StartUp Health cofounder Unity Stoakes, speaking in Washington D.C. at Health Datapalooza 2015. (StartUp Health)
Far too often, radically transformative ideas get stuck on the starting block, never able to truly take off. These innovations languish because a series of roadblocks make success seem impossible. In the U.S. healthcare system, radical change is often held up by regulatory hurdles, lack of resources and inadequate funding. Sometimes, the new technology just seems too futuristic for the general public to embrace.
At StartUp Health, I am often confronted by the tug-of-war between a brilliantly innovative solution, and the harsh reality of a system that isn’t ready for it. Hundreds of pioneering digital health companies are paving the way, but many find themselves tangled in bureaucracy, stalled by lack of funding and challenged by the fear of doing things differently.
Just look at consumer genomics company 23andMe, which was soundly rebuffed by the FDA over its personalized genomic health product. The company started off as a popular ancestry service, making use of a DNA spit test to map personal genomes.
Realizing potential, 23andMe moved swiftly into the medical arena, offering patients customized health reports that predicted risk of heritable diseases. The FDA’s 2013 order to pull the health product until 23andMe could prove it was interpreting the results correctly had a chilling effect on a burgeoning industry of consumer genomics offered by the private sector.
There are dozens of digital health concepts I wish I could fund now, yet many of these would not be accepted by today’s market. If regulators, more investors and the general public were willing to embrace these concepts, here are five technologies that could radically improve human health.
Embeddable Consumer Devices
The concept of embeddable consumer devices moves way beyond wearable sensors. An embeddable in this context isn’t a traditional medical device like a pacemaker or a stent. It’s a tiny sensor swallowed or embedded to constantly monitor biometrics. Consumers would be able to track the effect of a new diet on blood pressure, or the effect of a new medication on sleep patterns.
A company called Proteus Digital Health is taking the first steps with its ingestible sensor that sends a signal to a battery-operated patch worn on the skin. At this stage, Proteus seems focused on improving medication compliance. If privacy and safety concerns can be appropriately addressed, embeddable consumer devices could be used outside the healthcare setting to focus more broadly on daily health and wellness.
Consolidated Health Dashboard
Diagnostic tools are becoming more sophisticated and cloud storage of health data will soon be universal. With these developments, each patient should be able to access his or her own health dashboard the same way we can for our Web sites or automobiles. And I’m not referring to what the medical industry refers to as an electronic health record. What’s needed is a consumer-friendly dashboard that operates as simply as Google Analytics -- with consolidated, easy-to-use visualization of data in real time.
A similar concept would be a dashboard for employers and businesses to track the wellness of their teams the same way we do their productivity metrics. An employer dashboard could track healthcare decisions of each employee, identifying preferences and trends over time.
One big roadblock to a health dashboard is data fragmentation. Many small companies already offer their own dashboards, but there is no one consolidated provider to streamline the experience across different datasets that impact our health and wellness on a real-time basis. In addition, the data we collect today is catalogued in different ways, making it difficult to synchronize.
Microbiome-Based Consumer Goods
The concept of personalized medicine is intuitive. Every patient has a unique medical history and physiology, so why shouldn’t treatments be personalized? In addition to personalized medicine, we should have personalized consumer products. Consumer goods like toothpaste, shampoo, lotion and cosmetics could be tailored to suit each person’s microbiome.
We are learning more about the essential role of the microbiome - the billions of bacterial cells that comprise between one and three percent of our body mass. One person’s oral microbiome, for example, could be paired with a complimentary toothpaste, the ingredients designed just for that individual, potentially saving millions in healthcare spending for minor infections and other issues.
For this concept to become a reality, consumer product companies and healthcare companies would have to collaborate in an unprecedented way. The medical community is also still in the early stages of microbiome research. The FDA is unlikely to support personalized consumer goods just yet, as they rely on a system of rigorous batch testing to guarantee products are safe for everyone. Personalized products might be perfect for one person but unsafe for another, presenting a unique challenge in the era of 3-D printing and personalized everything.
Today’s autonomous devices can perform many of the same tasks performed during a regular checkup. It’s unlikely that a robot will replace a family practitioner any time soon, but in some remote regions of the world, a machine equipped with the basic diagnostic technology could identify common medical ailments that would otherwise go undiagnosed. I call this concept "RobotDoc."
Today, a tiny handheld device made by a company called Scanadu can check blood pressure, temperature and heart rate. The company is also developing a urine test kit. The technology exists today, but it’s too expensive to be practical around the globe.
Ethical and cultural considerations for RobotDoc would need to be navigated, as will the many regulatory hurdles, but the benefits could be astounding. For this concept to fly, the RobotDoc would have to be inexpensive, perhaps $100. That’s an attractive price point for agencies looking to fund healthcare solutions in developing nations.
Today, it’s often a mystery what you are ingesting. Food labels aren’t very helpful and chances are high if it requires a food label it’s not very good for you anyway. Some people hire nutritionists to evaluate their medical history and make personalized diet recommendations. That’s too expensive to be practical. There’s a bigger opportunity in leveraging wand-like sensors, or even a small portable assay, to take the guesswork out of the equation.
Armed with the patient’s complete medical history, a food analysis technology could help consumers determine the foods that are best for them to eat and understand the health value of each food item in real time. This would encourage smarter eating habits and more precise information about the stress felt when trying to make the “healthy” choice based on a nutrition label. In addition, this type of technology could immediately flag allergens, perhaps preventing hospitalizations.
The big challenge is creating an affordable solution that is not only accurate, but also fits seamlessly and unobtrusively into our everyday lives, so people will actually stick with it.
Unity Stoakes is cofounder and president of StartUp Health, a health innovation company with more than 100 digital health and wellness companies in its portfolio.
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