continued from page 11
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46 May 2013 I
IUD MAD
At what point will the Food and
Drug Administration (FDA) want
to review a health app before it
is released is a common topic of
discussion among physicians using
technology with patients.
Currently, there is only draft
guidance from the FDA regard-
ing requirements for the review of
medical apps. To date, the FDA does
not regulate smartphones, tablets
and most mobile health applica-
tions. A review is deemed necessary
only for mobile-health apps used in
conjunction with already-regulated
medical devices, or those that would
transform a mobile device, such as a
smartphone or tablet, into a regu-
lated medical device.
A second area for discussion is
that not everyone is excited about
patients taking charge of their own
healthcare. Historically, healthcare
is a very paternalistic and conserva-
tive industry, and many physicians
may not want patients to become
independent and too empowered.
Topol points out, however, that as
medicine becomes more of an infor-
mation science, patient engagement
will lead to better healthcare and
lower costs.
"These days, I'm prescribing a lot
more apps than I am medications,"
Topol says.
Indeed, the number and sophis-
tication of health apps is growing
and many are available at little or no
cost. Seldom does a health app cost
more than $10 dollars. Topol points
to a growing number of apps and
devices, none of which he is paid for
using or endorsing, that are capable
of measuring vital signs and then
transmitting that data to smart-
phones. Whether it's your heart rate
or your sleep habits, Topol believes
we should track our own conditions
through our phones and use that
data to see patterns and warning
signs of illness.
Topol speaks of a future where
human beings are digitized through
sensors in the bloodstream. "By
having a sensor in the blood, we can
pick up all sorts of things — whether
it's cells coming off an artery lining
[indicating heart attack], the first
cancer cell getting in the blood-
stream, the immune system revving
up for asthma or diabetes, or you
name it. All these things will be de-
tected by sensors in the blood, which
will then talk to the phone:'
And when one of these warning
signs is picked up by the sensor, a
special ring will be sent to your cell
phone. Like an engine warning light
on your car's dashboard, this ring
will indicate that trouble is brewing
in a certain area of the body. Ideally,
this would prevent life-threatening
incidents, like heart attack.
He argues that in the near future,
everyone should have his or her
DNA sequenced, which would
reveal what diseases or conditions
an individual is prone to, and also
what types of drugs will or will
not be effective for that particular
individual. Topol is in full support of
DNA sequencing, but there is some
controversy regarding how effective
DNA sequencing is when it comes to
predicting illness.
A few years ago, it cost Steve Jobs
$100,000 to sequence his DNA;
today you can do it for less than
$5,000, with information available
in a couple of weeks. Topol expects
the cost of a genome sequence to
drop below $1,000 in the next three
to five years, and there's a distinct
possibility for the $100 genome.
Topol further predicts that finding
a cure to ailments, from cancer to
heart disease, depends on sharing
our medical information. He insists
that if we were serious about the
war on cancer, people who had the
disease would get their tumor ge-
nome sequenced, record treatment
techniques and outcomes, and then
make it all public knowledge.
"If we started to bring all this
information together, the accelera-
tion of knowledge and the transfor-
mation of what we could do for the
future of disease would be extraordi-
nary?' RT
DMC Health For
Life Apps
For the sixth consecutive year,
Detroit Medical Center (DMC) has
been named to the nation's "Most
Wired" list in the July 2012 issue
of Hospitals & Health Networks
magazine and as one of the Top 25
Connected Healthcare Facilities in
Health Imaging & IT Magazine. DMC
lists several health-related apps on
its website (www.dmc.org/apps):
•Child Medical Guide answers
questions on everything from ani-
mal bites to earaches.
• Run with DMC, a training com-
panion with a running log to
record your run details and keep
you injury free.
• DMC Pedometer to keep track of
your steps toward a healthy life-
style.
• ER Wait Time to show the current
ER wait times and a map showing
you how to get to the DMC from
any location.
www.redthreadmagazine.com