Rethinking the Patient Journey, Part 1: Diagnostics

A patient’s medical journey begins with a diagnosis. According to a report by the National Institutes of Health “Getting the right diagnosis is a key aspect of health care—it provides an explanation of a patient’s health problem and informs subsequent health care decisions.”

Common diagnostic modalities include angiography, ultrasonography, conventional radiography, computed tomography (CT) scan, bone scan, and magnetic resonance imaging (MRI). All these modes call for large, complex and expensive systems that require the patient to spend countless hours in a medical facility. Furthermore, patients may have to wait days before a professional diagnostician has an opportunity to read and interpret the scan results. Despite the importance of diagnostics in the health care process, today’s methodologies yield significant problems. The NIH estimates that errors in medical diagnostics account for between 6 and 17 percent of adverse events in hospitals. That’s bad for the health care provider and potentially devastating for the patient.                

Change is afoot. Medical diagnostic technology is evolving and bringing the health care system along with it. Medical professionals want to shift the system from one focused on reactive treatments to one based on prevention and proactive diagnosis of diseases and disorders. This is compounded by the larger changes in the health care system as it shifts from a fee-for-service model to a managed-provider model more focused on the quality of care versus the quantity of care. Furthermore, patients themselves want to have more control of and insight into their own health management. Next-generation medical diagnostics is a key enabler for these transformations.

For diagnostics to play a more significant role in the health care process, it must first become much more continuous. Today, diagnostics occur much too infrequently. Think of it as trying to operate your car but the dashboard gauges only update once every 5 minutes. Not very practical. Continuous diagnostics is made possible by the same innovations that have given us smartphones and wearable devices. Indeed, these devices — along with new types of flexible sensors, energy harvesting hardware and artificial intelligence — are coalescing into the foundation that will make continuous medical diagnostics a reality. This trend will soon allow patients to monitor their health 24/7 with the same precision and detail as has historically been possible only with expensive, hospital-grade equipment.

Medical diagnostics must be convenient if they are to be continuous. Already smartphones are being incorporated into diagnostics. From apps that can replace a stethoscope or monitor the gait of Parkinson’s patients to add-on devices that continuously monitor blood glucose levels (CGM), technology is proving to be indispensable in revolutionizing medical diagnostics.

In addition to implantable sensors made of biocompatible materials, breakthroughs in manufacturing processes now allow for inexpensive — even disposable — sensors nearly as thin as a sticker that can affix to the skin of a patient for continuous monitoring of biosignals through electroencephalograms (EEGs), electrocardiograms (ECGs), pulse oximetry and galvanic skin response. Data from these sensors can be transmitted using very low power technologies such as near field communications (NFC) to a receiver that a patient can attach to their clothing or wear as a smartwatch. From there data can be relayed to a physician’s smartphone or even directly to the cloud using more powerful wireless technologies such as Bluetooth or WiFi.

Algorithms in the application will analyze the in vitro diagnostics (diagnostics that analyze samples taken from the human body such as saliva or sweat) and take immediate action should it be necessary. For example, CGM technology married with artificial intelligence provides a continuum of care that monitors a patient’s blood sugar, diagnoses when levels are high and applies a therapy by sending a command to the insulin pump to deliver the insulin — all without doctor or patient intervention.

Another shortcoming of today’s diagnostics methodology is that it mostly focuses on measuring and analyzing biosignals and biomarkers without any regard to the genetic, lifestyle and environmental factors that can vary significantly from to person to person. Biomarkers are the chemical signatures found inside a person’s body that reflects the health of the individual and potential existence of a disease. And while analysis of these markers is important, without appropriate context it is difficult to improve the quality of medical diagnostics. The good news is that the same hardware that measures biosignals and biomarkers can be applied to measuring lifestyle attributes such as how sedentary a patient is or environmental factors such as air quality. Fusing this data goes a long way in improving the accuracy of the diagnosis that has until now been nearly impossible to accomplish in a continuous manner.

The last piece of the diagnostic puzzle is adding genetic data to the patient’s overall health snapshot. So-called precision medicine recognizes that diseases can manifest in physical symptoms that differ from patient to patient. Understanding disease in the context of a patient’s genetic background allows physicians to compare the patient against aggregate data sets to reveal how symptoms of diseases appear in genetically similar people. Achieving this level of diagnostic resolution is no small feat, as the processing power required to do so at scale is not insignificant. Advancements in artificial intelligence algorithms and specialized hardware to run those algorithms are crucial to augmenting doctors’ and diagnosticians’ efforts to reduce the time between diagnostic scans and reporting results.

Biomedical technology companies are at the forefront of the charge to reshape health care. Molex has the expertise to help clients that are committed to delivering the next generation of medical diagnostic technology. From our knowledge of the science of biocompatible materials to our capabilities to manufacture high-quality flexible printed circuits, along with our expansive expertise derived by working with various but parallel industries, Molex is poised to partner with those ready to rethink medical diagnostics.