amongst independently living seniors.

Dr Samir Damani, MD Revolution

It’s great news to learn that MDRevolution and DexCom are now collaborating to launch a mHealth blood sugar monitoring program to see the impact of mHealth sensors on behaviour change with patients who don’t have diabetes.

Unimpeded by regulatory requirements this could create some incredible new insights into behavior change and it’s hard to imagine the size of the addressable market that it could open up for Dexcom if the findings are interesting…

MD Revolution’s “Global Health Postitioning System” that is trying to approach healthcare information from a patient centric rather than a Doctor centric approach is interesting but I’m not sure I agree with Samani’s thinking as to the reason we’ve replaced maps with navigation systems.

He suggests it’s because one’s “static” and the other is “dynamic” whereas I think it’s got more to do with Moores Law, the convergence to mobile and major tech investments like Nokia’s $8 Billion takeover of Navteq, as some of us did after all have unreliable and expensive navigation systems back in 2002 (when they were already options on production cars).

He more than makes up for this though as he nails the hopeless ineffectiveness of Doctor’s taking patients weight, BP, etc in their office:

if you tell people what their numbers mean and give them an opportunity to understand themselves better, which is what we/re all about we’re about information we’re about data what we’re finding is that it has an amazing impact on the way they look at their health,
at their life… …and it’s not looking at their weight, it’s the ability to take control and be in control, and that’s what the quantified-self does, it allows you to feel like you’re in control

Dr Michael Nova, Pathway Genomics

Michael gave us some interesting insights into the work of Pathway Genomics and the objective of the companies use of data:

It’s all about how you present the data to the Doctor

The challenges he touched on with regard to patients preconceptions of genomics will be fascinating to anyone looking to work in this field. He highlighted his work in this space by referring to the challenge they faced when they were asked to sequence the DNA of Mexican Billionaire Carlos Slim Helu:

He was so worried about us looking at his soul on the data that he didn’t want anybody else to see the data except himself. But his idea was, his understanding of genetics was, I got these genes I’m going to get this stuff, that’s not what genetics is about at all it’s basically about tendencies and if you’ve got a certain blueprint and your environment will kick you over on certain issues and behaviour is a lot like that. Behaviour is like how your environment can infleunce something you do and everyone

If the world’s richest man (who can presumably would have no trouble affording any Doctor or treatment he wants) is in any way uncertain about the risks and challenges of his genetic information being sequenced I think it’s an indicator of the size of the challenge ahead of those technologists who think that the public is just going to get this stuff.

As genomic data becomes ever cheaper I imagine the opportunity for personalised attention with an informed professional is going to be massive.

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