Sunday, December 11, 2011

Diagnosis Without Doctors

I should be doing other things tonight, but this thought hit me and I feel compelled to write a short post on it. I have a number of other thoughts for longer blog posts, but they will have to wait until February after my textbook draft is in.

Earlier today I shared this article. It refers to "Race Against the Machine" and includes quotes from one of the authors. In many ways I think it is a great article. However, I was struck by how they list doctors as a relatively safe profession. Martin Ford points out how many specializations for MDs are at serious risk. However, I haven't seen anyone who is predicting the demise of the primary care physician. I'm going to predict that here. I had a previous post about the "Doc in the Box" idea of having scanners watching people in a clinic. I still think that works well. However, I'm going to take it a step further.

Let's start with WellPoint hiring Watson. This is basically an insurance company setting big-data analytics loose on a bunch of medical data. I want to up the ante a bit and make the data bigger. Imagine WellPoint distributing something like the JawBone UP to people on plans with them under the condition that they really use it. Go a bit further and set people up with some low cost devices or apps to monitor other things like this. Maybe a scale and something to measure blood pressure. How about giving them an easy way to indicate eating habits and other things that might impact their health. Feed all of that into the machine. Now we are talking some really big data. Within five years I have a feeling you completely change the shape of medicine.

Five years isn't enough time to really see what happens with any given person. However, you will make up for that quite a bit by having previous medical history (much less detailed data) combined with tracking huge numbers of people. Get some lab on a chip stuff going as well and it's over. You have a company that will be "watching" body changes in hundreds of thousands of people all the way down to activity levels and blood work. You won't go to your doctor when you get sick. They will start warning you 24 hours or more in advance that you are getting sick and tell you what to do about it.

Note that I put the word "watching" in quotes above. That's because no humans need be involved in this process at all. This only works because you can throw vast amounts of data at computers that can crank through more information in a day than a human could process in a lifetime.

What do you think? Would you sign up to have your health habits tracked closely by an insurance company so they could turn medical diagnosis from the current state of a flawed art to a true science?


  1. Completely agree, and I think this is likely to be seen adopted fairly widely within the next 5 years. I liked your earlier "Doc in a Box" piece (if anything, I think you were too conservative).

    This idea couples well with many ongoing efforts to enable persistent monitoring of people's bodies (e.g. the X-Prize Tricorder efforts: As technology enables cheaper & cheaper data-collection, healthcare increasingly follows the trends of other Information Technology arenas (something Ray Kurzweil routinely highlights, as he distinguishes those industries that can reap exponential trends from those that cannot).

    I was sick for a few weeks recently and saw a healthcare provider on two occasions. I was really surprised that on neither occasion was any blood-work done, just basic vital checks (single time-step data capture) and an X-ray on one occasion. Given the costs of technology today, it really reinforced to me how ridiculous it is that I'm not able to constantly record my body's data to provide a regular baseline from which to discern trends & abnormalities.

    We're doubtlessly heading there, but far too slowly. And, it's sort of amazing as well that -- given the significant trends in healthcare burdens the US faces, and all the debate over medical care & insurance in the past few years -- there really isn't any vocal clamoring for accelerating these kinds of capabilities.

    I'd sign up for these kinds of services in a heartbeat if my insurance provider offered anything like it (for that matter, I'd sign up for similar vehicular data analysis from my auto insurer for a rebate as well).

  2. This is definitely a rich area. These two articles just happened to be on my starred list for Google reader.

    So progress is definitely being made. The question is, when does the explode out to the public? When will I be able to track my vitals 24/7 and link that in with other medical information? I'd even be happy to have it tracked and put into a huge database with others for data mining. I feel that would be a huge benefit to the health of the general public.