The doctor in your pocket, to a new medicine

Internet has changed the world. The way we relate, how to buy, how many business and operating our leisure. medical practice will be different because of the huge medical databases and new applications for smartphones.

The future will be dominated by two emerging technologies: remote powerful computers that analyze millions of data in seconds from a multitude of people and friendly interfaces and sensors installed in our smartphones. Meanwhile, the medicine seems mired in practices more characteristic of the old century. But all indications are that this situation will change.

The problem

Think what happens when you visit the doctor. You wait a long time in the waiting room until you receive. Take (if any) your medical history. Read what he has been written before. Please review the analytical results and imaging tests (if any). I wonder what's wrong. You might consider. Makes a presumption of your illness. You might ask for additional evidence (and the cycle repeats). I prescribe treatment and fires you. If you do not return, it assumes that you are cured. The average in Spain is 10 minutes per patient.

What problems does this proceed?

• You have to physically go to the doctor. This makes sense for exploration that is visual and auditory. But it takes time to go to the doctor and the patient often delays the decision to seek medical advice.
• The patient without medical training decide when to go and where not to go to the doctor.
• It tells the patient that their symptoms to the doctor.
• The tests are performed when you are sick. There are no measurements when you're healthy.
• Many of the tests can be done routinely at home with the help of a computer and a smartphone minimum: blood pressure, pulse ...
• The doctor asks every time in the history of symptoms and test results.
• The waste of human and material resources is enormous.

This is compounded by the fragility of human memory. Doctors can not remember all the patient data and the point may or may not. Even the patient can do. Physicians also can not remember all that you have studied and understand the interrelationships between treatments. And even less so when we approach to personalized medicine. It is safe even reading the book is already obsolete.

Electronic medical record

The first step to solve this is the electronic medical record. It is increasingly popular but far from being implemented in all healthcare organizations.

Data from all patients are stored centrally so that the patient and the doctor can consult at any time, anywhere. This is the case when a person is attended by another physician or first enters on a new hospital. Safeguarding the confidentiality of course. Not only the data points of a diagnostic test but the complete record of when it is wrong and also when well. And this centralized data can be used for statistics revealing that today are impossible.

Doctor Watson

Watson is the IBM computer that won the game show Jeopardy. WellPoint, the largest U.S. health insurer with 34 million members, has hired the services of Watson. Watson capabilities fit perfectly with the medical diagnosis:

• Manage the natural language
• Consultation million unstructured text documents, images, audio and video in seconds
• Makes assumptions that results in a ranking of responses
• Assigns a confidence level to each response
• Presents evidence for each answer
• Learn and up to date

Addition to diagnosis, systems of this type serve to perform gigantic data analysis. Based on millions of electronic medical records can extract data and turn information into knowledge discovering unknown patterns.

One problem that has to work with humans is the ambiguity: "I am not very good" "I do not know what happens." It is also a problem of data quality as you know many companies that have duplicate records in your files and generally poor quality data. But a property of Watson is that it moves in ambiguity, seeketh not the answer but a good response.

To this we must add the ability to make personalized medicine based on data from the genome and proteome of the patient, which can hardly be done without the aid of a computer. This is not as far as a company has announced that can sequence the genome of an individual for only $ 1000.

The doctor in your pocket

Probably not be necessary to resort to a query to perform most common diagnostic tests. Vital signs may be recorded with the help of home appliances connected to smartphones without being a doctor or nurse or go through the university. The iPhone app store has fifty applications to grow. Some are mere toys but some are very serious. One can detect skin cancer using the iPhone camera. We already have tension meters and these peripherals will increase home and connect to smartphones to measure pulse, respiration, and blood tests, urine or saliva. According to IDC 14% of the U.S. population uses their smartphone for medical aid and 200 million medical applications have been downloaded.

These medical gadgets connect to large databases to receive personalized advice to our health. The health consortium Kaiser Permanente already has 10 million medical records with details of 30 million virtual visits.

Maybe it's a bracelet that measures waking my sleeping patterns, my sport, my addiction to snuff or my hormone levels. May measure the allergens in the air and my genome junction to warn of the risk. May not serve only to detect medical problems but to better target a normal life. You can measure my sweating and tell me if I get nervous in front of a girl or my boss, or babbling or my voice is firm. And the list is endless.

And how will the case of underdeveloped populations with more than one doctor for every 100,000 inhabitants is located 50 km?

Internet is changing our lives and will soon change the world of medicine.