By Cathy Yarbrough
At the 2014 AAPS Annual Meeting and Exposition, I overheard an attendee who was telling a colleague, “I need to walk another 300 steps.” Pointing to the Fitbit band on her left wrist, she said, “If I walk around the exhibit floor one more time, I’ll meet my goal.” Like myself and many other Fitbit users, each day she tried to walk a specific distance and burn a specific number of calories.
Because the Fitbit and its app for the smartphone are relatively simple and inexpensive, it ranks as my favorite technology in the relatively new field known as digital health, mobile health (mHealth), or digital medicine. I even gave a Fitbit as a Christmas present to a close friend who is also a writer, a very sedentary profession. It lets us know whether we should take one more walk or jog around the block.
An abundance of digital health/mHealth/digital medicine devices and apps are now available to consumers and health professionals. Because I’m free of chronic disease, my self-monitoring is limited to one device: Fitbit. However, I’ve experimented—and been impressed—with digital technologies that can track an individual’s sleep patterns, blood pressure, and heart rate over time.
Consumers also can track their—or their children’s—temperatures over time. Last year, FDA approved the first smartphone-connected oral thermometer, a gift to anxious parents of sick young children. However, I’m much less enthusiastic about the “TweetPee” device for detecting a baby’s wet diaper. Just call me old-fashioned; parents should regularly check on their babies, not just their diapers.
Not surprisingly, biopharmaceutical companies are adopting digital technologies. Biogen Idec gave Fitbits to 250 patients with multiple sclerosis to track their level of activity and sleep patterns over time. Novartis used the Proteus Digital Technology’s ingestible “smart pill,” which was approved by FDA in 2012, to evaluate 20 patients’ adherence to the blood pressure drug Diovan. The “smart pill,” which is taken along with the prescription drug, contains a sensor that transmits a signal that is relayed to a mobile phone app. Obviously, these and other digital technologies could help drug makers obtain patient outcome data to help justify medication pricing.
Digital technologies designed primarily for health professionals to use with patients include the AliveCor Heart Monitor, an electrocardiogram (ECG) for the iPhone. During two airplane flights, San Diego-based digital medicine guru and cardiologist Eric Topol, M.D., used the AliveCor Heart Monitor to evaluate ill passengers, one of whom was suffering a heart attack, with the other passenger experiencing an episode of atrial fibrillation.
I had the opportunity to learn first-hand about Topol’s vision for digital as well as genomic medicine in 2011 to 2012, while working as a freelancer to improve and expand the website content of the Scripps Translational Science Institute, which he heads. Topol’s latest book, The Patient Will See You Now: The Future of Medicine Is in Your Hands (2015), which is on my nightstand, is a fascinating description of a “new era of medicine that is powered by unplugged digitization with the smartphone as a hub.” While respecting Topol’s expertise and remarkable ability to apply the rapid-fire advances that are occurring in digital technologies to health care, I agree with New York Times’ journalist Abigail Zuger, M.D., who wrote the following in her review of the book: “Healthy people may certainly enjoy monitoring their own physiology, but that activity can take up an awful lot of time. There are many wonderful things to do in this world other than keeping track of your own organs. Sometimes, it just makes sense to have someone do it for you.”