As part of the Stanford Medicine Alumni Association's Alumni Day event, I recently moderated a panel discussion on "The digital medicine revolution." The talk featured three panelists with formidable futuristic credentials in the field of applied digital medicine: Ian Tong, MD, a Stanford clinician and the chief medical officer of start-up company Doctors on Demand; Mintu Turakhia, MD, co-director of Stanford's Center for Digital health and director of cardiac electrophysiology at the VA Palo Alto Health Care System; and Sumbul Desai, MD, vice chair for strategy and innovation in Stanford's department of medicine and executive director for the Center for Digital Health.
"The digital medicine revolution" is a mighty big topic. I sawed off a few slivers and fed them to the panelists, in the form of questions about what concrete developments we might actually hope to see within the next three to five years in three specific areas:
- big-data searches (the dark art of pulling out needles of useful medical information from pools of patients' electronic medical records as well as biomedical databases)
- wearable sensors (I asked for a show of wrists: probably one-fourth of the 280 or so people in the audience were wearing one)
Here are some of the issues the panelists grappled with:
Telemedicine: "What can telemedicine do that the standard office-visit model can't?," I asked. "Can you establish a doctor-patient relationship with a video visit? Is the screen a barrier or a window?"
Big-data searches: "Clinical trial results may not apply to that unique patient right in front of you now, whose particular demographic description and particular medical history differ broadly from those of the subjects recruited for those trials. It's been proposed that warp-speed crawls through millions of networked patient electronic medical records could fish out enough patients closely fitting your patient's description to yield an on-the-spot, customized, push-button diagnosis, prognosis, and prescription for your patient s. Is this a realistic possibility? If not, what's slowing it down? "
Wearable sensors: "That sensor on your wrist streams data on your heart rate, skin conductance and temperature, and motion to a distant server. It even claims, like Santa Claus, to know when you've been sleeping and know when you're awake. What other health-relevant data might become amenable to this kind of routine monitoring in the next few years?"
Curious? The video of that panel discussion, and the lively audience Q&A that followed it, is above. Would-be watchers who are a bit too busy to view all 45 minutes of it might consider skipping the intros and jumping in at about 0:11:40 on the timeline, when the conversation begins.
Previously: Stanford Medicine's Alumni Day, in pictures, Push-button personalized treatment guidance for patients not covered by clinical-trial results, Stanford panel: Big issues will loom when everyone has their genomic sequence on a thumb drive and $23 million in NIH grants to Stanford for two new big-data-crunching biomedical centers