Wearing Our Hearts on Our Wrists

For now it tends to be the more motivated among us who sport Fitbits and the like in order to keep track of our steps, heart rate, diet, sleep, and other signs that we are alive and well. But the renowned cardiologist and geneticist Dr. Eric Topol sees a future when many more of us will be “digitized” with biosensors capable of measuring almost any physiologic metric – blood pressure, glucose, oxygen level in the blood, or impending signs of an asthma attack. “We will be able to send that data wirelessly through smartphones to our doctors, and use it ourselves maintain our health and direct our own care,” Topol told the Wall Street Journal in 2013, “and that is the essence of digitizing a human being.”

Facebook’s Mark Zuckerberg is all in, having recently told Topol that he wants to invest in and potentially be one of the first to try a novel technology Topol is working on now – a nanosensor put into the bloodstream that can sense a heart attack days or weeks before it actually happens.

In his book The Creative Destruction of Medicine, Topol is cheerleader for the power of digital, wireless technology to transform how health data is gathered, interpreted and put to use on both a macro, population health level and in the intimacy of the doctor’s office. He sees this as part of a great “inversion of medicine” that is already beginning to challenge established medical norms that date back centuries, where individuals will have much more access to their own medical data because they will be generating and owning it.

But to what degree could all this technological wizardry challenge the intimacy of the doctor-patient encounter rather than foster it?

We already have seen that with the advent of the electronic medical record there can be problems with too much “screen time” in the doctor’s office, as healthcare providers divert eye contact from the person in front of them to a computer screen. Topol sees the danger. As he has told the Wall Street Journal, “when you have this type of rich data on an individual, there’s a tendency to treat the scan or treat the DNA or treat the sensor data output rather than the patient.” But he argues instead that by “embracing the shift of much responsibility for data collection to patients, and its interpretation by artificial intelligence, the human factor of the doctor – establishing trust and support with extraordinary communicative skills and real intelligence – will be indispensible.”

New York Times columnist Thomas Friedman has coined the term “STEMpathy” to describe the jobs of the future that blend STEM skills (science, technology, engineering, math) with human empathy. “Nobody cares what you know, because the Google machine knows everything,” he recently told the Colorado STEM Summit. Rather, he argued, the future is about what we can do with what we know.

And that is true whether you are a person with a Fitbit, or an oncologist with access to IBM’s supercomputer Watson, which is being “taught” by doctors at Memorial Sloan Kettering Cancer Center to interpret cancer patients’ clinical information and identify individualized, evidence-based treatment options based on MSKCC’s decades of experience and research.

Seeing these trends as a democratization of information rather than technological consolidation and de-personalization is a challenging but also liberating way to envision the future of healthcare.