Algorithms expected to replace doctors in prescribing meds
Scanadu CEO, Walter De Brouwer, has spoken to MedCity News, ahead of the 'Transforming Medicine: Evidence-driven Mhealth' conference. In a wide-ranging interview, Mr De Brouwer told journalists that in the future, doctors will delegate prescribing decisions to an advanced algorithm to lower costs. Star Trek-like "Tricorders" could also become a reality within a few years, with several companies testing out betas of handheld scanning devices, including Scanadu. Mr De Brouwer concluded: “Data will beat physiology, because physiology is basically small data, fragmented. We’re going to rewrite medicine. The consumer will be heavily involved in that.”

Scanadu CEO Walter De Brouwer played digital health provocateur during a talk at this week’s Transforming Medicine: Evidence-driven Mhealth conference at Scripps Translational Science Institute. The future of healthcare involves commoditizing the patient. Or rather, as he put it, the consumer.

Some background: Scanadu is developing a Jetsonian device that monitors bodily functions and vital signs; it relied initially on crowdfunding to kick off production. So, given the company’s forward-looking bent, De Brouwer highlighted the following concepts that he projects will be important over the next five years:

Applying the “toothbrush test”

The current mobile health technologies on the market are underperforming. Devices like FitBits are used for a few weeks, then shelved. So health innovators need to develop technology that passes the “toothbrush test,” De Brouwer said – craft an mhealth tool that users go to several times a day. Get them addicted.

“The toothbrush test for digital health isn’t giving consumers access to read their digital data,” De Brouwer said. “They don’t want to read it. They want to write it. They want to construct their own medical records, and self-aggregate their own data – then present it to doctors to have their own point of view.”

A data apartheid

Consumers will aggregate their own data, and the clinical community will aggregate data as they traditionally have – EHRs. When consumers begin chronicling their day-to-day health data, De Brouwer said, “it will surpass all the data that has been collected on the planet.”

“The complete chain will shift – and the medical industrial complex will have to give it up for the consumer,” he said.

Big brands will take over preventative medicine

“It might be controversial – that a big brand will take over preventative medicine,” he said.

But think of preventative dentistry as an example, he said – “It doesn’t exist anymore.”

Instead, we have the $100 billion toothpaste industry that’s been taken over by Proctor & Gamble, and GlaxoSmithKline. Dentists may suggest we floss, but the vast majority of preventative dental care is dictated by the drugstore products we buy on the regular. Given the right amount of money, our teeth are immortal, he said. The most entrepreneurial doctors are dentists.

“They don’t want evidence-based stuff,” De Brouwer said. “They want a brand.”

Autopopulation and Realtime

With Apple’s HealthKit, APIs and the Internet of Things, we’ll have the tools to autopopulate our health data, he said. Then, consumers will have the ability to simply check their digital dashboard to gauge how they’re doing on any given day.

Also: We’re almost there – but very soon, just about anything will be accessible in realtime. The meteoric rise of China’s WeChat hints toward a not-so-distant “one app to rule them all” future, De Brouwer said, in which consumers can use a single service to contact health professionals – or plumbers.

“China is six years ahead of Silicon Valley in mobile technology,” De Brouwer said.

Algorithms will prescribe drugs

The main reason consumers need doctors? Prescriptions, De Brouwer said.

But if doctors simply delegate prescription information to the advanced algorithms that are currently being developed, that’ll cut down on patient face time with rote appointments, he said.

De Brouwer brought up the example of telemedicine – and said that many customers would choose to pay for doctors’ services in the parking lot of a Walgreens. Just so they can get the prescription, head into the drugstore, and pay $40 for this month’s meds.

“It’s time that algorithms take over that situation,” De Brouwer said.

Tricorders, a Lab in Every Bathroom and a Vital Signature

This Star Trek concept mirrors Scanadu’s hoped-for future technology – a machine that can simply scan a patient and learn what’s wrong.

Similarly, De Brouwer projects a situation where consumers will have a device (again, similar to the Scanadu concept) that can read their vital signs and bodily functions on the regular – and spit out any worrisome differences in a patient’s health.

The idea is to general a vital signature – a systemic study of a consumer’s overall health, as opposed to a snapshot in time approach to measuring a patient’s health.

And doctors, he said, will have a wildly changed role.

“Data will beat physiology, because physiology is basically small data, fragmented,” De Brouwer said. “We’re going to rewrite medicine. The consumer will be heavily involved in that.”