Healthcare 2.0 – The Rise of Self-diagnostics

More than 30% of Indians lack access to even basic healthcare services. Rural India has less than 1 doctor for every 5,000 citizens, this is 80% below the bare minimum recommended by WHO. It is a norm for people to have to travel more than 50kms to avail basic diagnostic facilities and medicines. Government infrastructure in healthcare is under severe need of a revamp. But it is not going to happen over-night.  So, is there a way we can leverage technology and provide healthcare facilities to the under-served using the current infrastructure?

The lack of access to doctors could potentially be solved by video consultations coupled with apps and wearable devices that measure basic indicators like Heart Rate, Blood Pressure, etc. and send the data to the doctor in real time, but what happens when the doctor prescribes a set of tests for better diagnosis. Where would the patient find the diagnostic facilities to undergo the test?
Around 5 years back, when my uncle first brought home a ‘Diabetic check’ machine to regularly monitor his blood sugar levels, everyone at home was floored by the possibilities. We took turns to check our sugar levels. It seemed fun. What was previously a tedious half-a-day long process now took less than a minute. My mom’s sugar levels were just on the border, we consulted our family doctor and were informed that she was “Pre-Diabetic”. With proper care and regular exercises she is now perfectly healthy. The device has immensely benefited my uncle who can now regularly monitor his glucose levels in a very cost efficient manner

Present day smart phones have more computing power than what most computers had 5 years ago. Coupled with the kind of penetration these hand held devices enjoy, they have the potential to revolutionize diagnostics for the times to come. Scientists and Innovators around the world are working tirelessly to harness this vast “man-made resource” to create apps and devices which when combined to your phone will have the potential to put the modern day diagnostic centres to shame in terms of both speed and accuracy.

Well, as it stands we may be closer to this future than we realize:

Senseonics is developing a continuous glucose monitoring system consisting of three major components: an implanted sensor, a wireless transmitter that communicates with the sensor, and a smart-phone mobile medical application. With this device, a diabetes patient’s glucose levels could be measured remotely every few minutes, and accurate and specific alerts would be sent to both the user and the physician about impending hyperglycaemia or hypoglycaemia.

Another example is “Smarthaler” a concept system Sagentiarecently developed for asthma patients. The concept uses a novel acoustic detection technology, together with a cloud-based server and mobile app, to monitor and interpret whether a patient is administering doses properly. The system could warn the patient that a dose was taken incorrectly, coach the patient to improve dosing technique, and provide the doctor with a historic record of treatment adherence to determine the context of an asthma attack and options for improved treatment going forward.

Opko Diagnosticscreated ripples a couple of years back when it claimed to be able to detect Syphillis and HIV using a handheld device in less than 15 minutes and costing less than 1$! They are currently working to expand the current technology to facilitate testing for prostrate cancer, Alzheimer’s, Vitamin D deficiency etc.

Another study entailed connecting a single-lead ECG to a smartphone to diagnose and follow treatment with sleep apnea, providing a possible alternative to costly and labor-intensive polysomnography.
“Mobile apps have the potential to transform health care by allowing doctors to diagnose patients with potentially life-threatening conditions outside the traditional health care settings, help consumers manage their own health and wellness, and also gain access to useful information whenever and wherever they need it,” said Dr. Jeffrey Shuren, director of the FDA’s medical device center.

Cameras in smartphones will inevitably replace nearly all portable cameras and camcorders, but could they also make basic medical instruments obsolete?

A magnifying ball lens (on top of your smart phone camera lens) can reveal signs of iron deficiency Anaemia, or the deformed red blood cells of Sickle cell, and larger lenses could help diagnose even skin diseases, better software might even count and identify blood cells for an even wider range of diseases.

By swapping in a spectrometer for the lens, researchers can also use iPhones to measure the amount of oxygen in the blood and diagnose diseases based on their chemical markers.
A startup called CellScope plans to turn your smartphones into digital first aid kit. It is developing an iPhone attachment that turns the smartphone into an otoscope, providing a magnified view of the middle ear. The peripheral attaches to the top of an iPhone and provides a 10x magnification.Using CellScope’s web platform, users can upload captured images and paediatricians can remotely assess the severity of the infection

But what about the lack of internet in most rural areas, how can mobile phones there help provide better healthcare?

“TREAT with AL* all children under 5yrs weighing >=5kg coming with FEVER for first visit & without severe signs. Quote: “Opportunity seldom knocks twice”
*Artemether-lumefantrine, the recommended antimalarial

Messages like the above are sent by the Health Ministry in Kenya every Tuesday morning to its more than 15,000 health workers throughout Kenya, who then provide more accurate treatment to the masses. The Kenyan government realises that there is a severe lack in basic healthcare services and is using mobile messages to spread awareness, and initiatives like the above have been found to improve the quality of treatment by 25%

Government of Tanzania is running a similar successful initiative for promoting healthy pregnancy and healthy motherhood 

Professor Bob W Snow, who heads the research group in Nairobi, says: “The role of the mobile phone in improving health providers’ performance, health service management and patient adherence to new medicines across much of Africa has a huge potential to engage and promote health to many people, who despite being poor and often inaccessible nevertheless have access to cell phone communication.”

A growing number of companies are developing more complex apps and attachments that perform tests and other functions once reserved for the doctor’s office. While the idea is not to remove the doctor entirely, it can act as an assistant, so that the doctor can focus his resources on the most critical part in the treatment cycle, the ones which cannot be solved by your smartphone, yet!!