In this fourth of an eight article series on the United States Healthcare System, we will review the technological acceleration of diagnostic solutions.
Comprehensive Physicals and Executive Health Programs
Concierge Medicine clinics like MDVIP and executive health programs from premier health systems like Cleveland Clinic, Mayo Clinic, and John Hopkins are leveraging cutting-edge diagnostic solutions to conduct comprehensive physicals. These physicals extend beyond typical testing and can include EKGs, stress tests, CTs, and MRIs. By defining baseline physiology for assessment over time and identifying emerging clinical issues, clinicians can diagnose illnesses prior to individuals noticing symptoms.
Human Longevity Inc. takes comprehensive physicals further by testing your microbiome and providing complete genomic testing. Tracking your complete genome, combined with the expanding knowledge of the genome’s link to severe and chronic ailments, will better guide proactive and preventive efforts. Medical treatments would therefore become increasingly tailored to the individual, which is the definition of precision medicine.
One application of the genetic testing of microbiomes could be analyzing the composition of bacteria in our gut to understand what organisms are in our digestive tract, what organisms might be missing, and what organisms shouldn’t be there. The understanding of the microbiome’s impact on our health, immune system, and nutrition will enable fine-tuning of our gut bacteria to improve health and wellbeing. Imagine swapping bacteria to better control your body fat percentage!
Exponential Improvement in Genomic Testing
Illumina, a leader in genome sequencing, has recently launched its latest generation of genomic sequencing solution, NovaSeq, which will slash the cost of a complete genomic sequencing to the $100 level. Illumina has also launched new companies to leverage their genomic sequencing technology in specific applications. GRAIL is developing cancer tests that use blood samples to determine the presence of DNA segments shed by cancers that are active in the body. Helix, which may have the largest reach of all of Illumina’s spinoff companies, is establishing a platform for companies to develop solutions to leverage the information coming from genomic sequencing – much like a genetic testing App Store.
The cost of sequencing a genome has raced from over ten million dollars to one thousand dollars in less than ten years. At $100/genome, another order of magnitude in cost will be removed. Combining the expanding uses of genetic testing with the exponential reduction of genetic testing costs creates tremendous leverage to increase diagnostic accuracy and lower costs.
Smaller, Cheaper, Faster!
Aviana Molecular Technologies and other companies are developing lab quality testing solutions that detect biomarkers and infectious agents in minutes at the point of care. Using a variety of techniques, these new devices identify biomarkers around concussions, cardiac events, and an ever-increasing list of traumatic events and conditions. Other devices, including ThermoFisher Scientific’s PCR OpenArray platform, provide the ability to detect infectious agents like viruses and bacteria. Although these systems still need to pass FDA clinical trials, they portend the capabilities that will be available in urgent care clinics, physician offices, and even pharmacies. They will reduce the equipment size, cost, and time to complete a diagnosis, without reducing the accuracy.
Pharmacy or Grocery Store as a Lab
Pharmacies are expanding their popular in-home tests, like pregnancy tests, to include Strep, HIV, A1C, urinary tract infections, and more. Current trends depict pharmacies transitioning to include clinics for minor issues. Most grocery stores have pharmacies, and Walmart, Kroger and others are also adding medical clinics. It’s no stretch to imagine that your pharmacy or grocery store will expand to provide more medical lab services as many tests move from the lab to modest sized equipment.
In-home Biometric devices
Many diagnostic solutions will be available in families’ homes, especially the homes of those with chronic conditions. In addition to your Bluetooth connected scale and blood pressure cuff, you can have a basic ECG/EKG from an in-home device, like Kardia Mobile, that measures electrical activity through your fingertips and displays the readings on your smartphone. Philips’ Lumify device provides a portable sonogram that displays on your smartphone or tablet. These are all devices that are currently available and integrated with your smartphone.
Evolution of Portable/Mobile Diagnostic Solutions
The ultimate in medical devices are still a part of science fiction, but maybe even those devices are closer to reality than previously imagined. Qualcomm has been working with the XPRIZE organization to push technologists and entrepreneurs to develop a realistic version of Star Trek’s tricorder, which detected most health issues using a non-invasive hand-held device. The goal of the Tricorder XPRIZE, is to “develop a Tricorder device that will accurately diagnose 13 health conditions (12 diseases and the absence of conditions) and capture five real-time health vital signs, independent of a health care worker or facility, and in a way that provides a compelling consumer experience.” This year, Final Frontiers Medical Devices and Dynamic Biomarkers Group both won the Tricorder XPRIZE by exceeding these defined requirements.
The accelerations in breadth, accuracy, accessibility, and affordability of diagnosis solutions is astonishing and will drive vast improvements in the precision and personalization of medicine. The quicker and more accurate the diagnosis, the more effective the treatment can be.
Wearables as Clinical Devices
The next article, Wearables as Clinical Devices, will explore the advancements in devices that move with us and measure our physiology in real-time. Our healthcare insight will grow as we move from the fitness wearables of today to embeddable, injectable, and digestible sensors of tomorrow. You can find all the published articles at Articles and Essays.
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by Matt Larsen, Principal, Healthscient
Published on Healthscient.com: Aug 29, 2017