"Many of the people who come to my office...have come because modern medicine has failed them in some way, or they have used up its power to help them and they know not what else to do." --Rachel Naomi Remen, MD
|Initially an engineer by training, Paul Abramson, MD is "beta testing" a healthcare model that matches patients with quant coaches in addition to Quantified Self-savvy physicians. Image from Stanford Med X.|
A couple of weeks ago, at Stanford Med X, Paul Abramson, MD used that quote to kick of a presentation on how the Quantified Self movement is intersecting with medicine. Abramson, originally an electrical engineer by training, discovered he was more motivated by listening to people's stories and trying to help them than doing research in engineering. He then enrolled in medical school, and eventually began practicing family medicine. Later on, he began to dabble in self tracking to find out why he had been experiencing recurrent headaches. He later used data garnered from the experiments to link the headaches to a sleep problem and had an epiphany: "Why can't we do [something similar] for a lot of people?"
Among the biggest problems in medicine, as Abramson sees it, is a lack of patient empowerment and poor customer service. The Quantified Self movement can be harnessed to help address such problems, he explained. In many ways, what health trackers are doing is an extension of a long medical tradition. "Doctors have been prescribing headache logs for people with migraines and dietary logs [for a long time.]" While the Quantified self movement gives adherents new power to monitor their health, most people, however, have limited success with self tracking unless they are highly motivated, he acknowledged. To deal with that issue, Abramson has come up with a paradigm in his medical practice to put the patient in touch with a data-tracking coach as well as the doctor. "It is a team based approach but it is really based on this self-exploratory model." The quant coach works with a patient as a peer to help motivate them and interpret their health data.
Despite its steady growth of the Quantified Self movement, it is still something of a niche movement. It stands to become more mainstream as manufacturers better understand how patients' evolving needs and expectations as mobile technology continues to proliferate and evolve.
On a related note, consider the case of Bastian Hauck, a tech-savvy diabetic, who presented recently at the MedTech Forum 2012 in Brussels. He uses an app called MySugar to track his diabetes on his iPhone but his insulin pen is unable to transmit data to the app. "Why not build in Wi-Fi or Bluetooth?" he was quoted as asking on medtechinsider. The field is open for companies which, as, for instance, AgaMatrix has done, develop medical devices that make it easy to access, and understand health metrics using mobile technology.
|"I am prescribing a lot more apps than medications these days."
--Eric Topol, MD
As algorithms become more powerful over time, the Quantified Self movement will likely continue to make inroads in motivating patient behavior change and deepen their understanding of their health. For instance, look at what has already with patients using devices from iHealth or Withings to track their blood pressure. Those systems gather data and then graphically show it to the patients, enabling them to better understand changes in their blood pressure over time. Eric Topol, MD, the author of "The Creative Destruction of Medicine" explains that he has seen patients in the clinic who have collected hundreds of blood pressure readings. A result of that is that patients discover for themselves that their blood pressure might spike as their medicine wears off, or that it goes up on Monday morning as they return to work. "They are seeing this because it is their life and they know the pattern and they have all of this data now," he says. "They are seeing trends that I wouldn't have been able to pick up," he says. "Here I am and I am prescribing a lot more apps than medications these days and my patients have all of the data and they know how to interpret it because of the software that is part of the app."
Brian Buntz is the editor-at-large at UBM Canon's medical group. Follow him on Twitter at @brian_buntz.