Tablets and apps might be doctor's orders of the future By Jane Wakefield

Technology reporter Published duration 16 December 2013

image caption Is the doctor's waiting room due for an update?

If you have ever sat in a doctor's waiting room, next to someone with a hacking cough and with only a pile of out-of-date Reader's Digests for company, then you may have asked whether the system was fit for 21st Century living.

The NHS seems under increasing pressure, from GP surgeries to accident and emergency rooms. It feels as if the healthcare system is in desperate need of CPR - the question is will technology be the thing that brings it back to life?

Daniel Kraft is a trained doctor who heads up the medicine school at the Singularity University, a Silicon Valley-based organisation that runs graduate and business courses on how technology is going to disrupt the status quo in a variety of industries.

image caption Tricorders were a must-have on the Starship Enterprise

When I interview him he is carrying a device that looks suspiciously like a Tricorder, the scanners that were standard issue in Star Trek.

"This is a mock-up of a medical tricorder that can scan you and get information. I can hold it to my forehead and it will pick up my heart rate, my oxygen saturation, my temperature, my blood pressure and communicate it to my smartphone," he explains.

In future, Dr Kraft predicts, such devices will be linked to artificial intelligence agents on smartphones, which in turn will be connected to super-computers such as IBM's Watson, to give people instant and accurate diagnoses.

"It may say, 'Daniel, this is looking bad - you need to go to the emergency room', or it might say this is probably just the flu because there is a lot in the neighbourhood and your symptoms are consistent with that."

No such device is yet on the market but in the US there is currently a $10m (£6m) prize on offer to design one that is suitable for use in the home; 300 teams are competing.

image caption Devices can enable doctors to closely monitor a patient

Wearable devices such as Nike's FuelBand or Jawbone's Up are making people ever more aware of their health.

Wristbands

These days it seems as if there is an app for every medical condition. Diabetics can monitor their blood sugar levels via their smartphones, there are apps to track diet, pregnancy and menstrual cycles. It is even possible to get smartphone-enabled blood pressure cuffs.

Dr Kraft is wearing four wristbands, monitoring a range of things including his heart rate, his sleep pattern and how many steps he takes each day.

Such devices, he says, make him the "CEO of his own health" and he thinks that doctors will increasingly be prescribing such tools instead of handing out pills.

"I might prescribe you exercise. I might say, 'Here's a band and I want you to wear this and I want to see that you are improving your exercise.'"

Last year, the UK's Department of Health said that it was looking at the possibility of doctors prescribing apps, although they are currently unregulated, leading some medical experts to question what role they should play in healthcare.

In September the US Food and Drug Administration said that it would regulate only the small number of apps that act like medical instruments.

Surgery via Glass?

"Such tools can be valuable but there are privacy issues about whether patients want to share their data with their doctor as well as how accurate such data is," said Mary Hamilton, managing director of consultancy Accenture's technology labs.

image caption Google Glass could prove a useful tool for surgeons

Accenture and Philips recently conducted a proof-of-concept demo in which a surgeon wore Google Glass, allowing him to simultaneously monitor a patient's vital signs and react to surgical procedural developments without having to turn away from the patient.

Such devices could also be used to instantly bring up patient data when a doctor conducted his ward rounds, says Ms Hamilton.

If wearable technology and the data it generates does get integrated into the health service, GPs will know exactly whether a patient is following doctor's orders.

"If you do a good job your healthcare premiums might get lowered or the NHS might give you an incentive like tickets to a concert," says Dr Kraft.

Insurance firms such as PruHealth are already offering lower premiums for those who can prove they have healthy lifestyles.

Citizen scientists

image caption Citizen scientists are offering new ways to solve medical problems

Last year, speaking at a health conference, tech entrepreneur and co-founder of Sun Microsystems Vinod Khosla made the extraordinary claim that in the future 80% of what doctors do will be replaced by technology.

He likened current healthcare to "witchcraft" and argued that machine learning would be a much more efficient, accurate and cheaper diagnosis tool.

The shift is already happening, says Dr Kraft. "There are robotic anaesthesiologists coming online and applications to take pictures of a skin lesion that can do a better job than dermatologists."

Meanwhile IBM's Watson is giving human doctors a run for their money when it comes to diagnosing cancer.

In February the super-computer was made available to rent to any hospital or clinic that wanted to get its opinion on oncology-related matters - and with its ability to take in and analyse vast quantities of data, it may just be just the extra medical mind that doctors need.

But it isn't just machines changing the way medicine is conducted.

When 14-year-old Jack Andraka discovered a new way of testing for pancreatic cancer just by searching Google and borrowing some lab space from nearby Johns Hopkins University, it was an indication that the old way of doing things might be over.

Prof Raymond McCauley runs the US's first ever bio-hack lab, where members of the public are invited to come in and "play around with DNA" and conduct other experiments.

"Things that were major government and academic projects a few years ago are now things that junior high school students are doing in their basements," he says.

Whatever the future for healthcare there is little question that the system is in desperate need of an overhaul.

"Healthcare today in many ways is broken," says Dr Kraft.

"There are lots of challenges with costs, ageing populations, fragmented big data but we have the opportunity with many of these new and exponential technologies... to help reinvent elements of health and medicine.