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Health technology - Is it a brave new world?

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“Alexa, how do I perform CPR?”

While Amazon’s partnership with the American Heart Association may help save someone’s life, Alexa can’t actually perform the resuscitation “herself,” at least not yet!

Amazon’s Echo, however, is as much at the intersection of healthcare and new technology as the ovulation-tracking smartwatches now available or the blood glucose-measuring implants that soon will be available.

In the past, people would get a check-up and some “lab work” maybe once a year. Today billions of activity trackers and $1.99 smartphone health apps provide a plethora of data, some of it accurate but all of it symptomatic of a thirst for health status information, with constant updates.

The increasingly blurred distinction between “consumer” and “medical” devices and applications is part of the new healthcare technology landscape. It’s one that presents an opportunity to improve both delivery and outcomes, as well as the potential to bring down costs.

For any of this to happen service providers and consumers need to change the way they think about healthcare. Clinics and hospitals may no longer be the primary point of care, and a patient’s healthcare “team” will consist of not only physicians and nurses but also family, friends, and devices!

Such is “the internet of things” in healthcare. A place where smartphones, home-based monitoring systems, and implants will communicate with each other and with medical professionals, patients, and their care givers. Algorithms will allow physicians to tweak treatment regimens and will send automatic alerts to patients, their care givers, and medical team when something’s not right, enabling a proactive response.

As always, every “brave new world” must have its dystopian scenario. For every person that believes technology will liberate society, there’s another who fears it will enslave it.

All stakeholders in this technology-based healthcare partnership must agree on limits for what it’s allowed to do and who has access to the data it generates. Issues of ethics and security may be secondary to healthcare but they are, nonetheless, very important.

Should the continuous positive airway pressure (CPAP) machine that sends nightly sleep data to a doctor be allowed to send the same data to the customer’s insurer? Shouldn’t treatment compliance decisions be made at the physician’s office, not by the company paying the bill?

Nowhere do ethics issues raise their head as high as in the subject of genetic testing-based health. The FDA recently gave approval for 23andMe to offer its genetic health risk tests to the public. The test reveals a person’s predisposition to twelve health conditions, including Alzheimer’s and Parkinson’s.

GWG Life, a life insurance provider, has just acquired an exclusive license to biomarker-based life expectancy predictor technology. Other companies are pursuing the same end by measuring the length of telomeres, which are the protective caps on the ends of a person’s DNA strands that tend to shorten with age.

At the moment, the results of personalized genetic tests are largely protected by the Genetic Information Nondiscrimination Act. The recently House-passed American Health Care Act (AHCA), at least in its current form, does away with the Affordable Care Act’s protections against discrimination for preexisting conditions (such as having a breast cancer-related gene) revealed by physician-ordered gene tests. Taking it a step further, the AHCA considers the presence of this same breast cancer-related gene to be seen as a preexisting condition and thus, insurers would be allowed to adjust premium prices due to the findings of these gene test.

Then there’s the matter of data security. Imagine if the recent WannaCry ransomware attack had been perpetrated against individuals, threatening to reveal personal genetic test results to health and life insurers, unless a $300 ransom was paid! All of these concerns will multiply as the internet of things creates a web of interconnected devices and health systems. The benefits of latest generation healthcare technology cannot be denied but the potential pitfalls should also not be ignored.

“Alexa, how do I make the best use of new healthcare technology?”

“Hmm, I don’t know that one!”

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