By Mary Kozelka
Rock Center
It happened on flight from Washington, DC to San Diego.
The pilot’s urgent question reverberated over the intercom during a cross country flight, “Is there a doctor on board?” A passenger was experiencing severe chest pains, and luckily for him Dr. Eric Topol was sitting in seat 6A.
Topol is the energetic chief academic officer of Scripps Health, a prominent cardiologist and the foremost figure in the field of wireless medicine. He believes the future of health lies in our own hands, namely in our smart phones and other portable electronic devices. According to Topol, “the smart phone will be the hub of the future of medicine. And it will be your health-medical dashboard.”
That day on the airplane, Dr. Topol displayed the potential of wireless medicine when he snapped an AliveCor device onto his iPhone and performed a cardiogram at 30,000 feet. Using this portable, cellphone powered device, Topol was able to see that the passenger was definitely having a heart attack and he recommended an urgent landing. The passenger was rushed to the hospital and survived.
Topol said this was a “Eureka!” moment for him; such devices could lead to better and cheaper health care everywhere, from airplanes to senior citizen’s homes.
“These days, I’m prescribing a lot more apps than I am medications,” he continued.
Topol points to a growing number of apps and devices, none of which he is paid for using or endorsing, that are capable of measuring vital signs and then transmitting that data to smartphones. Whether it’s your blood sugar levels, your heart rate or your sleep habits, Topol believes we should track our own conditions through our phones and use that data to see patterns and warning signs of illness.
Topol speaks of a not-so-distant future where human beings are digitized through sensors in the bloodstream. He explains, “By having a sensor in the blood, we can pick up all sorts of things, whether it's cells coming off an artery lining [indicating heart attack], whether it's the first cancer cell getting in the bloodstream, whether it's the immune system revving up for asthma or diabetes or you name it. All these things, will be detected by sensors in the blood which will then talk to the phone.”
And when one of these warning signs is picked up by the sensor, a special ring will be sent to your cell phone. Like an engine warning light on your car’s dashboard, this ring will indicate that trouble is brewing in a certain area of the body. Ideally, this would prevent life threatening incidents, like heart attack.
Topol calls the medical community ossified for its hesitance to embrace wireless technology. This he sees as destructive to the advancement of medicine.
He is similarly critical what he calls “population medicine”, in other words, one standard method of treatment used on all patients. He says that mandated mass screenings, such as the annual mammogram for women over 50, are not only wasteful, but can cause needless anxiety from false positives and biopsies. Only 12% of women will ever get breast cancer, so instructing that all women be screened yearly exposes many to unnecessary radiation and often leads to false positives and biopsies causing needless anxiety for both the patient and his or her family.
When describing medicine today, Topol says most doctors “fire into a black box, give someone medication, go home and pray." He argues that instead, in the near future, everyone should have his or her DNA sequenced which would reveal what diseases or conditions an individual is prone to, and also what types of drugs will or will not be effective for that particular individual. Topol is in full support of DNA sequencing, but there is some controversy regarding how effective DNA sequencing is when it comes to predicting illness.
Right now a full DNA sequencing costs about $2,500, but Topol expects that within the year, the cost will drop by more than half. It is his hope that DNA sequencing will soon be affordable for all.
Topol further predicts that finding a cure to ailments from cancer to heart disease depends on sharing our medical information. He insists that if we were serious about the war on cancer, every single person who had the disease would get his or her tumor genome sequenced, record treatment techniques and outcomes, and then make it all public knowledge. This data combined has extraordinary potential.
His enthusiasm is infectious as he describes his vision for the near future, “If we started to bring all this information together, the acceleration of knowledge and the transformation of what we could do for the future of disease would be extraordinary.”
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Contrary to the above headline, do not keep your cell phone in your pocket unless it is turned off completely. We have considerable evidence of sperm damage and infertility in men from exposure to cell phone radiation. Also, women should keep cell phones away from their reproductive organs. We have growing evidence of increased breast cancer risk and effects on the fetus.
For more information about the health effects of cell phone and other forms of electromagnetic radiation and what needs to be done see my website, Electromagnetic Radiation Safety, at saferemr.blogspot.com .
Interesting!
Has this research been published in JAMA or elsewhere? How many people were in the studies? How are you precluding other factors?
Dr. Moskowitz, Ph.D. does not equal Medical Doctor.
the info you provided is a blog, not a medically peer reviewed publication.
The information regarding apps for smartphones in the above article is not a new phenom. The Canadian medical community is already heading in this direction and utilizing tablets and smartphones for various uses. It's about time technology has found its way back in the US,given that we are one of the leaders in this industry!!!!! :)
I spent 2 years on a job that required several hours a day talking on a cell phone. Being right-handed, I held the phone in my right-hand and talked with it on the right side of my head.
My cell phones would last a month or two. They would get too hot at times to hold onto them. I would give them a rest for a few minutes, and sometimes hold them in front of an air conditioner in the summer. In the winter, I would place them outside my car or hotel window.
Ten years later, I had a Grand Mal Seizure and was taken to the ER. The hospital did many tests including an MRI. They discovered a tumor on the right-temporal lobe of my brain. The cause of this tumor could not be determined. I was lucky that I was otherwise healthy and survived the radiation, chemotherapy and surgery.
Today, I avoid using a cell phone. I own one and carry it in case of emergency. I am not allowed to drive a car. You see, if I miss a bus, I may need to call a taxi. Fortunately, I am now able to walk. It took me 2 years to overcome the paralysis in my left side.
Is this the same "technology" Dr. Topal thinks is a medical breakthrough? No thank you.
TeriquaJones: I am very sorry to hear about what happened to you. However, tons of people nowadays carry smart phones with them anyways. If he can find a way to use them in a productive way to save lives, then we should be supporting him. The technologies that are used to actually take the measurements are the same either way. Smart phones aren't going away any time soon, so if there are means of harnessing them to save lives and reduce medicine waste (and other side effects), those with smart phones should use them.
I am a psychologist and my patients and I use a disease state management system from McGraw Systems called bStable to help keep their mental health disease state in check. It has been effective in providing a transparent view into how my patients are doing on a daily basis to avoid crisis situations. It is not a smart phone app but the patients and I enjoy the larger form factor that Macs and PCs provide to see the data and analytics provided by the application.
I sincerely hope we're commenting on Dr. Nancy's piece this evening, 1.24.13, with Dr. Topol. How thought-provoking. Thank you, Dr. Nancy, for bringing this to the attention of all of us. WE WANT THOSE APPS!!!
Does anybody have any information on the blood the blood glucose device shown on this report that is places on the belly. My wife has Type 1 and I am always looking for new ways to better monitor her sugar levels.
Yes I would like to know the answer to this question since I have diabetes!!
I am looking for the same information. How can I get the glucose device?
Yes, a continuous glucose sensor is generally linked to a device that administers continuous insulin infusion. The person has a needle placed under the skin which stays in place for 3 days (and then must be changed) to deliver insulin which is connected to a small plastic device that is worn under the clothes. This device also receives information from a seperate sensor for continuous glucose checks from a seperate site on the body. A endocrinology specialist can educate you more about whether this device would be helpful for your particular case. Not all diabetics need continuous insulin administration.
if you have ferro magnetic particles in your blood, like I do from MRI dye/contrast aka GADOLINIUM metal and other NANOPARTICLES< this is how the information is transmitted to the skin patch and your phone. YOU DO NOT WANT THIS METAL IN YOUR body , it has no biological function and can cause fibrosis, pain, joint contracture, vision changes, it deposits in the bones/skin, skin biopsy and skin sores along with normal or abnormal kidney function and intake of zinc, calcium, iron and other metals cause retention of this toxic dechelated Gadolinium. see mayomedicallaboratories com G for Gadolinium ,treatments and side effects of MRI and biological damage from xrays and BEIR VII reports. they know what they are doing and it's killing us, not making anyone better, the Gadolinium is deadly, see fda gov Blackbox warnings and don't think it won't happen to you. nyas org Fourth Annual NSF Conference e briefing 13 Sept 2012 Jack Gauldie, "if it's in them, we put it there" next epidemic of the decades/gadolinium metal induced fibrosis, mimics numerous diseases, lungs, eyes, skin, allergy sores not hsv. watch out. watch out for other tracers in common meds, www dvice com fda approved meds with cu/mg tracer that dissolves in stomach acids. What a lot of NERVE.
I would like to know the name of the blood glucose monitoring system/program Dr. Topol has. I really need this for my mother.
The glucose monitor appeared to be Dexcom G4 Continuous Glucose Monitoring System. Here's a link to the FDA approval:
There are youtube videos on it. Search "Dexcom G4 platinum."
Google "Dexcom G4 Platinum" for more information.
Hopefully there will be more products like this in the future and the cost will come down for all devices that communicate with smartphones.
Fascinating piece about some ideas and apps that may impact many of us. The medicine of 20 years from now may be radically different thanks to the innovative work of researchers like Dr. Topol! Great segment by Dr. Nancy Snyderman...Thanks so much!
Completely inspiring. This is what needs to be happening MORE in Heath Care to cut down on very high medical expensives. Why aren't more doctors trying new items like this to get approved. Medical costs are so high, medical expensives & health insurance company's need a major over hall & soon.
I'm guessing Holly a major over hall and serious efforts to reduce healthcare costs and fraud are in the works.
I've been recommending that all my doctors should be pushing for full DNA sequencing for all their patients. Their comment is always the same, "The cost is too prohibitive." My response is also always the same, "How much money is spent on each patient each year shooting in the dark?"
I can appreciate patients wanting certain tests and "pushing their doctors" to get them, but as a physician, I can assure you that the response of," the cost being too prohibitive" regarding medical decisions is not coming from your doctors desire to stonewall you. The insurance companies control the money and for every new test that may have tremendous value for the patients, the insurance companies initial response is always to deny the request and say no. Your doctor in turn fights with the insurance company on your behalf (phone calls, letters of pre-authorization, more phone calls ...that take up a significant amount of time), only to be told by the insurance company that they don't have a protocol for that test, which is insurance company code for "it costs too much and we won't authorize it." Your doctor then has to then turn to plan B, C, D etc until the insurance company authorizes treatment that the physician is trying to implement. That is the unfortunate reality of what goes on behind the scenes. So until patients are willing to pay cash for these cutting edge technologies/tests and eliminate the insurance company from the equation, the physicians hands are tied. As physicians we are trying to provide the best care we can for patients within the confines of the rules set before us, as most patients are not willing to absorb the cost of their health care. So please, if you want to be a champion for change, direct your energies toward the insurance companies.
I work for an HMO in Massachusetts, and I could not disagree with you more, Doctor. Thousands of prior-authorizations are approved daily when submitted properly by the provider. If a member/patient's plan covers a test, according to the Summary of Benefits and Coverage, then it will be authorized and then covered. The issue is more that the physician does not submit the prior-auth in a timely fashion or correctly/completely. Another issue that is quite obvious to all is that the cost of the tests and visits that are charged by the greedy physicians, hospitals, etc. is ridiculous. Anybody that goes in for a checkup at 30 years old in perfect health and asks to get an itemized bill of their visit, only to find that the insurance company was charged $350 to get a height/weight check and turn & cough, knows that you are the frauds in the system. The issue I explained above will hopefully be resolved with the ACA and capitation payments, so you can maybe stick to one expensive car and home instead of living like a king. United States Marines should make more than you. Stop taking bribes and kick-backs from pharmaceutical companies and hospitals for doing business with them, and start doing what you swore to do when you took the oath. You did take the Hippocratic Oath, didn't you Doctor?
As a UK doctor it is hard to know what to say to this rant. If this is the future of collaborative healthcare (rather than a healthy tension) and where we are headed in the UK then God help us. By the way doctors have not sworn a formal Hippocractic oath for years, What oath (code of practice) do health care mangers swear by?
We patients should ALL be recommending to our physicians that they demand full DNA sequencing for all patients. They say it costs too much, I say it costs MUCH more not to do it. Now doctors are shooting in the dark for answers to their patients problems. Full DNA sequencing for all patients will result in VAST improvements in medical care (while saving huge amounts of money!).
what proof do you have that DNA sequencing will help? DNA is mutable and WILL mutate with time. the only benefit you have with pre sequencing your DNA is a before and after. Say a mutation leads to cancer, you can still sequence your post cancer DNA to find that mutation. even more so the treatment is directed to the findings in the post cancer sequenced DNA not the pre cancer sequenced DNA. Sequencing DNA isnt needed to help improve medical care, DNA sequencing is only needed and will only help those with actual genetic problems. not the everyday patient
"DNA sequencing is only needed and will only help those with actual genetic problems. not the everyday patient"
And how do you propose to separate those that will benefit from it, and those that will not. The above is a very typical argument for maintaining the status quo, by those that benefit from the status quo.
If you didn't see this you should have. Our medical future is about to change dramatically!!!
We hear far too much talk about medicare costs and seldom do we have access to the answers looming on the horizon. Thanks MSNBC - Hopefully, we will see much more on this topic and others - always comparing them to fears being generated by the costs we have accumulated in the past.
Excellent coverage on the changing face our healthcare delivery system.
These iPhone and iPad Apps empower what I like to call end-user healthcare consumers to help monitor our daily health. Smartphone and tablets won't replace hands-on care provided by doctors, nurses, physician assistants and others; rather they will enable us to engage with our health in new and yes, even fun ways. I say bring 'em on!
Thank you MSNBC!
Really? He could tell the pt. was "definitely having a heart attack" with a simple rhythm strip?
It would let them know what the rate was and the rhythm as well as if there was any ST elevation or depression. As well as the width of the qrs and possible blocks. This then could indicate a more thorough exam was needed, including a 12 lead ekg. Although I did think the rhythm strip had a lot of artifact in it and was hard to read
Good answer, Jane. I think that the trace is pretty good for a very portable device. I am used to having to read a monitor on the floor of someones home, or in the back of a squad going quickly to the hospital. I think such devices are a tremendous help in pre-hospital emergency care.
Most of us are wanting more control over our health and this seems to get us there. Personal electronics innovation used as preventive medicine is equally important as developing new treatments. Saving time and money is also great. This was an exciting segment and I would like to see more in the future.
I think this evolving technology will make primary care more accessible to people with disabilities and chronic conditions.
This is the type of progressive medicine that not only needs to be put in place in every MD's hands as well as the patients connection. This will actually make the Doctor/client relationship more personal not inpersonal. Bring on the new age of Medicine! It's about time. Saving money and less burden on Insurance claims. Everybody wins. less paper work as well.
This is the first time I'm seeing a way to cut down costs for MD's as well as patients. Have more effective results in a moment and have a personal contact with clients because all results will be individually tested due to their specific DNA. What a genius invention. All MD's should be implimenting these APS and informing the public and being approved by AMA ASAP.
What are you waiting for? The Technology is already here!!!!!! Get with the Program Docs.
Is there a simple list of the apps/devices shown in this segment?
I would like to be a member of any of Dr. Topol's research projects. I have significant family history on both sides. He is the kind of doctor America needs.
How can one find physicians in Seattle that support this thinking?
I have long wanted to have more control and access to my medical records and test results.
It seems that many doctors don’t trust and share with patients to the extent that some of us would like.
A good example is INR testing that is not widely supported for home testing in the US.
I assume one of the contributing factors is that many of these tests are significant profit centers.
"I assume one of the contributing factors is that many of these tests are significant profit centers."
The amount of resistance to any procedure that cuts costs is directly proportional to the amount it reduces health care profits.
Of all industries that have benefited from technology, health care is the only one where technology has increased costs. The customer (patient) is trapped in a system that severely limits competition, and with insurance companies and the government paying the bills, doesn't worry about customer (patient) ability to pay.
A good amount of similar apps that are meant for home/consumer use are already available at Apple Stores, Best Buys, and other electronics retailers.
Just a few that come to mind: The LarkLife wristbands, The Up wristband, the Withings Wireless Scale, the Withings Blood Pressure Monitor, the iBGStar Blood Glucose Monitoring System... These sorts of things are generally known as "app-based accessories." They serve a function on their own, but they work best in tandem with an app for your smartphone, and you end up feeling more empowered because of your increased knowledge and ready access to it.
As the developer of a medical app I get emails from people everyday that thank me for helping them make their lives a little easier. People who take a lot of medications can benefit from apps like mine. "Dosage" is the name of the app and it helps people manage their medication's. Not just reminding them when and how much to take, but the app comes with an extensive database of medications, drug interactions, labels, guides and just about anything else you might need if your taking medications. Dosage comes in two flavors, one for iPhone and one for the iPad. Doctors sometimes write to tell me how impressive it is and that they recommend it to some of their patients. To say the least it has been a very rewarding experience developing such an app that makes peoples lives a little bit easier, especially when they have health issues. You can check it out for yourself in the iTunes app store, Just search for "Dosage".
I recommendation of "Sleep' by company known as Motion-X. I tried everything to improve my sleep. Then for $3 I have a great experience. Amazing the power of self-management it is....
Its great to have the empowerment that this information brings but are we responsible enough to use it wisely? We know that lack of exercise, smoking and eating energy dense foods is bad for our health, but we continue with our bad habits. What I need is an app that stops me sitting in front of the TV eating pizza! Encouraging to see the brilliant and creative work people have done that improves others' lives though.
This all sounds like a fools dream to me, even though I know it is a good thing that you can do it. There is virtually no security in a cell phone and would you really want everyone knowing your issues.
If you were dying wouldn't you want everyone to know so they can help you??? I would!