The future of medicine: when will we be able to be treated without leaving home?
Mobile Medicine
5 facts about portable diagnostics, implanted systems
and other technological solutions of mobile medicineOleg Medvedev, Post-science
Mobile medicine is a new direction in medicine, involving the use of devices like cell phones or tablet computers that we constantly carry with us.
It turned out that the use of such technologies leads to revolutionary changes.
1. Diagnostics at homeThese changes consist in the fact that the patient himself becomes the main focus.
We need to know how he feels. For these purposes, more than three hundred different monitors or sensors have already been developed that allow you to take data from any person, transfer it to a cell phone and send it to a doctor using cellular communication or transfer it to the cloud for further analysis.
We can register an electrocardiogram, measure weight, pressure – see how the pressure changes during the day. Previously, for this, the patient had to be in the hospital. But inpatient placement is the most expensive thing in medicine. Data from Western researchers show that one day spent in a hospital costs from 1 to 10 thousand euros – due to expensive infrastructure, the need to comply with all sanitary and hygienic standards, high salaries of doctors and nurses. Therefore, the main trend now is the gradual transfer of treatment and early diagnosis to the patient's home.
Now the patient can use most of the sensors or sensors at home. You can apply electrodes and take an electrocardiogram, and then the doctor will decode it, or an automated system on a computer will do it. We can find out the level of oxygen saturation in the blood, oxygen oxygenation of the blood, and thus see whether enough oxygen is entering the lungs, whether enough oxygen is being brought to our organs and tissues. We can even look at biochemical parameters, because measuring glucose levels is quite simple, most diabetics do it.
This is a fairly new phenomenon for our country, but in the West, in Europe and the USA, these technologies are becoming more widespread. Already, this market amounts to several billion dollars a year – these are the devices themselves and the service that is provided.
2. Video recording of vital signsOne of the problems that arises when using these technologies is that patients know very little about the possibilities that really exist.
When the patient looks at the screen with all its indicators, it is perceived as a plot from "Star Wars", as something distant, fantastic. In fact, this is far from fantastic, most of the technologies and programs have already been developed. There are more and more programs that do not even require the imposition of sensors on the body. For example, when processing our video image, it is already possible to determine both the heart rate and the respiratory rate.
Such systems work very simply. An ordinary webcam or a camera built into a computer, or iPad, or iPhone, perceives a picture of our face, and a computer analysis of the slightest color fluctuations occurs, which depend on the fact that with each heartbeat a new portion of blood flows to all organs and tissues, including the skin of the face. But on the skin of the face it is easier to register. And the fact that the eye does not distinguish, but the computer can already distinguish – with each heartbeat there is a slight pinkness of the skin. By the pinkness of the skin for each beat, we can determine the heart rate. And by the oscillation of the upper body, we can determine the respiratory rate. At the same time, there are no sensors on the person, and everything is recorded directly from the camera.
This implies the emergence of completely new opportunities. For example, a person comes to the bathroom in the morning, brushes his teeth, washes, and the camera shoots him and gets vital signs: heart rate, respiratory rate. At the same time, he can stand on the floor, where electronic scales are built in. This information goes into his individual database, into an electronic medical history.
3. Bioradar and implanted systemsThis is a movement towards early diagnosis of diseases, towards early prevention.
It is known that every ruble or every dollar invested in prevention saves seven rubles or seven dollars that will be spent on treatment. This is beneficial both from the point of view of the country's economy and from the point of view of the entire healthcare system.
The next changes in this direction will be related to contactless sensors, some of which are being developed in Russia. For example, a bioradar. We can irradiate a person with an intensity thousands of times less than that emitted by a regular cell phone, and determine the heart rate and respiration. Several institutes in Moscow and Russia are already engaged in these technologies.
There will be a growing interest in implanted, or implanted, systems. There are more and more opportunities for making genetic diagnoses when we analyze genes and understand what features, what changes a person has and what diseases can be expected. If there are suspicions of the development of diabetes, then it is logical to implant a sensor that will determine the glucose level, and as soon as this danger becomes real, start diabetes treatment. Until then, no need to waste energy and no need to use medications. This is a way of individual early treatment.
4. Individual standards of healthThe widespread introduction of such technologies, mobile healthcare, or mHealth, is fundamentally important, because at the same time we get an individual norm for each person, this is a movement towards personalized medicine.
Now, when we say whether you are sick or not, we can only be based on the data that was obtained during the examination of a large group of people. We can tell if your blood pressure is above 140 that it's not quite good anymore and you need to see a doctor. But if a person constantly had a pressure of 110, then an increase in pressure even to 120, which is within the normal range for the population, may already mean a bad trend, which must be reacted to at the very beginning.
If the data from each of us will come to such a call center, then the doctor, after looking at them, can tell when it is necessary to increase the dose of the drug to reduce pressure. Now it is really impossible to do this, because no one knows what is happening to the patient at home until he gets to the hospital with a crisis.
5. Control of medication intakeMany people, especially in the elderly, often forget to take medicine, and if this happens for one or two days, then they no longer take drugs for a week, until complications appear.
There is an automated reminder system for such cases. But even such a system or registration system, when a person opened a medicine box and took a pill, shows only the fact that the box was open. Whether he swallowed the pill or not, we don't know. mHealth can help here too. Microscopic millimeter-by-millimeter processors have been developed that attach to each tablet. Electrodes made of different metals are built into each such processor, and when a potential arises in the stomach, this microprocessor begins to transmit data that it has been swallowed and is inside the body. This is very important both for highly effective treatment, in which you need to take medications regularly, and for conducting clinical trials, when clinicians need to be sure that the drug is used correctly, at the right time.
In 2012, a book by the famous American cardiologist Eric Topol was published, which is called The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, which describes the consequences of the introduction of new technologies.
Medicine itself must change completely, because now it reacts only to a sick person.
A person should come with some symptoms, complaints, then medicine begins to pay attention to you.
In the case of widespread adoption of mobile technologies, mHealth, the patient pays much more attention to his health, he becomes more responsible, and this will lead him to the hospital much later.
Thus, the burden on the entire healthcare system decreases, and on the other hand, the quality of life increases, and a person remains active and capable of both work and creativity for longer.
About the author:
Oleg Medvedev – Doctor of Medical Sciences, Professor, Head of the Department of Pharmacology of the Faculty of Fundamental Medicine of Lomonosov Moscow State University.
Portal "Eternal youth" http://vechnayamolodost.ru16.12.2014