Scientia est potentia is a latin phrase that means "knowledge is power". Lately, medical devices seeking to empower patients with such knowledge regarding their physical health have created quite a buzz. Companies such as Alivecor offer specialized ECG (Electrocardiogram) smartphone cases that enable patients to monitor and analyze their heart rhythms simply by touching two embedded sensors on the back of the case. These rhythms can then be stored online and accessed by the patient's physician, allowing him/her to monitor their patient's status remotely. Even technological giants such as Google Inc. are seeking to contribute to the medical community.
On January 16, 2014, news was released about Google testing smart contact lenses that measure and monitor the wearer's blood glucose levels through his/her tears. These contact lenses would greatly impact a diabetic patient's quality of life both by eliminating the traditional finger-pricking blood tests and by actively alerting the patient when his/her blood sugars are low. As the usage of "sensory" medical devices continue to expand, physicians may be able to detect diseases during its early stages, allowing medical treatments and medications to be more successful and effective.
Implantable Sensing Device
Conventionally, physicians assess their patients' status through performing a brief H&P (history and physical), which then guides the next steps of assessment. However, accurate assessments may sometimes be difficult of obtain due to the subjective nature of a patient's response. A patient may forget and/or dismiss seemingly unimportant symptoms, which could aid the physician in making a more confident diagnosis or modifying his/her current plan of treatment. Inventor Scott Mazar and his co-inventors seek to improve the current methods of patient management through his invention, US 8,628,471, titled "System and method for predicting patient health within a patient management system" ; granted January 14, 2014.
Mazar envisions a device that, once implanted into the patient, can measure and track the following activities: 1) breathing, 2) heart rate 3) gross/fine body movement, 4) oxygen saturation and 5) blood glucose. In addition to acquiring raw data from its sensing components, Mazar's device would also clinically analyze all the data to provide a meaningful diagnosis and transmit the information wirelessly to an external database. Mazar also states in his patent that other sensors could be attached to the device to diagnose early onsets of diseases such as "stroke, chronic depression, and cancer tissue (onset, progression, recurrence).
Sensory Components and Its Applications
Although the idea of implanting a monitoring device into a human is anything but new, combining the aforementioned five sensory components into one medical device is highly innovative. The medical device significantly impacts the following two aspects of medicine: patient management and diagnosis/treatment. Let's take a look at how the widespread application of Mazar's device can transform current management and treatment procedures.
Microscopic Level Patient Management
One of the most unique features of Mazar's invention is integrating an accelerometer into his medical device. Depending on the sensitivity of accelerometer, the medical device would be able to determine the activity that one is performing, whether it's sleeping, exercising, or even coughing. With this information alone, a physician could analyze his/her patient's daily lifestyle to identify unhealthy habits. Furthermore, the accelerometer could help physicians gain a better picture of the patient's overall condition and make a better diagnosis. For example, if a patient has been experiencing fatigue and frequent fainting, but failed to mention it, the physician can obtain this information and investigate the potential causes for these occurences. When the accelerometer is used in combination with the other sensors, the medical device can measure the slightest change in biochemical function and immediately diagnose the issue. This decrease in time for a diagnosis may significantly impact a patient's prognosis.
Early Diagnosis and Treatment
In discussing how Mazar's implantable device could impact the diagnosis/treatment of a patient's illness, it is important to look at the communication component of the device. Although the patent does not divulge deeply on this topic, besides stating that the component would report the diagnosis to a clinician, there are possible applications worth discussing. If the communication system could be linked to an emergency medical system, the implanted device could potentially contact 911 once it senses the first signs of a life-threatening illness such as a heart attack. This would reduce the response time for emergency personnel, thereby allowing the patient to receive treatment before permanent damage sets in. Furthermore, the device could transmit live patient's vitals to both the EMT and attending physician so that both healthcare professionals could monitor how the patient is responding to their treatments. Lastly, if the implantable device constantly monitors the patient's blood for disease markers (such as cancer tissue), patients could seek treatment earlier and stop diseases during its nascent stages. Early detection will allows physicians to treat using lower dosages of therapy, which would be less toxic and more tolerable to the patient.
Moral and Privacy Issues
Where there is a transmission of personal information, moral and invasion of privacy issues are sure to follow. One case to consider is whether a patient could "block" certain data from a physician. For example, if a patient does not want the physician to notice their "high-risk" activities, would it be possible to prevent the device from sensing such information? Furthermore, could insurance companies require access to the device's data prior to providing medical coverage? Imagine a future where health/life insurance companies are constantly overseeing one's accelerometer to determine if one is engaging in high-risk activities and, as a result, increases one's monthly premiums if such activities are "indicated". According to a patent filed by inventor David Peak, such a future seems quite plausible. However, there are other applications that boast a more "secure" future. For example, Apple Inc. patented an integrated heart rate monitor that could be used for password authentication purposes. As medical devices continue to converge with every day electronics, we may begin to see a push for DNA-based authentication that can open everything from smartphones to locked doors.