Sunday, March 18, 2012

Your Tricorder Will See You Now

What happens when a tricorder's
batteries go dead
Heads-up displays in cars. Apps that can remotely open garage doors. Cable TV embedded in bathroom mirrors. The techie Disease Management Care Blog lusts after all of them and understands when advances like these cross from being mere conveniences to vital necessities.  While it waits for an unenthusiastic DMCB spouse to catch up, it looks forward to the arrival of other lifestyle enhancements like internet-enabled goggles, ear hair curing nanotechnolgy and Star Trek styled tricorders, preferably with lots of blinka blinka diodes.      
Good thing that the X-Prize Foundation agrees on the latter, though without the blinka blinka.  According to this web page, it will award $10 million to any outfit that can cram "artificial intelligence, wireless sensing, imaging diagnostics, lab-on-a-chip and molecular biology" in a single home-based "tool" that is safe, weighs no more than five pounds and has internet connectivity. Competitors for this "Qualcomm Tricorder X PRIZE" are expected to make trade-offs between audio, visual displays, imaging technology, portability, bandwidth-use, power requirements, and sensors.

The Foundation antcipates that the device will enable consumers to "incoporate health knowledge and decision-making into their daily lives." The ultimate goal is to allow end-user "direct care" for "15 diseases" that trumps "science" over the "art of medicine," bypasses the monopolistic "bottleneck" created by the traditional doctor, clinic or hospital and places diagnosis and measurement under the control of the patient.

Gosh. It wasn't too long ago that credentialled physicians totally owned the health care space. Thanks to their brute force learning, a rigorous apprenticeship and 10,000 hours' worth of experiential heuristics, patient-consumers could be be highly confident of getting a correct diagnosis and treatment.

While that's still true, that space is changing: networked e-Patient communities can harness the wisdom of crowds, IBM's "Watson" can strip-mine the world's medical knowledge to answer a single question for anyone anytime, computers are aiding the interpretation of imaging studies, non-physician clinicans can monitor as well as coach personalized self-care for thousands of consumers from afar and elite surgeons can remotely project their expertise worldwide with stereotaxic robotics.  While skeptics may doubt the short-term prognosis for this particular X-PRIZE, there can be no doubt that the concept is ultimately sound.

Big changes are in store for medical practice.

The impact will be greatest for care for persons with chronic conditions.  This not only represents another threat to the viability of primary care but undercuts a major value proposition for ACOs.

Providers and health insurers that adapt will survive; those that adopt or co-opt will thrive.
Depite the vision of a fully self-sufficent health care consumer, the DMCB doubts physicians will go extinct. They will  adopt and co-opt because high tech plus high touch trumps high tech with low touch.  The sum of a tricorder plus a provider will be far more than the sum of its parts. 

Even the Enterprise needed a Dr. McCoy on board.

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