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Participating more in your health examinations?
Nov 24, 2021

Will home-based diagnostic tests remove barriers to care?

Your ankle has been hurting for a while, and today it hurts a lot. Not knowing why you are in pain is making you anxious. If you could x-ray it in your living room, and send it to someone to look at, would you? What if instead, you had chest pains or heart palpitations? If you could send a recording of your heart sounds to a doctor, would you?

Most people who feel unwell want answers right away. They want to be examined when they are symptomatic, but it is rare to get an appointment with a medical professional instantly. If there are follow up tests or consultations with specialists, it feels like it will take weeks or even months before  anyone is ready to start solving your problem. For most of us, it seems that health care doesn’t move forward until you are examined, and your diagnostic health information is actually recorded.  These tests initiate the process of evidence collection around which clinicians can rally and move towards a diagnosis to treat your ailment.  Many times, however, you feel like you are going in circles until the right clinician listens to your chest or looks at your x-ray or sees your symptoms firsthand.

Now consider if the nearest medical clinic that can provide you with diagnostic and ambulatory testing services is three hours away and understaffed. What if you must take time off work or have other responsibilities? Effectively coordinating the doctor, clinician, patient and testing equipment in the right place, at the right time now gets a lot harder.   This burden ultimately rests with the patient or a concerned family member, yet there are few if any options other than waiting for appointments just to get the ball rolling. Troublingly, 53 million people in North America live in areas that are considered medically underserved; globally the number is in the billions.  Not surprisingly, these populations are at higher risk of complications due to undiagnosed conditions like CVD, heart failure and COPD. According to the Institute of Health Metrics and Evaluation in Washington DC, these conditions are the root cause of most deaths in both rich and poor nations.

Over the past 18 months, medical visits in the USA that were initiated using a telehealth or telemedicine platform to connect patients with healthcare professionals have increased 38 times more than before the pandemic.[1] And approximately 40% of surveyed consumers stated that they will continue to use telehealth to access healthcare services. In Canada, a 2020 report on consumer attitudes for telemedicine indicated that nearly 70% of surveyed consumers believed that virtual healthcare would allow people to be more proactive about their health and the health of their family members.[2] These and other reports suggest that remote and virtual access to healthcare services will soon become a normal and possibly preferred way to access care. This trend begs the question as to whether virtual healthcare consultations can be made more meaningful (and even rewarding for the patient) by also incorporating some of the diagnostic testing you would normally need to travel to a clinic for.    

Rina Carlini is President and CEO of Optimal Innovation Group. Her company consults with medical technology innovators who are developing digital and mobile health solutions and delivering better access to healthcare services. She sees things changing in a big way:

Rina, do you think there is room for a more democratized approach to healthcare – one where the patient can contribute to the process by providing diagnostic data they gatherd at home?

“Yes, I think the process has always been inefficient, requiring people to wait a long time for care – hours, days, even several weeks for specialist care. For those who live in rural or remote communities, the inconvenience and inefficiencies become a more significant barrier. Giving patients the ability to initiate more of their own care from home (rather than the waiting room) is long overdue.  Thankfully, we now have the technology solutions that offer virtual, mobile access to healthcare services for people wherever they are.  To realize the full potential here, we also need proactive and equitable healthcare policies, funding and educational support. The payoff is a true democratic access to healthcare for everyone.    

Do you have first-hand experience you can share ?

“Yes, as do many people. My mother had complained of occasional heart palpitations and feeling lightheaded since her mid-40s. Now that she’s elderly and living alone, the frequency of these incidences has increased. She’s undergone testing at clinics and hospital centers using the typical diagnostic tests – ECG, BP, etc. – but none had ever revealed a conclusive sign of an underlying condition. These palpitations were short-lived when they happened in her home, and by the time she got medical attention in a clinic (typically 1-3 days later), they had often passed. The physicians thought it was “in her mind” and suggested that she see a psychiatrist; for her, this was both disheartening and patronizing. If only she had the tools and ability to record her sensation of heart palpitations right when they happened. Recently she was hospitalized, and the internist physician finally determined she was living with mild arrhythmia and was prone to atrial fibrillations. The diagnosis set her on the right course of care with medication to regulate her heart rhythms. She would have been spared years of stress and anxiety if we could have gotten here sooner.  

Today we have available a wide range of clinically-validated digital health tools and mobile apps that can empower patients to perform diagnostic health tests. My mother and many other people across the world should be able to access these apps. This is a way to empower people through recorded evidence of their ailment. The test data could be shared by the patient to their healthcare provider and circle of care.  That is digital health equity, and it makes democratized access to healthcare possible.”    

What if the patient, or their caregiver, had the option to initiate simple tests like recording heart and lung sounds, or an ECG, instead of having to wait for a primary care physician or nurse-practitioner to do it in a clinic? Could simple home-based diagnostic tests qualify as an auditable record of the patient’s medical evidence that will lead to a faster diagnosis? What if all this could be done without the need or cost of special equipment, using just a normal smart phone or tablet?

At Sparrow, we think this type of democratized access to clinical-quality virtual healthcare is both inevitable and necessary. There are 3.3 billion smartphones in the world.  What if there was a specialized app that transformed these into “smart stethoscopes” –  augmenting virtual care examinations for patients anywhere, anytime.  Technology solutions like this can be a true liberator for many people, including physicians and clinicians who want to deliver the best evidence-based care for their patients without the traditional barriers. It’s not about replacing gold-standard tests or diagnostic skills with new technology; it’s about offering millions of people a faster and easier way to get the ball rolling when it really matters.

By Mark Attila Opausky

[1] McKinsey Report: “Telehealth: A quarter-trillion-dollar post-COVID-19 reality?”;  O. BestsennyyG. GilbertA. Harris, and J. Rost, July 9, 2021.

[2] Environics, 2020; “Canadian Attitudes on Healthcare and Telemedicine.”

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