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Medical apps shift control of care from doctors to patients

Doctor mobile appsIn his new book, “The Patient Will See You Now,” Dr. Eric Topol envisions patients as partners in their own health care rather than petitioners to the medical establishment. Armed with smartphones equipped with apps to monitor vital signs and perform diagnostic tests, patients’ reliance on physicians will diminish, he predicts, and doctors will generally assume a consulting rather than controlling role with their patients, who will monitor and manage their own health for the most part.

Topol notes that the technology is already available to perform many tests and exams via smartphone, including apps that check for ear or skin infections and perform electrocardiograms. He predicts that routine diagnostic tools will grow exponentially in the next few years.

Doctors’ skills will continue to be important in emergencies and in treating serious or complicated conditions, Topol says. But for routine health care, patients will be in the drivers’ seat.

Topol is a cardiologist and director of the Scripps Translational Science Institute in La Jolla, Calif., a research and education center that focuses on genetic factors in health and disease and using digital technology for health monitoring. We spoke recently about his new book. This interview has been edited and condensed.

Q. You’re pretty passionate that people should be the boss of their medical lives, including owning and taking charge of their medical information. But taking responsibility can be a scary burden. To what extent do you think people need to be persuaded that this is something they want for themselves?

A. First, most people have been suppressed for so long that they don’t realize they can be liberated. The information hasn’t been shared as it should be and it and hasn’t been owned by people. In surveys, 80 percent of consumers say they want to have their medical data and take charge of it. But it’s not for everyone. There are people, some seniors for example, who are happy with the way it is. But the dominant number of people want a new model. It’s their body and their data, so why shouldn’t they get it?

Q. When you discuss people getting unfiltered access to medical test results, you sometimes seem pretty breezy about people’s ability to understand what the results mean. Regarding lab tests, for example, you say there are reference ranges that explain for people what the results mean and leave it at that. But it’s not that simple. How will people interpret all this data that they’re in charge of?

A. Are you a doctor? You’re sort of sounding like one. I’m not talking about major trauma. I’m talking about ear infections and heart arrhythmia, things that are quite routine. It’s like Rodney Dangerfield: Patients don’t get no respect. There’s a lot of software with great data visualization, and with the right educational data and good support, the patient is often capable of handling the data without any need on the diagnostic side for the doctor to know what is going on.

Q. As technology plays a bigger role in how consumers receive medical care and manage their health, it seems we could be headed toward a new type of have and have-not divide, where people who are comfortable with technology may be more likely to be healthy than those who aren’t. Do you worry about this?

A. I have a lot of patients in their 80s and 90s we convert to smartphones so we can get a better handle on their heart rhythms or glucose, for example. For those that are willing and able, they may be particularly enthralled by this new way of being the patient in charge.

The number of people who are interested [in seeing their data] is higher than might be anticipated.

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