Do you use any personal health monitoring devices (Fitbit, Apple Watch)? If so, what information do you find most useful?
I do use personal health monitoring devices, but since I’m a physician, I also have a doctor’s bag filled with more traditional instruments that I use regularly. I believe blood pressure and weight are some of the more important measures to track. Elevated blood pressure can be asymptomatic, until it is too late, so that is an important vital sign to monitor ourselves.
What additional features do you think personal monitoring devices might/should feature in the future?
I’m amazed at how many physiological measures can be made with current devices, such as gait changes that can predict onset of neurodegenerative changes, camera photos that can be used to estimate calorie content in your meal, and videos that can sense heart rate and vascular perfusion. With advances in wearable electronics, we’ll see patches that will sense the molecular content of sweat and oil from your skin, and possibly glucose and drug levels.
What role will physicians play in a future where people can monitor their own health using their phone?
There will always be a need and role for physicians in the patient-doctor relationship. While these monitoring devices will certainly collect and provide more data to impact and advance the “science” of medicine, there will always be an “art” to medicine as well, and that will be best practiced by a compassionate physician with whom a patient can confide in, and someone who can identify the subtleties of perhaps a rare disease or an uncommon presentation of a common disease.
What do you see as the biggest challenge for doctor’s offices now in integrating technology into their practices?
Physicians and our health care systems are not fully prepared for the deluge of data and information that is becoming larger every day. We not only need to more effectively enter and manage the large volumes of data coming in from many new and different sources (digital pathology, diagnostic radiology, genomics, personalized monitoring, extensive past medical records), but we need to also more effectively turn that data into knowledge for better medical decision making and patient care.
How do you think Big Data will impact medicine in the future?
Big Data in medicine is upon us. I’m most excited about the potential and impact of artificial intelligence (AI)/machine learning in medicine. Whether it be a radiological image, a photograph of a patient’s face, a digital pathology dataset, or historical trends in patient data, the number of parameters is enormous, and AI will help us to identify patterns that will predict disease, or monitor disease progression or regression; patterns that we cannot see ourselves.
How do you think you’ll interact with your physician 20 years from now?
I believe I will still sit in an exam room and talk to my physician. However, ahead of my visit, my physician will have already downloaded all my personalized medical data from my wearable and at-home-, work-, or car-monitoring devices, will have run algorithms on the data to identify trends and predictive factors, and will have a pre-visit assessment and plan established. The visit and interaction will be an opportunity for “shared-care,” that is to review all the data and plan together, check for any inconsistencies, and talk about and consider factors of health and wellness that simply cannot be measured.
