For years, I have been hearing about how new technology will transform every day clinical practice, and I have been looking forward to it. Who wouldn’t want to be able to understand better the basis of human disease based on the “new taxonomy” of precision medicine? Or offer personalized therapeutics based on full genome sequencing? Or have the ability to predict better which patient will decompensate based on advanced analytics? And yet… most of us are pretty much doing what we have always done – diagnosing disease based on signs and symptoms, prescribing drugs based on their likelihood of efficacy in a population that more or less looks like the patient in front of us, and waiting for patients to decompensate and then reacting to it. Yes, we are doing all this while using (struggling with?) an EMR, but still, the basics are all pretty much the same.Then last week happened, and I caught a glimpse of what this new world is supposed to look like. I saw a patient with palpitations, and asked all the usual questions, and did the usual poking and prodding (and did the usual echocardiogram) and was explaining how I wanted to get the usual Holter monitor, when she asked (a little sheepishly) if she could use the new phone app that measures HR instead. Shazam! Patients monitoring themselves! Cell phones transformed into medical devices! How cool is that? Eric Topol, in his recent book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, describes how this is just the beginning.
It started for me last week. Has it started for you? What do you think?