How Technology May Change Your Clinical Practice

With technology continuing to advance rapidly, clinical practices are trying to identify innovative new solutions to improve patient experience with a focus on "placing the patient at the center of care." The first of these is Verily. Formerly known as Google Life Sciences, the company "lives at the intersection of technology, data science and healthcare." Their mission is to "make the world's health data useful so that people enjoy healthier lives." Cardiologist Dr. Jessica Mega of Verily asks, "What is valuable to an individual and how do we do that?" To answer these questions, they have launched a new platform, Onduo, which is focused on helping patients make better decisions about how they manage their condition. It also aims to improve parameters including managing medication, health goals and healthy behavior. This product is designed for patients, clinicians, payers and healthcare professionals. The goal of Onduo is to extend the platform to those who suffer from type 1 diabetes. They intend to work their way up to high-risk groups, so that disease onset can be prevented. One example of a product in development is a miniaturized continuous glucose monitor, which is currently being developed by Dexcom. Continuous glucose level monitoring is a particularly hot topic for the medical technology field, with Verily saying that they are "building miniaturized sensor electronics on an adhesive patch to make continuous monitoring less disruptive." This patch will ideally serve to monitor a patient's interstitial fluid, enabling them to measure their glucose levels less often. The question is, would this kind of continuous data monitoring really allow for better care, by making the individual's needs more understood? Euna Chi, M.D., (an assistant professor of clinical medicine at the University of Illinois Hospital and Health Sciences System in Chicago) says that, "continuous glucose monitoring may be particularly beneficial in patients with poorly controlled diabetes who are insulin dependent with labile blood glucose levels or asymptomatic hypoglycemia, or perhaps in patients who are nonadherent to frequent fingersticks." Such a process would aid both clinician and patient by providing more data to help titrate medication and avoid hyperglycemia. However, Dr. Chi does mention that while the technology sounds promising, the cost of such devices would be very high and it's unclear whether continuous monitoring would actually correspond to better outcomes for the patient. As Jessica Mega, M.D. of Venily says, "As a clinician, there's always the importance of taking care of the person in front of you. This felt like an opportunity to scale solutions and help the larger population." Guardian Health is another tech innovator in the medical field. A company with a focus on beating cancer with data, they created a system titled The Guardant360 with the intention of identifying a set of specific mutations associated with solid tumors. Liquid biopsy systems promise to provide this information while avoiding uncomfortable and potentially risky tissue biopsies. According to a paper in Nature Oncology Reviews, liquid biopsies "could provide a more comprehensive view of tumor characteristics, including aggressiveness and the overall molecular landscape." As part of their very ambitious LUNAR project, Guardant Health is in the process of collecting samples from multiple trial sites from individuals at high risk of early stage cancer. With the intention that project LUNAR will be able to "detect a single mutated DNA fragment among hundreds of thousands of genome copies," according to Amir Ali Talasaz, (Ph.D., president of Guardant Health) the future seems promising. This knowledge is helping scientists better understand how tumors evolve in the first place, as well as giving academic and clinical institutions the knowledge and understanding they need to develop novel therapeutics to combat them. With early diagnosis, continued monitoring of a patient and early detection of emerging resistance to standard therapy, all of these are promising to have a positive impact on long-term clinical outcomes for patients. Sync Project is another company that's interested in reinvention, and music therapy is their weapon of choice. Marko Ahtisaari, CEO, says that he and his team are looking at music as precision medicine, or rather using music for health and wellness purposes. However, Ahtisaari wants to take things a step further by creating music that's responsive to physiology. By pairing up scientists and musicians, Sync Project is digging deeper into how aspects of music (including beat, key, timbre) can impact heart rate, brain activity and even sleep patterns. Ahtisaari goes into further detail explaining that their creation, unwind.ai, is "intended to relax the listener before sleep, using heart rate as a 'musical thermometer' to alter the soundtrack each time it plays." The issues they're targeting with this project are sleep, relaxation, anxiety and pain. Ahtisaari says, "I believe 10 years from today, we will consider it absurd that we did not use these non-drug modalities at near or drug-like effect as how we treat our health and how we live our lives. It's just that we haven't had the data to implement them."