II - The Portable Doctor

Reliability - Consistency - Security

The Portable Doctor also known as Telemedicine or Telehealth is on the rise around the world, first starting off as video conferencing and heading into tying your personal health data from heart rate to recording glucose measurements and having that information sent directly into a data repository for your primary care provider to monitor and review.

The reason this section is titled as it is is due to the complete necessity of having this information being consistently reliable and consistently secure, this is a must and there are no shortcuts to achieving such standards. Even if users opt to simply record their information on their phones and send their information to their primary care doctor at a later date this must continue to be consistently reliable and consistently secure. 

Based on FDA "assurances" and requirements, many products including the Watch won't go through such certifications to be classified under strict guidelines. But this offers third party manufacturers with a way to tie specific information into platforms such as Apple's HealthKit and Google's FIT API's consumers have a way of tracking substantial information related to them using specified products that tie into these platforms. This same information can be pushed to their primary health provider. But the requirement for anyone to trust such services is that they remain consistent in their reliability and consistent in security.



Digital Physician's Assistant

As previously mentioned there are many third party manufacturers coming out with devices that are so portable won't only assist any physician but a patient could easily utilize these devices as well. An example is the Scanadu Scout, a portable device smaller than that of a hockey puck that can measure such vitals as temperature, blood pressure, heart rate, oximetry, ECG, HRV, stress levels, and UA. Tying all of this into a patient's profile could improve the quality in which a patient is treated.

Qardio is a company behind a medical grade EKG/ECG monitor called the Qardiocore as well as the Qardioarm, a smart blood pressure monitor consumers could carry with them as well sending their results to the Health app in iOS pushing that information to the primary doctor for reading, analysis, and any necessary follow ups.

This is just a small sampling of the products that are inevitably on their way to the mass market available not just for physicians but consumers as well from Withings to Jawbone. One would wonder with a new shift in focus on health could insurance companies eventually start offering discounts on these specific products? Or could these products be covered under available insurance plans in the future? The questions are relevant and necessary given that a patient and doctor would eventually work closer hand in hand with improving their health or sustaining and maintaining a healthy lifestyle.

Also consider a few of the partners that Apple has signed on with for receiving and transmitting quality health metrics from their API, services such as EPIC which is a company that many medical organizations utilize for EMR (electronic medical record) data worldwide, and a service many physicians trust, along with the Mayo Clinic, though not a part of the EPIC program will implement services available to physicians for a more detailed review of a patient's health.

This set of hardware and software that connect to an all encompassing digital backdrop of a smartphone tied into secure enclaves will likely grow. More devices such as bluetooth glucometers and many others will engulf the market bringing down costs while increasing effectiveness of one's health. Though the fear of security of one's private health data will always linger it's up to the manufacturers and software developers to create systems where a patient's trust isn't abused.



Insurance...😣

*Making things as clear as possible, yes there are substantial issues with the healthcare system in the U.S., no there's no need to leave any self-righteous or sermon-like commentary, yes the system remains screwed up. This is an analysis of what's available today and what's coming down the road...breathe.*

One of the most complex issues with regard to healthcare is insurance and understanding the "legalese" behind the way insurance programs and premiums have been constructed. There are services that are increasingly becoming available for consumers to evaluate cost savings based on medical procedures and available facilities in their area that accept their insurance carrier but there should be additional steps taken by carriers themselves, one way this will occur is the rise of new insurance carriers that believe in technology being beneficial for everyone involved and not perceiving such as a burden.

One of the most intriguing insurance companies out now is Oscar Insurance Corporation, that seems to have been built with the digital age in mind. Being able to locate providers, clinics, hospitals, and pharmacies wherever one may be using their smartphone with an application tied to their insurance carrier is beneficial, and more carriers are implementing such features (though not all are clean or user friendly). But it goes beyond that, getting estimated costs on mobile devices for prescriptions, office visits, as well as seeing the status of deductibles and co-insurance rates, and a number of features that shouldn't be trivial to consumers but remain so at the behest of the carriers.

Tailoring services to the consumer should be the primary goal, unfortunately in many cases this just simply isn't the deal. But one could imagine having their digital insurance card implemented with the insurance carriers mobile application where upon going to the doctor going through the redundant process of inputting information that should already be stored or retrieved through EMR databases utilized by physicians that are a part of that carrier's program. It's because of these things that the User Interface (UI) and User Experience (UX) are heavily necessary to produce a system that can be beneficial to all.

As euphoric as that sounds...there's obviously a long way to go maybe companies would consider taking a few pages from Oscar if it was in the shareholder's best interest, unfortunately that's one way a well established insurance carrier would consider moving the needle to make services better for their customer.



Globalized Telemedicine

Consider everything mentioned earlier, many countries don't necessarily have medical insurance, but with the growing database of systems that contain information to many medical issues including how best to handle the simplest of diseases before they get out of hand. With the rise in usage of smartphones (not just the iPhone but Android phones as well), the integrated cameras for pictures, video calls, and access to medical information online can be immediately helpful to those in countries that don't have immediate access.

Global collaboration in medicine could increase at a more rapid rate, considering a service similar to that of Waze where a community of medical professionals can report on viral outbreaks, diseases, or any other pandemic that could be sourced, tracked, and analyzed to counter with treatment at an earlier date and timeframe. Such technology won't just be centralized to connect a person to their doctor in the same town rather across the globe physicians could have a significantly stronger network of collaboration all through the use of devices that one uses on a daily basis. 

The overall advancements and measures of security brought into the iOS platform and to an extent Android has provided the ability to utilize services that could diagnose, treat, and monitor patients from around the globe without compromising sensitive information. Though this will still be met with some criticism, as not all devices are secure and "not all services can be trusted" is an understandable feeling to have. Though such methods in medicine will likely continue to utilize technology available to help those in dire need especially in countries that aren't well off. There are companies that offer units that can best be described as kiosks with specific medical equipment for on locations nurses to operate as a patient has a videoconference with their physician.



Logic(?)

The concerns related to the inevitability of medical care using a smartphone mainly ties to security and the protection of information. Though one would have to ask, of those that are concerned of the security, how many have purchased an airline ticket not the internet, or purchased a random product to have shipped to their home? Is it fair to say that to many of these individuals that have an issue with sharing sensitive medical information with their healthcare provider over the internet have no problem with sharing such financial information?

Not to take these concerns lightly but, one questions the logic that a person will readily handover their credit card information including their home address to a website that may or may not be secure with their personal and private details rather than share information over the internet through a smartphone to their healthcare provider.

And before arguments come up that a lot of people make purchases in store rather than online, that moment you scan any card that information is being relayed over a server, online, to the financial institution and sent back to the store, how else would hackers have gotten a hold of all of the financial information throughout 2014 from Target, Home Depot, Neiman Marcus, and several others as the list continues to grow. Does one's financial information take a backseat to one's medical information? Logically both should be equally important and protected substantially, unfortunately logic isn't a benefactor to many.