The convergence of two powerful forces are changing the practice of laboratory medicine in ways never imagined a generation ago. These twin forces are the movement to value-based healthcare from the fee for service model, and the rapid development of mobile technology allowing for continuous healthcare monitoring of patients beyond the clinical setting.
The central focus of value based medicine is increasing the value of medical services provided for patients based on the health outcomes achieved per dollar spent. The goal is to achieve good outcomes efficiently. This is the most effective way to truly contain costs in health care. Achieving and maintaining good health is inherently less costly than dealing with poor health; reminiscent of the old adage “an ounce of prevention….”
Laboratories can impact the value proposition by increasing the speed and accuracy of correct diagnoses, monitoring patient health to prevent disease, providing rapid turnaround times that allow reduction in length of hospital stays, and promoting the most appropriate test selection options with applicable interpretations in order to help avoid adverse events and point to the most appropriate treatment protocol. Translating concept into practice, however, can be challenging. Generally, the biggest hurdle is obtaining the necessary data, which must be in the right format and of sufficient quality for decision makers to gain the medical information they need.
This is why Point of Care testing (POCT) has become the fastest growing area of laboratory medicine; bringing laboratory testing conveniently and immediately to the patient. The new technology is the merger of molecular biology, information technology, and biomedical engineering. POCT increases the likelihood that the patient, physician, and care team will receive the results sooner, which allows for immediate clinical management decisions to be made. With fast turnaround times and portability to a variety of settings, POCT offers many advantages for disease management. It enables migration of testing from core hospital labs to specialty-care units, doctors’ offices, and homes to provide access to healthcare services, thus improving patient compliance, reducing hospital stays, and lowering overall healthcare costs.*
It is this need for immediacy in data collection and dissemination that is further driving mobile technology past POCT to wearable monitors that monitor everything from glucose levels to cardiac function. This cuts costs, as well as increases connectivity and provides the platform for shared medical data in real time.
Wearables are coming to a joint near you
This new mobile technology is based on the same mobile platforms for telephones and tablets. It is expected that mobile technology will allow virtually universal quality, cost effective, preventable healthcare even in lesser developed countries, in much the same way that mobile phone technology has allowed countries to leapfrog beyond land-line phones to the cell phone era and all its possibilities.
It is now clear that the tech industry sees medicine as the next frontier for exponential growth. Companies such as Apple, Google, Microsoft and Samsung and hundreds of start-ups also see the market potential — and have big plans. This is happening because several technologies such as computers, sensors, robotics and artificial intelligence are advancing at exponential rates. Their power and performance are increasing dramatically as their prices fall and their dimensions shrink.**
We will soon have sensors that monitor almost every aspect of our body’s functioning, inside and out. They will be packaged as wearables, as watches, adhesive bandages, clothing and contact lenses. They will be in our toothbrushes, toilets and showers. They will be embedded in smart pills that we swallow. The data from these will be uploaded into cloud-based platforms.
Artificial intelligence-based apps will constantly monitor our health data, predict disease and warn us when we are about to get sick. They will advise us on what medications we should take and how we should improve our lifestyle and habits.***
All this will translate to improved patient care through patient centered preventive medicine at reduced cost, and to the more efficient treatment of both acute and chronic illnesses; the very definition of quality care.
*Medical Laboratory Observer (MLO), January 2011. POCT key to widespread access to healthcare. Harry Glorikian, BA, MBA; Aruna Rajan; and Kerry Xie,
**V Wadhwa. Health Care Revolution, Starting with your Wrist. March 24, 2015. http://amestrib.com/opinion/vivek-wadhwa-health-care-revolution-works-starting-your-wrist
***V Wadhwa. Health Care Revolution, Starting with your Wrist. March 24, 2015. http://amestrib.com/opinion/vivek-wadhwa-health-care-revolution-works-starting-your-wrist