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Welcome to the Brave New World of Personal Digital Medicine

Welcome to the Brave New World of Personal Digital Medicine
A revolution is just getting underway that will transform the medical landscape and has the potential to markedly improve your own health and longevity. This will evolve to be among the most important developments ever in the history of medicine, perhaps even more significant than the understanding of germ theory and the discovery of antibiotics. Digital personalized medicine will allow average citizens to easily and inexpensively collect data about everything from their unique genes, to their patterns of sleep and exercise, to their personal hour-to-hour fluctuations in blood pressure (BP), blood glucose and hormones.

Information is Power

The first step in changing anything is measuring it accurately. After that it’s simple: when we know better…we try to do better. If we can detect the beginnings of disease earlier, we will be able to avert its devastation long before it ever gets a foothold in your system. In their recent Wall Street Journal article, “How Digital Medicine Will Soon Save Your Life,” Eric Topol and Robin Cook wrote, "Sick care - the current model of waiting for you to get sick and then trying to alleviate symptoms and make you well - will become true health care, where prevention is the mantra and driving force.”

This revolution is being propelled by the emergence of many rapidly evolving technologies including: ultra-sophisticated smart phones and/or wearable computers, cloud computing, nanotechnology and gene sequencing robots. Importantly, this digitalization of medicine will tailor your health care to your individual needs and genes. Treatments will be customized to each person’s unique genetic makeup, risk measurements and history.

Today, therapy is generally prescribed based upon population characteristics. Patients are lumped into groups as a function of their symptoms, age, or results of simple tests such as cholesterol or BP levels. Drugs are then used as a one-size-fits-all blanket treatment for everybody, even though they might be helping only a fraction of the group. By utilizing data easily recorded and accessed via digital devices, and taking into consideration your precise DNA, we will be able to use specific treatments that will be effective, safe and necessary for you. And we will also avoid subjecting you to therapies that are likely to be ineffective and/or dangerous.

Giving a drug to a person who will not benefit from it subjects that individual unnecessarily to expenses and potentially dangerous side effects. For example, rather than prescribe statins to lower blood lipids to everyone with high cholesterol, we now calculate each person’s individual risk based on traditional risk factors like BP, cholesterol, diabetes, smoking and age, and then if they are over age 40 for men or 45 for women, we also usually have them undergo a CardioScan (a five-minute, non-invasive $50 high-tech test).

A Coronary Calcium Score of zero means that the person has absolutely no hard plaque present in their coronary arteries. So if someone has gotten through the first 45 years of their life, for example, without developing any plaque in their coronaries, then they may be able to focus on diet, exercise, stress reduction and other natural therapies to lower cholesterol and cardiac risk without resorting to powerful cholesterol drugs.

On the other hand, even if your cardiovascular risk factors (like BP, glucose and cholesterol) suggest that you are at low risk, but your CardioScan shows that plaque is growing in the arteries supplying your heart, we know that we can prevent heart attacks and premature death in you by using potent statins to bring your cholesterol down.

Are We in the Cloud Now?

Cloud computing is another technology that will revolutionize your medical care. In the not-too-distant future you will be able to store in “The Cloud” all of your medical information including prior tests, conditions, medicines, allergies, doctors, genetic data, family medical history, prior surgeries, insurance and any other personal health information.

Admittedly, “The Cloud” sounds nebulous, but this breakthrough technology (which is already available) will allow each of us to have a secure, always accessible personal medical record that resides on the Internet - probably for free if Google’s version wins out!

This will empower each person to control his or her own medical and genetic data and share it instantly, whether they are in their local doctor’s office, on a cruise ship in the middle of the Caribbean or an emergency room in Rome, by simply connecting to the Internet and signing in with a secure password.

The Doctor’s Phone Will See You. . .

Currently, on my personal smartphone I have technologies that allow me to record a high-quality ECG, measure heart rate, steps taken, miles walked, calories burned and sleep time. In my day-to-day life I often use all of these features.

For instance, when someone is telling me they are having symptoms like chest pain or heart rate irregularities, I ask them to hold my iPhone with both hands, enabling me to view and record an ECG in real time to make sure they are not having serious heart problems, like atrial fibrillation (AFib) or a heart attack. Soon, smartphones also will be able to analyze blood chemistries by inserting a test strip into a device (some already exist) plugged into a phone equipped with an app.

Home Digital Medical Devices to Consider Now

Already there are a couple of digital tools that I believe most households should have today. Most importantly, you should own an automatic blood pressure (BP) cuff. My favorite is the Omron line of BP cuffs. I would suggest purchasing the simplest one: Omron Series 3. This is an inexpensive ($35) and easy-to-use upper arm cuff that will give you an accurate digital reading in just a few seconds.

Make sure that when you measure your BP, you’re relaxed and seated with your arm resting comfortably on a surface that is about at the same level as your heart. Your blood pressure will vary, sometimes widely, depending on your circumstances. By following your blood pressure at home you can figure out natural strategies like exercise, diet, rest, fasting, meditation, etc. that might work for keeping your BP normal (less than 140/90).

A glucose monitor (glucometer) is another helpful digital device for home use. There are several good options for a home glucometer including One Touch Ultra2, Accu-Chek, and FreeStyle. These are surprisingly inexpensive - about $10 to $20. By checking your blood sugar about an hour after eating, you can learn an amazing amount about your specific metabolism and what sorts of foods and beverages are best for you. The goal is to keep your blood sugar between 70 and 100 most of the time; even after you eat it’s best if your blood sugar doesn’t rise above 110.

Gene sequencing machines are becoming increasingly fast, accurate and affordable, allowing us to read and understand the billions of bits of DNA data in each person’s unique genome. This will enable medical science to collect and analyze the DNA from millions of people, yielding critical genetic insights that will uncover each person’s unique vulnerabilities. Armed with this information we can focus on strategies that will prevent the specific diseases for which we are predisposed, and to choose the right drug when one is needed.

Until now, the more technology advanced, the less physical work people did in their day-to-day lives. Consequently, in 2014 most Americans sit all day. . .while they grow overweight, unfit and unhappy. Thankfully, the tide has turned. Brilliant new technology is making it easier and more enjoyable to become more fit and healthy.

Wearable tech is the term for smart digital devices that you wear on your body. This craze is just getting underway, and is not going to slow down anytime soon. Indeed, experts predict that wearables will revolutionize our everyday lives in the coming decade. Smart watches that monitor your steps taken, exercise intensity, calories burned, and sleep quality and quantity are already available. These bracelets are rapidly becoming more sophisticated and affordable. My favorites are Vivofit by Garmin, Fitbit and Jawbone. Apple is rumored to be developing an iWatch that when it’s released, may set the new standard for wearable tech.

A Bright Idea Whose Time Has Come

The era of digital medicine has already dawned, and in the next few years its full force will arrive with the power of a tsunami. Surprisingly, one of the advantages conferred by digital medicine will be lower health care expenses.

Previously, technological innovations in medicine such as new drugs or high-tech tests have come with high price tags. However, digital medicine will be a transformative technology that should reduce costs - for individuals, their employers and the overall economy. The emphasis on prevention dramatically lowers hospitalizations and costly health catastrophes such as stroke, diabetes, cancer and heart attack.

Also, this enlightened strategy saves money by helping to keep people fully functional and working.

In Good Health,

James O’Keefe, MD

Photo Credit: Creative Commons