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       Star Trek is still having an impact, decades after Gene Roddenberry first got it on the air. It has become a standard for comparison when evaluating different visions of the  future. The latest area where Star Trek may have given us a model to emulate is in the field of health care: the medical tricorder.

         The concept is simple: a hand held device equipped with sensors that can measure a wide range of health indicators (pulse, blood pressure, temperature, etc. etc.) combined with software and enough computing power to interpret the readings and give a quick and accurate diagnosis of a life-form's state of health. Imagine what a device like this could do for health care, if widely available and adapted for use by anyone, not just a Dr. McCoy.

        By 2015, you might not have to imagine it any more; you might be able to hold one in your hand. More below the Orange Omnilepticon.

             The X Prize Foundation back in 2012 at the Consumer Electronics Show announced the $10 million Qualcomm Tricorder X prize. The genesis of the competition began in 2010.

Each year, the XPRIZE Foundation gathers thought leaders from around the world, for a 3-day summit called Visioneering, to debate and brainstorm solutions to the world’s “Grand Challenges” through incentivized prize competitions. During one session in 2010 The Artificial Intelligence (AI) Physician and Lab-on-a-Chip prizes were conceived. Immediately it became clear these two concepts complemented each other and should be combined into one prize with a new and unique focus on consumer needs rather than a device for clinicians and doctors.

It was envisioned that this hand-held consumer device would allow individuals to access the state of their own health anytime, anywhere, and potentially revolutionize how people could interact with the healthcare system. Contributing to both prize development and the architecture of prize design was Dr. Daniel Kraft, a Stanford- and Harvard-trained physician-scientist with over 20 years of experience in clinical practice, biomedical research and innovation.

      To emphasize, this is being envisioned as a disruptive technology - because it is intended to reshape the way health care is provided. It's aimed at consumers - NOT doctors, as is stated above. If it can be realized, it will be a game changer.

      Anyone who has ever had a child become sick late in the evening, or over a weekend knows what it's like to wait to contact a doctor during normal office hours. Anyone who has begun to feel not quite well, but unsure what's going wrong knows what it's like to wait for a diagnosis. Anyone who has had to wait for test results to come back knows how nerve-wracking that can be. Anyone who has had a doctor misdiagnose an illness, or take forever identifying an effective treatment knows how frustrating and potentially life-threatening that can be.

The Details

     The tricorder is intended to address those situations by providing a quick and accurate diagnosis of 16 different conditions - as well as ruling them out. How it will do it, and exactly what will be on the list is why this is a contest - it's about pushing the technology. Some of the conditions that have been suggested for targeting are things like: ear infections, blood pressure, anemia, diabetes, heart attack. The full guidelines are here (pdf). Here's a summary:

The winner(s) of the $10M Qualcomm Tricorder X PRIZE will be the best‐performing solution in its ability to assess a set of 16 distinct conditions and five (5) vital signs in a pool of people within three days, while providing a strong consumer experience in the areas of usability, understandability, engaging and desirable presentation of information, and ability of the solution to willingly invoke action on the part of the user. In addition, the winning solutions must:

• Meet minimum scores for both consumer experience and health condition assessment
• Continuously monitor five vital signs over the course of the consumer testing period and log this data to the cloud
• Have a maximum mass of no more than 5 pounds for the entire solution provided by the team to the consumer

This assessment and monitoring, as well as the interpretation and interaction of the solution must be performed solely in the hands of a consumer, independently of a healthcare worker or facility. Use of telemedicine or simply sending a person’s health data directly to a healthcare worker is not acceptable. This requirement is intended to put the means for health awareness, metrics, and initial steps of care first in the hands of the person to whom the health belongs.

    In short, it looks like they want to have enough 'smarts in the box' to function without needing to uplink to more powerful processing power/databases or a human diagnostician - but data can be stored and transmitted to make that possible, since it's obviously a good thing to be able to do if needed.

    The rationale for developing the medical tricorder is pretty convincing. Again, a selection from the pdf file:

Unfortunately, the cost of healthcare is not the only problem the U.S. faces. There is strong evidence that despite having access to some of the best modern medicine, the care being delivered is prone to delay and inadequacies in the eyes of the most important party: consumers. Consider these common situations faced by many people seeking medical attention:

• It takes 21 days on average to obtain a doctor’s appointment (4)
• Three out of four people have difficulty making appointments or receiving after‐
hours care without visiting an emergency room (5)
• Only 57 percent of people report that their doctor listened, explained, showed
respect, or spent enough time with them (6)
In addition to affordability and access hurdles, when individuals finally do obtain care, only 55 percent receive the recommended screening, diagnosis, or treatment. (7)

Change is long overdue but it needs to be directed at the heart of the problem; peripheral improvement within the system has been unsuccessful. Funding has been poured into this problem; healthcare reform has been a priority for decades across presidential administrations. Yet not only is the system hemorrhaging the increasing resources that we are putting into it, but there are also many signs, some previously noted, that it is fit for change so radical it would be classified as “disruption.” Some researchers, stakeholders and others are fighting to change the existing paradigm, but displacing such a swollen, self‐serving system is no easy task.

4 Merritt Hawkins & Associates, 2009 Survey of Physician Appointment Wait Times
5 The Commonwealth Fund, A Call for Change: The 2011 Commonwealth Fund Survey the U.S. Health System
6 The Commonwealth Fund Commission on a High Performance Health System, Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008.
7 Elizabeth A. McGlynn, Ph.D., et al., “The Quality of Health Care Delivered to Adults in the United States, The New England Journal of Medicine, June 26, 2003.

       
This Is Not Going To Be Easy, But...

        There are a lot of hurdles to clear here. It's not enough for the device to detect health problems within the range it is supposed to cover. It has to minimize both false positives and perhaps more important, false negatives. And, of course, it should be able to inform the user when it can't make a diagnosis, but it is detecting conditions that need further testing.

  Is it going to be possible to design sensors that will be reliable, rugged, and easy to use? Will there be consumables that need to be replaced? Can they be designed to work in the hands of people with no medical training? Is it going to be possible to make them non-invasive?

      The question of legal liability if the device fails in some way is rather a hurdle as well. Cost is another question; what price point will allow enough people to buy one of these to sell enough to make them economically viable? Will they covered by health insurance? The medical profession is going to be highly skeptical if not outright hostile to this idea. What will it take to get them to buy in to the concept?

        The record of health care delivery as described above certainly suggests a medical tricorder that works as intended has a huge opportunity to improve things. It's easy to envision someone with a chronic illness could benefit greatly if they could take regular scans at home to allow their physician to monitor their health - especially with software smart enough to pick up warning signs from long term trends. Watson showed what happens when you put massive computing power together with parsing algorithms and a vast database. It's already being turned to medical uses.  Kevin Drum over at Mother Jones has a thought-provoking article arguing that we are very close to the point where robots will be able to fill many jobs now being carried out by humans - and it's going to happen sooner rather than later.

        There are already a number of teams working on the competition, who are investing serious time and resources. The potential is huge - and applicable in ways beyond a hand held device. For example, Dr. McCoy's Sick Bay had a bed with a lot of scanners built into it that were non-invasive and wireless. The sensors and software being developed for the tricorder could certainly be used in that way. Consider also the research that could be done using the information in a standard format gathered by thousands or millions of people getting scanned on a regular basis. Anonymized and monitored over a long baseline, it could revolutionize medicine.

         The X Prize foundation hopes to announce a winning finalist team by June 2015. There is still time to register; entry fees will be going up so don't delay if you think you've got a shot at this.

Originally posted to xaxnar on Sat May 18, 2013 at 09:58 AM PDT.

Also republished by Star Trek fans.

Poll

If a working medical tricorder comes out of this contest:

7%2 votes
11%3 votes
3%1 votes
11%3 votes
15%4 votes
15%4 votes
7%2 votes
15%4 votes
7%2 votes
3%1 votes
0%0 votes

| 26 votes | Vote | Results

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Comment Preferences

  •  Tip Jar (11+ / 0-)

    The future isn't what it used to be. How about we start seriously trying to make it better rather than worse?

    "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

    by xaxnar on Sat May 18, 2013 at 09:55:09 AM PDT

    •  This is quite scary to me because the (1+ / 0-)
      Recommended by:
      whaddaya

      human body is so fraught with subtleties and unique reactions to outside stimulation in its quest for homeostasis that all the individual reactions couldnt possibly be so black and white as to be put in a database of possibilites that produces a concrete diagnosis. And I wouldnt trust said technology if it seemed to. Look, we are barely on the threshhold of understanding the deep ways that the human body works...we still cannot even provide such fundamentals as defining what sleep is,or what makes the initial electrical currents begin in the heart, or the mind body connection of illness. Heck, we cannot even 'cure' any disease beyond infection, we simply cut out the offending body part or hand out medications to treat symptoms, often at a peril worse than the said problem. This technology is too soon...before can be more comprehensively diagnosed and we still have to be able to actually irradicte the problems once it can do that or what's the point? More meds? And this is just the medical diagnositic side to it. Do we really want to look at the health industires technology being sold to us as consumers? Look how well that captialism is working out in other areas!

      •  You raise some good points (1+ / 0-)
        Recommended by:
        whaddaya

        But I think you're overestimating the difficulty of the problem here. The deep ways the body works are certainly worthy of more study - but we already have a huge amount of data on the basics. Yes, there are some really tough to diagnose conditions that take a lot of expertise and testing to diagnose correctly - but there are also quite a few that are pretty straightforward, and where getting them diagnosed quickly can make a big difference, or just being able to monitor them on a day to day basis.

        If you don't like the way the health care industry works currently, this device is disruptive technology that's going to force changes across the whole system. We're about due.

        "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

        by xaxnar on Sat May 18, 2013 at 12:46:54 PM PDT

        [ Parent ]

        •  Myabe, but wanting something to change (0+ / 0-)

          without directing how it changes can often leave changes you may not be happy about. IOW be careful what you wish for if you arent aware of unintended consequences.

          •  Well, sometimes you have to take a leap (0+ / 0-)

            There are some consequences you can only find by experience - no way to predict them. They are not always negative - and if the situation you're currently in is less than desirable, taking a leap based on your best estimates of what you do know is not unreasonable. In fact, it may be unreasonable NOT to take that leap.

            Every solution creates new problems. The trick is making sure they replace your old problems instead of adding to them. If you're headed in the right direction, it's the price to be paid.

            "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

            by xaxnar on Sun May 19, 2013 at 04:19:32 PM PDT

            [ Parent ]

  •  I would want one if (3+ / 0-)
    Recommended by:
    Horsefeathers, whaddaya, Chi

    the results were for my personal use and I could choose whether or not to share with my physician.  My concern would be that this could be a five pound ball and chain anyone with a chronic condition would have to drag around everywhere to demonstrate "compliance."  

    Democrats give you the Bill of Rights; Republicans sell you a bill of goods!

    by barbwires on Sat May 18, 2013 at 10:42:09 AM PDT

    •  Well, as they're describing it, (1+ / 0-)
      Recommended by:
      whaddaya

      You'd use it on a completely self-contained basis - no one else would have access to the information it would gather unless you actively chose to share it.  As for the five pound problem, that's the upper limit - from what I gather most of the teams are looking at something the size and weight of a smart phone.

      Compliance is another question. If used punitively by insurance companies to deny benefits, that's obviously an issue. But studies like this one have shown (pdf) lowered costs and improved outcomes for a select group of elderly patients with a particular set of chronic health problems, when equipped with equipment that allowed remote monitoring of their vital signs and symptoms on a regular basis. Something like the medical tricorder would be a step beyond the systems described in the paper.

      The idea is empowerment - you can a much better handle on your health when you need it. You don't have to wait to make an appointment to see a doctor, or wait until something is bad enough to have to go to an emergency room.

      "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

      by xaxnar on Sat May 18, 2013 at 12:35:47 PM PDT

      [ Parent ]

  •  Hand held devices are clearly going to play (2+ / 0-)
    Recommended by:
    whaddaya, xaxnar

    a larger role in healthcare going forward as more computing power is available in small packages. There are many challenges, including how do physicians get paid for telemedicine?

    "let's talk about that"

    by VClib on Sat May 18, 2013 at 01:02:17 PM PDT

  •  I want it to be as cheap as a glucose test kit (1+ / 0-)
    Recommended by:
    xaxnar

    (good ones are out there for <$30 now) and as reliable as my Motorola cell-phone (I have the flip phone RazrIII. Yes. It is that old. It works fine. It's metal, and fits in my pocket) and as indispensable as my Leatherman. If it costs $300, it'll be worth that to me, so long as it lasts a minimum of five years before its internal components degrade past usability; and the insurance company can go fly a kite.

     Walgreens has a thermometer available now that you touch to the temple, and a watch-size bp monitor. You can buy a breath tester there as well, to make sure you're not too drunk to drive. Why not combine those into one device, like, I dunno, Android's Pebble, maybe, that could be attached to your phone and use an app? You could carry ICE identification and phone numbers and it would be no more "ball and chain" than a medic-alert bracelet is.

    LBJ, Lady Bird, Van Cliburn, Ike, Ann Richards, Barbara Jordan, Molly Ivins, Sully Sullenburger, Drew Brees: Texas is NO Bush League!

    by BlackSheep1 on Sat May 18, 2013 at 03:04:47 PM PDT

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