Is healthcare becoming a consumer product?

Is your smartphone your new doctor?

Economist has a run-down of new age startups taking a stab at this. I’d like to quote here and then provide my inputs.

How health care is turning into a consumer product | The Economist

This includes devices to analyse everything from blood sugar to stool samples. Levels Health, a two-year-old American startup, sells app-synced continuous glucose monitors directly to consumers, after seamlessly connecting them via the internet with prescribing doctors. Its founder, Josh Clemente, was inspired by having to ask a friend to smuggle such a monitor for him from Australia to confirm his hunch that he was, like one-third of Americans, pre-diabetic—in America the devices were available only on prescription to people with uncontrolled diabetes. The startup’s waiting list now stretches to 145,000 people. Digbi Health, another American firm, uses fecal matter to analyse its customers’ gut microbiome to promote gastrointestinal health. Skin+Me, a British one, uses selfies to save people a trip to the dermatologist by providing prescription-grade skin care. Thriva, also from Britain, analyses blood from finger pricks to shed light on conditions such as high cholesterol and anaemia.

I have no idea about these companies (and I have a strong reason to believe this is a paid PR marketing stunt wrapped as an article). Nevertheless, the assertions are valid- and there are writings on the wall.

Telemedicine might lurk around the corner, waiting to disrupt the status-quo, but it is rife with issues. Least of them – hardware (smartphones) and connectivity. Both are unequal. While it is not universal, it represents the long tail of availability.

Running into regulation:

One strategy is to position yourself as selling “general wellness” products to evade rigorous scrutiny, and only consult medical professionals for advisory purposes or to convince potential investors that their products are backed with science. Thriva, for example, says its blood tests offer “insights” rather than official diagnoses.

I am worried about the influx of these wearables flooding doctors’ offices, because they don’t offer any specific insights. How do you explain to a “consumer” that sleep insights from the smart-watch is not quantifiable and have no correlation with the real-world scenario? Or that it is not backed by “studies”? For those vested interests (like the ones pushing modulation in practice), it might represent yet another opportunity to advocate “patient-liberty”. I have seen some “non-profits” jumping on this bandwagon, usually with a sob-story that would shame the old Nigerian princes too.

The regulators, for their part, are trying to move faster themselves. The newly minted FDA chief is a former adviser to Google Health, the tech giant’s health venture. The industry hopes that on his watch the agency will finally adopt long-delayed standards for digital-health software. Australia, Japan, Singapore and the EU have set out digital-health strategies in order to create similar standards for determining the quality, safety and clinical value of new health devices. More countries are adopting data-protection rules that ought to make it clearer to entrepreneurs, investors and consumers what data can be shared, with whom and how.

conflicts of interest anyone?

Digital health is the new gold rush. There is an overwhelming sentiment against the “industrialisation of medicine”. However, regulators (and consumers) should be aware of basic ideas- all of this represents data grab and your wallet without being specific. The traditional doctor-patient relationship (wrongly described as paternalistic) is your best bulwark against the circling “investors” promising “wellness”. Instead of following fads around “gut microbiome”. Regular exercising and shifting to healthier eating has a better impact than sticking instruments in your posterior to measure “faecal matter”.

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