Data in Hand

The first generation of medical students that went to medical school with smartphones in their pockets is still in training. They’ve just finished their second year of residency and they’re accustomed to having the world’s medical literature at their fingertips. So are their patients.

Access to information about medical conditions is now so easily available that it’s hard to remember that this is a new phenomenon. In the early 1990’s neither clinicians nor patients could easily look up a condition online. And many medical libraries wouldn’t even allow patients to visit.

Today this would be unthinkable. And I’ve met people on the streets of Kolkata with access to more medical information than the US Surgeon General used to have just a few years ago.

But…

Most people today do not yet have easy access to their own body’s specific health information. Much of this valuable stream of health data is never collected nor recorded. And most clinical data that is recorded ends up in clinical labs or medical records – not in people’s hands, not in people’s pockets. Tomorrow this will be unthinkable. A tectonic change is afoot.

Access to one’s own bank accounts and credit card statements allows better managing of personal finance. Access to the body’s changing parameters allows a new level of engagement in one’s health.

Three examples:

1)    The temperature fingerprint

People often think the normal human body temperature is 98.6⁰F. But 98.6 is a population average – and not even an accurate average. Each person has their own average temperature and their temperature cycles throughout the day. For me, 99⁰F at 4 o’clock in the afternoon is normal; the exact same temperature at 4 o’clock in the morning is a fever (>two standard deviations from my normal).

Easy access to one’s own temperature curves and how they change over time provides early information about the onset of illnesses, the progress of illness, fertility, changes in cardiovascular fitness, and changes in the circadian rhythm and sleep quality.

2)    The flu window

The big decisions about flu are best made in the first 48 hours of illness. Anti-viral treatment is most effective if started early. Stopping the spread of influenza is easiest if people with who have it are identified early.

But today, people must still engage the medical system to learn if they have the flu. A test requires a clinician’s orders and a visit to an office or a lab. Many people with flu are never diagnosed; many of those that are, miss the 48-hour window. What would the world be like if barriers to access to data about one’s own body were eliminated?

3)    The blood pressure bonanza

Over a billion people have high blood pressure. For those who do, controlling it could be the single most important thing they do to add healthy years to their lives. A healthy blood pressure adds brain-years (through reduced risk of stroke and dementia), adds heart-years (through reduced risk of heart attacks and heart failure), and adds years of sexual pleasure (through reduced risk of erectile dysfunction).

But today, perhaps 20 percent of people with high blood pressure don’t even know this basic data about their own body. And for those who do? Most don’t have it under control. They know they have hypertension, but don’t know how their own body responds to various everyday activities. Does having a drink raise or lower their blood pressure? How about 3 drinks? How does exercise affect their numbers? Or a massage? What does their blood pressure look like the afternoon after a fast-food lunch? A fresh salad? What’s the impact of medications?

Health-saving data is squandered because it is too cumbersome to collect and analyze.

Soon it will be hard to remember navigating life with so little information about our own bodies (like life before MapQuest). Data in hand is worth far more than data locked in the system.