Much like the personal computer revolutionized and, in some respects, fundamentally altered our society, decentralized medicine and its democratization has the potential to do the same. Fasten your seat belts.
We are witnessing the transformation of patients to patient-customers to patient-clients to patient-consumers to prosumers to patient-self-providers. Do it yourself (DIY) medicine and behavioral health is becoming commonplace with the availability of online diagnostics and blood tests, more sophisticated consumer health products, digital health mobile medical apps, and community-based support and education groups. Crowd-funding platforms and digital clinical research tools have also turned patients into clinical research investigators and investors. What will be the impact of DIY medicine? While there will be many unpredictable results and unintended consequences, there are 5 major considerations:
1. Is DIY diagnosis and treatment better than the present model and does it achieve the goals of improving population health while lowering costs? Does it add value, and, if so, where? The saying goes that a little knowledge can be a dangerous thing. Will these technologies actually drive up the costs of care instead of lowering them? In most instances in medicine, unlike other industries, new technologies tend to supplement, not replace other technologies, thus adding to the cost and utilization.
2. How will the enormous amounts of self-generated data created by these self-initiatives be stored and accessed given the present EMR infrastructure and models? In previous posts, I've discussed the anatomy and physiology of digital health and its evolving embrology. Who or what will be responsible for doing something with the results? Will it be the responsibility of the patient to enter results in an open electronic medical record?
3. What new business models need to emerge to sustain any improvements in health that result?
4. What impact with DIY medicine have on the legal and regulatory environment of biomedical and health innovation and entrepreneurship?
5. What is the role of the doctor as they become increasingly disintermediated?
Putting the ability to diagnose and treat illness in the hands of patients will create profound change. Much like the personal computer revolutionized and, in some respects, fundamentally altered our society, decentralized medicine and its democratization has the potential to do the same. Fasten your seat belts.