Will e-diagnoses lead to improved health conditions?

Over the last 20 years, technology has flattened the world in many ways, increasing transparency and choice for consumers in multiple industries. Many of these changes have inspired governments and entrepreneurs to explore how health consumers, patients and caregivers can be empowered with tools to better manage their experience. Just like the travel, banking and retail industries have improved experience by moving more control into consumers’ hands, it is tempting to believe that providing technology diagnostic tools to patients can help with better management of their conditions. However, it is equally important to explore whether the various players in providing healthcare are ready for patients to manage eDiagnostic tools. 
 
In some ways, eDiagnostic tools have been around for a while. The use of digital machines to measure blood pressure and blood sugar levels is quite common, at least in urban middle class India. The last decade has seen a proliferation of companies that are designing wearables that help track  various health parameters. While the more mainstream of these wearables focus on fitness (the recent FitBit IPO is an example), there are many examples of other eDiagnostic tools being used, to diagnose mental health and monitor cardiac conditions, amongst other uses. The idea is compelling – if patients can use these tools to identify and diagnose their conditions themselves, the burden on our already busy doctors could be substantially reduced. There are three main challenges with these assumptions. 
 
Challenge 1:
The first is knowing how reliable these ediagnostics can be. It is one thing to design an eDiagnostic tool in a lab to provide accurate readings, another to ensure that the thousands (or millions) of the tools that are shipped provide the level of accuracy and reliability necessary to diagnose the conditions they are supposed to. Most labs find it difficult to have consistent results so to rely upon the home based eDiagnostic tools carries quite some risks. 

For eDiagnostic tools to be used in the mainstream by the mass market, regulatory bodies  will  play a very active role in ensuring these tools are approved and appropriately monitored for quality.
 
Challenge 2:
The second challenge is with how diseases are diagnosed and treatments planned currently. Hypertension is not diagnosed with a single blood pressure reading and diabetes is not diagnosed with a just high blood glucose reading. For most diseases, doctors are trained to evaluate several factors before arrving at a definite diagnosis. Patient driven tools runs the risk of over diagnosis, under diagnosis and missed diagnosis, because patients are not trained to review the findings in context of other factors. With many more patients self-diagnosing themselves (rightly or wrongly), the demand for doctors will go up even further. While increased demand for health services is good in general, it is exactly antithetical to the point of deploying such tools.

Challenge 3:
Finally, patient eDiagnosis runs the logical risk of self-medication, and could worsen outcomes for patients, especially in the case of inaccurate diagnoses. This is a big concern and must be considered before encouraging patients to use such tools. 
  
Possible Solutions:
So does this mean that eDiagnosis is not a useful tool. Not at all – like all tools, eDiagnosis is an opportunity that must be applied in the right context with the right reasons. Assuming the tools have been validated and pass regulatory scrutiny (this is a bar that cannot lowered), the biggest benefit from eDiagnostic tools is to use them under the supervision of doctors. They can be extremely useful in ongoing monitoring of chronic conditions to ensure patients are responding to treatment, making a provisional diagnosis (several tools for ediagnosing mental health are being tested) or in the hands of trained healthcare workers working in remote areas where access to facilities are limited.

 In all of the above examples, the use of eDiagnostic tools will help trained health professionals diagnose, monitor and manage health outcomes much better and in partnership with patients. That’s the main promise of eDiagnostic tools. When integrated with how doctors deliver care and as a tool in the right hands, patient driven eDiagnosis can be a powerful tool to make healthcare management easier for patients, caregivers and doctors. 

Dr. Aakash Ganju (@aakashganju) is the CEO of Mirai Health, a connected healthcare company that provides doctors with complete practice management solution