By 2020, big data technology will turn every person into his/her own mobile health network. Each person will wear a device -- a ring, a bracelet, a Google Glass -- wirelessly connected to an app that will monitor and transmit vital signs and key indicators of every condition they have.
Smarter and more complex fitness bands will marry up with the increasing sophistication of medical and wellness apps to create the ability to monitor and measure almost every significant indicator. Trailing results, plus medical records, DNA and up-to-the-minute stats, will be accessible to EMTs or in the ER, in the case of an accident or incident, and will be routinely trafficked to primary care providers. How we feel will be determined by a series of common, standardized data points instead of vague, indescribable feelings.
This data stream, which will be encrypted and stored in the cloud, will be seamlessly and continuously connected to each person's eMR, primary care and specialist doctors, their payer and probably some government entity, which will aggregate and analyze mountains of data. Personal data will be transmitted on a routine schedule and instantly compared to established norms, standards of care and business rules in real time. When spikes or anomalies occur in the routine transmission of personal data, alerts will be sent to the patient, the doctor, the pharmacy, the caregivers or EMTs, if necessary.
Many of the sub-components of this ecosystem exist or are in development. Drs. Robin Cook and Eric Topol, writing in The Wall Street Journal, argue that all the physiological data monitored in hospital intensive care units can today be recorded and continuously analyzed on smartphones. A variety of technologies under development will enable smartphones to produce and use all the studies currently done in a medical lab including chemistries, blood values and microbiological studies. And with slight variations apps will be able to carry out urinalysis, specific gravity pH and levels for glucose, protein, red and white blood cells, bilirubin and nitrates and determine if a woman is pregnant.
Preventive or compliance behavior will be programmed in advance with "if this; do that" automated logic. For Drs. Cook and Topol, a smartphone will become an avatar physician that’s always with you and always on. Between now and then, software standards will have to be negotiated and interoperability protocols established. This will be a prolonged marketplace battle well worth fighting.
We will all be connected to a national health grid that will be immediately accessible on many devices. Most people will be willing to trade a degree of privacy for a huge difference in health care. Over time the insights from this massive data mart will shape national health care policy and set new standards of care in each therapeutic category. This will be a messy, contentious, loud and intensely political exercise that will require a few iterations to get it right, given the array of vested and entrenched interests at the table.
But, as a result, our ability to predict disease progress and develop more effective and cost efficient treatment algorithms will triple. And our ability to proactively intervene and to respond quickly to medical problems will take a quantum leap forward.