martes, 22 de julio de 2014

martes, julio 22, 2014

July 18, 2014 7:23 pm

Technology: Wear your medicine

New wearable digital devices could signal a radical shift in medical practice

Google smart contact lens©EPA


Walter de Brouwer’s life changed when his son fell 35 feet from a window. Spending anxious months in intensive care, the entrepreneur became all too familiar with the machines that tracked his son’s vital signs. But for 23 hours a day he had to wait for a doctor to arrive to explain what it all meant.

As a baby boomer weaned on Star Trek, he remembers wishing for the science-fiction series’ Tricorder, a gadget that performed instant diagnostics with nothing more than a wave over the body. In the age of the smartphone, such convenience from an “intelligentdevice feels almost a right.

“I can push a button and have an Uber [taxi] three minutes later, or order a coffee before I’ve got into Starbucks, but the most important thing we know the least aboutour health,” Mr De Brouwer says.

His latest Silicon Valley start-up, Scanadu, is putting the finishing touches on a “medical grade Tricorder”. Called the Scout, it is packed with sensors that measure heart rate, blood pressure, skin temperature and other bodily signals, and sends them to a smartphone app.

“We want to be able to give to people that complete diagnostic experience,” he says. As much as Google has put information into the hands of the people, I think healthcare can benefit from that same disruption.”

Others in Silicon Valley have the same idea. The Xprize Foundation, which helped to stimulate the commercial exploitation of space when it offered a $10m prize nearly 20 years ago for the first privately funded mission, has promised the same amount to the first company to come up with something approximating a Tricorder.

Big companies are also waking up to the transformative potential of digital technology in healthcare. Just this week Google struck a partnership with Novartis, the Swiss drugmaker, to commercialise a contact lens that monitors glucose levels in tear fluid. It sounds like something from science fiction: a wireless chip embedded in a lens transmitting data to a mobile device from an antenna thinner than a human hair.

Yet this technologydesigned to help diabetics manage their diseasealready exists in prototype form and Novartis hopes to have a product ready for market within five years.

The smart lens points to a proliferation of new health monitoring devices.These are not Star Wars technologies that we are still waiting for,” says Freda Lewis-Hall, chief medical officer of Pfizer. “We have many of these technologies now.”

Healthcare has been slower than other industries to feel the force of digital technology. While the internet has changed the worlds of retail and banking, medicine is still largely conducted in hospitals and doctors’ surgeries, with patients the passive recipients of treatment and advice.

That finally looks set to change in some important respects. Three big trends in technology lie at the heart of this: the collapsing costs of sensors that can track bodily signals, such as the accelerometers in fitness wristbands that count footsteps; the prevalence of smartphones, which can act as the communication hubs and the brains for gathering and processing personal health information; and the new science of big data, with its promise of finding important insights buried in the masses of information that is being collected.

This could lead to a significant cultural shift in attitudes to healthcare. The proliferation of apps and so-calledwearables” will hand power to patients in the same way that technology has empowered consumers in other sectors, says Bruce Hellman, whose company, uMotif, develops software for healthcare technology.

“Your bank manager no longer controls your banking; you do it yourself. That will become true of healthcare,” he says. “Technology will allow people to take more responsibility for managing their own health.”

There are demand as well as supply pressures at work. Healthcare systems around the world are creaking under the weight of ageing populations and providers are increasingly being paid based on their ability to produce demonstrable improvements in health, says Shahram Ebadollahi, chief healthcare science officer at IBM. Measuring results – and using that information to influence patients’ behaviour – has become essential.

“It’s a culture shift for medical institutions,” says Pierre-Alexandre Fournier, chief executive of Hexoskin, which makes clothing that tracks vital signs. Health information will be produced in a decentralised way in the future. It can take a generation to change a culture and I think we are in the middle of this cycle.”

The monitoring is also about to become more invasive, with so-calledingestibles” that work from the inside out. The UK’s National Health Service, for instance, is assessing an “ingestible computingsystem from Proteus Digital Health, another Silicon Valley company, which has raised about $300m.

Proteus’s smartpills react inside the body to emit a unique identifier picked up by a Band-Aid-sized sensor attached to the chest, which in turn communicates with a smartphone app. Together, they can identify whether a patient has taken drugs as prescribed and whether the treatment is working.

“We are going to create medicines that measure,” says chief executive Andrew Thompson. “We are turning the single most common engagement transaction in all of medicineswallowing a drug – into digital information to help physicians make much better decisions about what they do with patients.”

The data that companies are looking to tap to improve health are also reaching beyond the purely physical. IBM, for instance, is among the companies to have experimented with analysing voice patternssomething made possible with a smartphone app – to identify mental health problems. Harvard and Massachusetts Institute of Technology scientists have developed an app that detects changes in heart health by picking up changes in the user’s face colour from self-taken mug shots.

With the outpouring of information from all these sensors and apps, the human body will soon come to resemble a modern car, says Daniel Kraft, a Silicon Valley healthcare investor. Constant monitoring will take place, with warnings flashing automatically when something is wrong, he says.

The companies lining up to provide the corporeal equivalents of the 10,000-mile check-up are some of the world’s best-known tech companies.

. . .

Apple, Samsung and Google have laid out their plans to turn their smartphones into personal health hubs, aggregating information about things ranging from caffeine and calorie intake to blood glucose, body fat and galvanic skin response. In the process, they hope to create mobile dashboards of our wellbeing.

Craig Federighi, Apple’s head of software engineering, says its health app will provide a “composite profile of your activity and healththat, paired with the apps from healthcare providers, could alert an individual’s doctor if his or her blood pressure crosses set personalised limits.

“The mobile phone is going to become the most important platform for healthcare service delivery in history,” says Mr Thompson at Proteus.

Some are betting that mobile devices will eventually move beyond monitoring and diagnosis into the realm of active medical intervention. Drugmaker Merck, for example, has invested in a company called electroCore, which makes a handheld device that seeks to treat migraines with electronic pulses delivered through the skin to the nervous system.

The treatment, which has proved successful in clinical trials, can be prescribed in the same way as a normal drug, with a fixed number of doses downloaded wirelessly to the device. It could eventually be integrated into a smartphone.

It is with the collection of personal data, however, that the biggest changes are likely. Combined with existing health records and genomic information – which itself is becoming far cheaper to generate – the mass of medical, social and environmental information spun off by personal electronics will lead to far more personalised treatments. “The future of [health] data is in user control.” says Mr De Brouwer.

In common with other areas where personal digital information is proliferating, that optimistic outcome is not guaranteed. Without adequate privacy controls or rules about how the information is used, health data could be misused, as most experts in the field acknowledge.

Insurance companies or employers who foot the bill for healthcare, for instance, might one day use the information to track people in their daily lives and require them to act in ways most likely to benefit their health even if that means limiting personal freedoms.

At the dawn of the personal health revolution, however, that is not the future that most in the industry are ready to countenance.

“It’s not about monitoring people and pushing them to behave in a certain way,” says Mr Ebadollahi. “It’s more [about] suggestions for better self-management, to make the right choices and have a better life.”


Copyright The Financial Times Limited 2014

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