Healthcare will be unrecognizable in the next 25 years, leaps and bounds are being made in technology, genetics, and biometrics. You will trust the artificial intelligence (AI) recommendations from your wearable far more than any human medical doctor, yes even far more than you even currently trust your Dr. Google search. This will be due to all the biometric data AI will have access to from the various health related sensors you will be wearing. The specific to you information is critical. I regularly have to remind my athleties that they represent less than 1% of the general population and general recommendations for health, nutrition and sleep do not apply to them appropriately. You must remember family doctors are trained to work with the majority of the general population not the entire population. The same recommendations for a sedentary stay at home mom and a university calibre athlete do not apply. Let’s use the cholesterol blood marker as an example. Safe cholesterol levels in a physically active population with high quality nutrition differ significantly for what is healthy for a more sedentary individual. Making the same recommendations for both could spell disaster for athletic performance in the athlete. As a side note... zero recommendations should be made on an overall cholesterol number from common blood work. These recommendations that are still commonly made are archaic and not based on our current level of understanding in the research on how cholesterol impacts our health, but I could write a whole other blog on this topic alone.
Most recommendations cover what we call two standard deviations. This technique covers 95% of the population however people that live more extreme lifestyles, such as athletes, are not covered by this approach. The individuals that fall into the other 5% fall outside of what we call statistical significance. Biometric sensors will make this entire lack of specific recommendations discussion irrelevant because for the first time individuals will receive specific recommendations based on their individual physiology as recorded by these sensors 24 hours a day. The biometric sensors will be able to constantly track many different health data points and big data algorithms will be able to interpret these findings. The many different health factors that make you entirely individual from anyone else will be the basis for these recommendations.
The three major pillars of health are nutrition, physical activity, and sleep. Generally your Dr. only has self reported data on these three areas. Very few things are less reliable than self-reported data. As the famous Dr. House constantly states on his popular show of the same name, “people lie”. All three of these pillars of health can be very accurately recorded with biometric sensors. We are just beginning to scratch the surface of the possibilities here with devices such as Apple Watch, fit bit bracelet, Garmin watches and phone apps. 5 years ago no one had any idea how many steps they took in a day, change comes fast. Within the next 25 years every major system will be trackable by biometric sensors and AI specific individualized recommendations will be made based on all the data recorded by these sensors. The most current Apple Watch 4, is already capable of taking an FDA approved ECG, or electrocardiogram. The ECG is the test most cardiologists use as the main piece of data for their blood work assisted diagnosis and heart health treatment recommendations. The typical cost for this test is about $150. The most current Apple Watch is also capable of correlating your ECG with findings of complex measures like an irregular heart rate, resting heart rate, and heart rate variability. Currently human doctor testing values for these measures could take weeks to get back to your family doctor and cardiologist only after wearing a prescribed home unit for a given amount of time. Obtaining these extra measures drives the healthcare costs into the thousands of dollars. Charging thousands of dollars to obtain these test results which can be obtained by a $500 watch 24 hours a day is unjustifiable. Very soon this will be cost ineffective and absolutely obsolete.
The ability of an AI doctor algorithm to collect and analyze these patient specific health data points from the biometric sensors and give early warnings, daily recommendations and diagnoses are almost here. Keep in mind this process will not have to be perfect, just be better than the brief interaction you get with your human doctor. Unfortunately human error and the abilities of the human brain are fallible and will pale in comparison to the abilities of big data algorithms to interpret data and make recommendations. I often tell my athletes and patients who all too often ask me to diagnose their condition over the phone, or even by text, that my or any other doctor’s recommendations are only as good as the information they have. This information usually means I need to do a bunch of clinical and physical tests. The AI doctor will be doing these tests 24 hours a day 7 days a week so the AI doctor recommendations will be based on vast amounts of information.
Our ability to understand and adapt to this as a culture is very poor unfortunately. Not a single politician or medical board is addressing this. Although insurance companies have already begun to see where the future of health care is headed. There is big insurance money involved in the future of health care. A prime example of this is the fact Apple cardiogram app users receive free, yes FREE, life insurance coverage of $1000 from multiple insurance companies. Of course, this is in an attempt to get and track your health data. Moving forward nothing is more valuable than data on this planet. The data recorded will also give financial rewards to those that take their health and AI recommendations seriously. I understand this sounds like an invasion of privacy to some extent but this is where the future is headed and this high level of data collection is going to be how we are able to eclipse the 100 year life expectancy as a human species.
Algorithms and AI doctors are ALL updated with new research by the push of a button. Human doctors on the other hand often continue to treat their patients based on the quickly outdated education they received in medical school. Human doctor recommendations, by the time they reach the patient, are often decades old and this practice should and will seem archaic an obsolete very soon. Not only will this health data from biometric sensors find its way to your health insurer, It will find its way to your government issued health coverage. If you fail to follow the AI Dr. recommendations it will impact not only your health but also your wallet, in the form of premium rate increases and increases in personal government taxation. There will be no avoiding this. Given all this health data imagine the ability to detect just a few cancer cells in the upper lobe of a single lung. The AI doctor recommendation to stop the progression of this cancer might recommend you stop smoking. Should the looming increase in your personal healthcare costs be covered if you should ignore the data and choose to keep smoking anyway? I am certain the other financial contributors in your health care plan who follow the highly specific AI doctor recommendations would agree your lack of adherence to the recommendations should cost you and not them. If this sounds like Orwellian science fiction from the famous novel 1984, think again, this is occurring right before our eyes or more specifically right on our wrists. This will give a whole new meaning to wrist watch.
In my practice, I have seen hundreds of patients lives and health drastically changed simply by increasing their physical activity through monitoring step count. I have seen patients drastically change their diet based on simply recording food intake into a dietary phone app or journal and I have seen athletes streamline their training and recovery by monitoring their heart rate variability to produce new personal bests in performance. The breadth and scope of these kinds of measures will exponentially increase over the decades to come, and the number of happy healthy years available to us will also significantly increase. If your financial situation allows you to buy these kind of biometric devices (Apple watch 4 is currently the best) do your health a favour and be ahead of the curve. There are no better investments than those in your own health. As I often preach... What we measure we manage, it’s hard to know how to compete if there is no score board.
As always the goal of these BLogs are to arm you with the tools to be happier and healthier than yesterday,
Have a HIGH PERFORMANCE day!
Dr. Brad Murray