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After spending only a few hours in San Diego at the FutureMed Conference, there was a palpable distaste for the status quo of our nation’s healthcare. Still, an optimistic crowd of 400 kept sights toward the future, because many technologies in the pipeline have a great deal of promise for clinical practice and better healthcare delivery.
Inspired by FutureMed, here are eight technological advances you can expect to see in the “new black bag” and medical encounter of tomorrow. Which would you implement first in your practice?
1. 3D-print bespoke therapy
Patients with musculoskeletal issues such as carpal tunnel syndrome can often feel better with regular use of prescribed durable medical equipment, such as wrist braces. However, compliance can be poor due to lack of custom fit and attractive styling. What if a medical device could be a customized, fashionable garment? With falling prices and more intuitive design software, 3D printers are becoming accessible to professionals beyond engineers. 3D printers, machines that instantly produce objects from computer models, will allow for custom design and production of therapeutic devices right at the point of care. No bigger than a microwave, these printers will be popping up in medical offices to provide a more custom experience, putting an end to the “one size fits all” approach. Specialties such as orthopedics, rheumatology, podiatry and orthodontics will likely see early benefit. We can also expect to see eventual ability to print custom-fit transplantable organs, as the use of biocompatible materials advance.
2. Wearable computers never break the doctor’s gaze
Poorly-placed computer screens distract the optimal doctor-patient interaction, and looking away at the wrong moment could turn a near miss into a catastrophic failure. Wearables such as Google Glass promise a whole new sense of awareness, where clinically relevant data is placed in front of the doctor at the right place at the right time. Leveraging mid-level staff, this whole new delivery ecosystem can expand doctors’ rounding reach via real time hands-free video. As a cutting edge telemedicine platform, wearables can aid procedural medicine such as surgery, emergency medicine and anesthesia, and they’re already undergoing pilots in top medical centers.
3. Photo-sharing tells a subtle story
Doctors have been sticking scopes into eyes and ears for decades. Patients never see what the doctor sees, and notations akin to “within normal limits” march throughout the chart. For diabetics, progression of retinopathy may be subtle. For skin wound checks, a “clean, dry, intact” incision might actually be slightly worse. But how much better or worse is the patient really, if there’s no image to compare? Is your smartphone’s camera roll even HIPAA-compliant? A number of companies, like Captureproof, are pioneering a new secure imaging ecosystem to remove some of the guesswork from image-based medical decision-making. Radiologists have long benefitted from powerful, secure PACS systems allowing image storage and comparison over time. Now, doctors and patients can overlay current and previous images on a smartphone to visualize incremental progress.
5. Smartphones make patients better data collectors
Despite heart disease killing more Americans than anything else, it’s hard to get patients excited by a blood pressure cuff. But smartphones are poised to transform patient-generated data. As demonstrated by The Smartphone Physical, smartphone-enabled home vital signs such as blood-pressure, weight, pulse oximetry, allow patients and physicians to trend numerical data in real life. No longer will blood pressure readings be relegated to spurious “white-coat” values in an uncomfortable exam room. The smartphone allows automatic capture in the cloud, making readings remotely viewable by the physician. Apart from vital signs, mobile devices allow patient capture of other clinically relevant data such as activity levels, sleep quality and heart rhythm.
6. Ultrasound pushing the stethoscope out of a job
Some of my attending physicians in the emergency department facetiously referred to the stethoscope as a “wheeze-o-scope,” because the actual utility of the stethoscope can be limited in many settings. With the rapid reduction in size and price of ultrasound, more medical students are starting with learning ultrasound on day one instead of the standard-issue centuries-old relic of tubes and diaphragms. Why stop at listening to the heart if you can see its function in real time on a hand-held device? Companies like Mobisante are making pocket-sized ultrasound devices that allow more ultrasound to be done by more doctors at the point-of-care. These radiation-free imaging studies can be ordered and interpreted (and often billed for) without sending the patient to another location or doctor. The more information the treating doctor can gather on-the-spot, the better for the patient’s therapy.
7. Power a sophisticated lab by your smartphone
Point of care lab testing is well-known to the CLIA-waived market, and many doctors check simple blood and urine chemistries right in the office. But molecular tests based on DNA amplification require expensive machinery, and are usually “send outs” for the independent physician. Key innovations in low-cost bedside DNA amplification (qPCR) will allow just about any doctor to have a molecular diagnostics lab in his pocket. Innovators at Biomeme showcased their smartphone-powered qPCR device, which has multiple applications such as in infectious disease detection, genetic testing and even GMO testing in the food supply. The price point is around $1000–soon to be low enough for the motivated home user.
8. The best pill bottles never forget
Up to 40% of patients do not adhere to the medical device they receive, and even the most well-meaning, earnest patients “forget” to take their medicine. The doctor may not find out until the patient’s heart failure hospitalization, or worse. Thanks to an innovative pill bottle attachment, pill bottles will all but chase patients down. CleverCap alerts the patient by visual, auditory or even text message stimuli when it’s time to take a pill. The device will dispense only the exact dosage, making over- and under-dosing nearly impossible. (The bottle is child and adult-proof when it’s not pill time.) Through wireless and cloud technology, the doctor can be alerted when adherence falls.
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