AHIP 2017: Eric Topol runs through the cost-cutting technologies that fit in the palm of a patient's hand

wearable smartwatch
Mobile devices and wearables could bend the healthcare cost curve, but it will take time and data to convince doctors.
Eric Topol, M.D.

AUSTIN, Texas—Eric Topol, M.D., has performed a full-body scan of himself using a smartphone and a mobile ultrasound device. He imaged his carotid artery, his liver, his kidney … even his left foot.

He calls it a full-body selfie and predicts that more folks will use these types of devices at home—no referral, doctor’s appointment or costly trip to the emergency room required.

“This is the modern stethoscope,” he said.

Topol, director of the Scripps Translational Science Institute and a professor of genomics at The Scripps Research Institute, spoke at this year’s meeting of America’s Health Insurance Plans on Wednesday.

He ran the audience through some of the technologies that will change the way patients interact with the healthcare system and, in theory, bend the cost curve.

When Topol felt pain in his kidney, he suspected kidney stones. Sure enough, the mobile ultrasound device revealed that his kidney was enlarged. He asked the audience to consider how much money his insurer would have saved had it been normal. 

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But there is debate over cost-cutting claims. A recent study, for example, found that nearly nine in 10 telehealth visits were new users interacting with the healthcare system rather than substitutes for in-person encounters. The savings from the lower-cost interactions were outweighed by the new care costs.

Also, early adopters of such technology tend to be the “worried well,” who might find cause for alarm in every blip in a blood pressure graph. That could also add to utilization.

Besides, most doctors would balk at accepting the results of an ultrasound selfie without ordering further imaging tests. “The medical community always wants to have data” that a technology works as well as or better than traditional tests and treatments, Topol said. Even with data, they don’t always believe it.

“Resistance is high,” he said.

Even Topol, one of the biggest champions of digital health technologies, has cautioned against “gimmicky” tech. To work, innovations must be proven, validated and well-accepted, he has said.

“Before we embrace these tools, we've got to prove that they work. Not that they measure the blood pressure or glucose levels, but that they change outcomes and that they lower costs,” Topol told FierceHealthcare in a 2013 interview.

But there are arguments and studies on the other side, too. And technology is constantly evolving. Proven technologies that are now used for a small set of patients with a specific condition could be expanded to the general population as wellness devices, which could in turn help cut healthcare costs.

For example, Topol said during his general session talk, a glucose monitor designed to help people with diabetes monitor their blood sugar without finger pricks could be adopted by patients with weight problems (or those trying to avoid weight gain) to help them learn what it takes to achieve glucose homeostasis. They could see in real time which foods have a negative impact and which do a body good.

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There's also both hope and hype when it comes to machine learning, artificial intelligence and algorithms that can chew up massive amounts of data and spit out clinical analyses. The technology is only going to get better. 

But it will take employers and health insurers to push this kind of diagnostic and decision support technology, because physicians aren’t going to do it.

“In the medical community we’re control freaks,” Topol said. “But we have to let go.”