 What’s in it for me? Get insight into the future of medicine!

 Smartphones allow greater access to medical information and will soon give patients
much more power to diagnose themselves.
 Technology will shift power from doctors to patients.
 Technology will overhaul our current medical infrastructure.
 We’ll soon be able to produce a complex map of everyone’s individual medical
information.
 A human GIS and access to big data would radically improve health care.
 Big data may even allow us to predict common diseases.
 Detailed medical data is dangerous if it falls into the wrong hands.
 Final summary

What’s in it for me? Get insight into the future

of medicine!
We’ve all been through the routine at the doctor’s: spending hours in the waiting room next
to sniffling, coughing people, which increases the risk of us getting sicker than we were in the
first place. And, when we finally get to see the doctor, we usually get 15 minutes or less of
face time and a prescription for an expensive medicine that might work if we’re lucky. And
that’s only if we live in a part of the world with easy access to doctors.

But this doesn’t have to be our future. New technology is changing the way medicine is
practiced and who is able to do it. It’s leading to a power shift and an overhaul in what has
become today’s medical industry. So let’s take a look into a future where we turn the tables
and say: “The patient will see you now.”

In these blinks, you’ll find out:

 why new technology decreases the need for hospitals;

 how an app can save you from a trip to the dermatologist; and
 how mobile phones will improve health care in the developing world.

Smartphones allow greater access to medical

information and will soon give patients much
more power to diagnose themselves.
Smartphones have revolutionized much of our lives. They provide easy access to
unprecedented amounts of information with only a simple mobile connection, which is
available to 95 percent of the population. They’ll no doubt have a big impact on medicine,
too.

Smartphones will soon make autonomous medicine possible, that is, they’ll allow people to
diagnose themselves. We already have some tools for it, such as the app SkinVision.

SkinVision allows you to send a photo of a skin lesion to a doctor, who can determine
whether it’s benign or not.

And photos are just the beginning. Microscopic scans will soon have such powerful zooms
that we’ll be able to scan ourselves for certain types of bacteria. Tuberculosis is diagnosed by
checking a sputum sample for the bacteria Mycobacterium tuberculosis. Soon, anyone with a
smartphone will be able to test themselves for tuberculosis.

Smartphones also have the potential to radically change the health situation in countries
where people don’t have easy access to medical professionals. In 2010, the average number
of doctors and nurses per 1,000 inhabitants in sub-Saharan African countries was 1.1. In the
United States, the figure was 12.3.

Mobile connections also provide people with greater access to health information. In 2013,
over 630 million people in Africa had cell phones, 93 million of which were smartphones.
Even non-smartphones can have an impact on public health. The South African project
Masiluleke, for example, sends millions of text messages every day encouraging people to
get checked for HIV/AIDS.

But, of course, smartphones are still more powerful. The biotechnology company
Nanobiosym even recently unveiled Gene Radar, a tiny chip that plugs into a mobile device
and can analyze a drop of blood or saliva for tuberculosis, malaria and HIV. Gene Rader will
allow people to diagnose themselves for those diseases at a cost ten times cheaper than the
market price today.

Technology will shift power from doctors to

patients.
In the modern medical world, patients have grown accustomed to following their doctor’s
orders. But this will change in the future.

Doctors have long been considered all-powerful authorities of medicine. In fact, even
Hippocrates, the Ancient Greek philosopher, said that physicians should conceal information
from patients for their own good.
Medical students still recite the Hippocratic Oath, which states that only people who’ve
sworn by it should be trusted with medical knowledge.

Recently developed standards still echo this sentiment, like the American Medical
Association’s Code of Ethics, which states that physicians are allowed to treat patients against
their consent if that consent would be medically contraindicated – or unhealthy for them.

The “doctor’s orders” still have the final say in a patient’s treatment. Patients don’t determine
their treatment themselves and most follow their doctor’s orders without question.

Patients will gain more power as technology gives them greater access to their own genetic
information, however. When you know more about your genes, you can make more informed
medical decisions.

Angelina Jolie did this when she decided to have a double mastectomy. She learned she had a
high risk of developing breast cancer and ovarian cancer by analyzing her family’s history,
and a genetic analysis of her blood confirmed it.

Jolie was found to have an 87 percent chance of developing breast cancer because of a
BRCA1 gene mutation, so she decided to have both breasts removed preemptively.

Jolie made her decision public in hopes of educating others on the power and importance of
genetic testing. Genetic testing will continue to get more publicity like this as it has become
more accessible.

The American company 23andMe already offers a gene variant report of your saliva sample
for a mere $100.

Technology will overhaul our current medical

infrastructure.
As smartphones give people more power, the medical world will change, too.

We’ll make fewer trips to the doctor, for one. Virtual health-care services like Doctor on
Demand, MD Live and Teladoc already allow patients to consult a physician without having
to go anywhere. A standard Teladoc appointment is roughly the same price as an in-person
visit, but Teladoc service is open 24/7 and there’s no waiting time. That’s much more
convenient than waiting an hour to see a doctor for only ten minutes.
Patients will also spend much less time in hospitals. This is already starting to happen. From
1975 to 2013, the total number of hospitals in the United States declined from 7,156 to 4,995.
A lot of treatments that used to require hospitals stays of several days are now treated within
24 hours on an outpatient basis.

Mobile technology will only further decrease the need for hospitals. Remote monitoring,
conference calling and smart pillboxes that track medication use will enable people to
monitor their health from the comfort of their homes.

The Montefiore Medical Center in New York is a good example of this. It has eleven floors,
twelve operating rooms and no beds, because no one needs to stay there overnight.

The high cost of health care will also be reduced. Health care in the United States is very
overpriced. Some hospitals charge $1,200 for every $100 of their total costs, and $190 billion
is wasted in administrative costs each year.

Few people in the medical world understand the severity of this problem. In fact, a 2014
survey of over 500 orthopedics found that they only accurately knew the price of commonly
used devices less than 20 percent of the time.

Smartphone apps like Castlight and PokitDok make the medical world more transparent by
offering precise information on medical costs so patients can compare.

We’ll soon be able to produce a complex map

of everyone’s individual medical information.
We now have unprecedentedly powerful tools for collecting and storing data. This is another
technological change that will soon have a huge impact on the medical world.

We’re currently moving toward developing a kind of Google Maps for humans: a Graphic
Information System, or GIS, that superimposes multiple layers of information onto a single
map.

GISes are already used to analyze traffic, satellite and building information. But soon we’ll
be able to develop a human GIS that will allow people to superimpose different kinds of
important medical information onto a digital map.

It would include physiological information like your heart rate, genetic information about
your DNA and its mutations, and anatomical information about the structure of your bones
and organs.
Some parts of the human GIS are going to be easier to create than others. The physiological
layer is already fairly advanced because we can already monitor physiological processes like
heart rate and eye pressure with commercially available portable sensors.

Other layers, like the genetic layer, are much more complicated. We’ve already collected a
lot of important information about genes: the Human Genome Project has identified, or
sequenced, 90 percent of human DNA. And the cost of getting your genome sequenced has
decreased dramatically: in 2004 it cost $28 million, and last year it cost less than $1,500.

There’s still a ways to go, however. Each person’s genome is made up of roughly 3.5 million
variants, and roughly 19,000 of those variants can’t be identified with modern technology.
We still need to invest a lot in genetic studies before we can produce in-depth genomic layers
for the human GIS.

A human GIS and access to big data would

radically improve health care.
What will we do with all the new information the human GIS will provide?

The human GIS will enable us to use a lot of new treatment methods. The physiological layer
will help us keep track of symptoms, such as monitoring an asthmatic child’s airways with
biosensors. That would allow the child’s parents to predict when her next asthma attack
might hit so they can make sure her inhaler is on hand.

The genetic layer will help us with disease prevention. Genetic information already serves as
a warning to parents, as most diseases have genetic predispositions. Nearly one in 40 people
carry dangerous recessive genes for cystic fibrosis, for instance, and one in 35 carry for spinal
muscular atrophy.

If a couple knows there’s a high risk they’ll pass a disease on to their child, they might want
to consider other options like adoption.

The range of available medical treatment will broaden even further as the human GIS is
combined with Big Data, improving areas such as cancer treatment.

We currently have a few cancer treatment options, like chemotherapy, surgery, radiation and
drugs. What works for one cancer patient might not work well for others, but GIS
information could be collected from patients who’ve been treated in the past and researchers
could use that data to determine what treatments are best for a patient’s particular genetic
makeup.
Big GIS data could help diagnose cases much more accurately. Today, there’s little help
available for patients with rare or unknown diseases, but a large GIS database would make it
much easier for scientists to gain an understanding of their conditions.

Big data may even allow us to predict

common diseases.
Do you know anyone with diabetes? You probably do, because it’s one of the most common
chronic illnesses. Roughly 29 million Americans have it.

Chronic illnesses are difficult to treat because they often can’t be cured. Treatment focuses on
managing their symptoms, so patients may suffer from symptoms their entire lives.

Chronic illnesses also drain medical resources. In fact, about 80 percent of the $3 trillion
dollars spent on health care every year in the United States goes toward chronic illnesses.

Big data has the power to change things, however. In the future, it may help us predict and
prevent chronic illness.

Consider Post-Traumatic Stress Disorder, or PTSD, for instance. PTSD affects an estimated
24.4 million Americans. If we could analyze that data, we might be able to predict when it’s
about it set in.

If health-care professionals could predict that a returning war vet was about to lapse into
PTSD, they could treat it preemptively, potentially saving the person from the condition.

This kind of advanced disease prediction might seem far off, but we’re already making
progress on it. In fact, a computer algorithm called Healthmap predicted the 2014 West
African Ebola outbreak nine days before the World Health Organization (WHO) did.

The Health Map prediction analyzed data from tens of thousands of online media providers,
like news sites, social networks and government websites. They mapped search engine results
for symptoms and their locations.

The algorithm was able to conclude that Ebola was the cause of the epidemic over a week
before doctors began to diagnose it, by which point it had already spread to some hospitals.

Predicting an Ebola outbreak is different from predicting an onset of PTSD, however. We

still have a lot of work to do to make them useful in individual diagnoses.
Detailed medical data is dangerous if it falls
into the wrong hands.
Big Data has enormous power to revolutionize the medical world. Unfortunately, that power
could also be used for evil.

Medical identity theft is already a problem in today’s world. People can steal your medical
identity and use it to obtain treatments like prescription drugs. They can also use your
insurance information to pay for their own medical treatment, or treatment for other people.

Sixty-eight US medical records have been breached since 2009. Hackers can do this in a
number of ways, for example, by getting into hospital databases or stealing hardware with
medical data stored on it.

Our medical privacy has to be protected. But hackers and thieves aren’t the only people we
have to protect it from.

There are also concerns with the privacy of genetic information. Insurance companies could
use it to discriminate against people who have predispositions for chronic diseases by
refusing them coverage. Some states have already enacted laws to prevent this by forbidding
insurance companies to gain access to genetic information.

Genetic information could also be used in unsavory ways by marketing companies. Data
brokers like Acxiom earn money by selling people’s personal data to marketing companies.
Acxiom already has the information on the names, income, home valuation and medical
history for over 200 million Americans.

If companies like Acxiom got ahold of our genetic information as well, the marketing
possibilities would be even scarier than they are today. Imagine you were to get an ad for
cystic fibrosis treatment before you knew you had it or were vulnerable to it.

Ultimately, your information should be yours.

Final summary
The key message in this book:

The future of medicine is upon us. Our technological developments are already
overthrowing the current system and many of those developments have only just begun.
New technology is improving treatment and giving patients more agency in their own
health care. Soon we’ll develop a system where every individual has power over his or
her own body.

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We’d sure love to hear what you think about our content! Just drop an email to
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Suggestedfurtherreading: Where Does it Hurt? by Jonathan Bush and Stephen Baker

America’s health care system is failing, and a revolution is needed. Hospital visits are a
messy experience, and people don’t have fast and easy access to the medical services they
need. In Where Does It Hurt?, Jonathan Bush argues that we can fix our broken health care
industry by making it more open. Entrepreneurs need the space to provide alternative
services, so hospitals will be forced to better themselves to catch up.