Wireless medicine has big implications for healthy aging – especially for anyone who might have trouble getting to a doctor’s office or who’s at risk for many of the so-called diseases of aging: diabetes, cancer and heart disease. So in a rapid-fire interview, we asked Dr. Topol for a bird’s eye view of this revolution in healthcare – how technology can help you monitor your health now and how it might be able to do so in the future.
First, can you define wireless medicine?
It’s being able to do things medically without the usual wired restraints. It means everything from being able to monitor the metrics of your body, like your blood pressure and your electrocardiogram from your smartphone, without any wires. It means being able to monitor your labs through your smartphone with a droplet of blood or urine or sweat or body fluids. It means being able to image yourself with your phone, or doing a consult with the doctor via your phone.
Give us some examples of what’s possible now with wireless medicine, and what might be possible in the not so distant future?
Right now, you can do your electrocardiogram through your phone as a patient. So if you have a history of atrial fibrillation or other heart arrhythmia – rhythm disorders of the heart – instead of going to the emergency room or an urgent care clinic, you can just put your fingers on your smartphone program and that will record a cardiogram rhythm strip, and then some of the apps will read the strip. It’s computer-read, and it will tell you it’s normal, abnormal, and whether you have atrial fibrillation or you don’t have atrial fibrillation.
So this is a big advance, because oftentimes when people have had a heart rhythm problem and they feel like their heart is racing or skipping some beats, they aren’t sure if this is an abnormal heart rhythm. This program can be extremely convenient, because it can give an immediate readout of what’s wrong or what’s right. A lot of times, it provides reassurance.
You can do your blood pressure without any wires to your phone. You just put a little cuff on your wrist, press start, and wirelessly the cuff inflates on your wrist and you get a blood pressure reading. If you have high blood pressure, you can get hundreds of readings wherever you are and have it nicely graphed. When you want to, you can just send that to your doctor. So that’s a much better way to get a handle on your blood pressure. It’s portable, you don’t have to carry anything around, it graphs everything, there’s no paper.
Another example is an alternative to the Holter monitor, which has been around since 1949. You have to go to the hospital to get hooked up and then back to the hospital the next day to have it disconnected. Now, the alternative is a band-aid – the iRhythm [Zio patch] – that’s sent in the mail. You just put that on your chest, and it stays on for about 12 to 14 days. It captures every single beat of the heart. And then you just mail it in in a little box and it’s all analyzed, and it’s far more sensitive than the Holter, because you get all those extra days. And it’s so convenient. The patient doesn’t have to go to the hospital or the clinic and doesn’t have to go back. You can take showers, you can exercise.
You can do your glucose now, but in the future you’ll be able to do your own blood tests – a lot of different blood tests will be possible through your smartphone, with just a single pin prick of blood.
You’ll be able to use your phone to image parts of your body. So let’s say you’re worried about your heart. You can just take your phone, put it on your chest and it will take pictures of your heart and an ultrasound. Or if you want to do your own breast screen, instead of a mammogram, you could use your phone to do an ultrasound of your breast – which is much more sensitive than a mammogram.
What are the most common negative reactions you hear, and what is your reply or response?
From patients, I haven’t heard anything negative. I’ve heard a lot of enthusiasm.
The doctors are not what I would call enthusiasts yet. They worry about all this data coming to them. However, doctors will start to realize that this is the future and it’s in the best interest of everyone that as doctors we let go and let patients do more in terms of generating their own data.
How is this wireless medicine going to make us healthier and more autonomous?
It’s patient generated, so first of all you are getting data you couldn’t get before. Before, you couldn’t do a heart cardiogram anywhere, anytime. You wouldn’t be likely to get 10 different blood pressure measurements during the day, when you are in traffic or under stress or having an argument with your spouse.
Each person can learn so much more about their own health and particular conditions that they are trying to manage or prevent.
What this is all about is getting a window into information for each individual that wasn’t obtainable before, and individuals taking charge, rather than being dependent on a doctor. It’s not that there won’t be a need for doctors, but it will be reduced, because some of the simple mundane things that a computer can do will be done for that patient right through their own phone.
What does aging with attitude mean to you?
To me it means each individual becoming more activated, engaged and in charge of their own health. It’s never too late to get that attitude.
So how are you aging with attitude?
I am aging, for sure. I’m a recent grandfather. I’m exercising more than ever, watching what I eat more than ever in terms of healthy foods. And I’m just really packing more data than ever into my own smartphone."