The 7 Must-Haves For The Doctor Of the 21st Century

For ages, physicians have been relying on traditional methods when it comes to consulting patients and following a rote template akin to the following: patients see the doctor who auscultates them with manual techniques, without forgetting the stethoscope, and will prescribe them some medication or lifestyle change. In specific cases, they will recommend a more detailed diagnostic method like the ultrasound, X-ray or even referring to a specialist.

However, we’re now in the third decade of the 21st century, and the disruption brought about by digital health has radically changed the way one can consult patients for years already. The doctor of the 21st century can literally carry a department’s worth of diagnostic tools in his briefcase, and yes, even the doctor’s iconic stethoscope is outdated.

So what are those must-have devices for the doctor of the 21st century? And why don't we see all of those high-tech doctors out and about, trying to put Doctor Who to shame? Also, are these replacements for the traditional healthcare system? Join us as we explore these questions and more in our latest article.

1. The stethoscope goes digital (and marries the ECG)

If we could take the TARDIS and go back in time to the 19th century, when a French physician going by the name of Dr Laënnec invented the stethoscope, we would be met by a familiar resistance to adopting new technology. Fellow physicians thought that it would be a burden to distance themselves from the patient, trusting their ears over some piece of technology. Three decades had to elapse before the stethoscope would be widely accepted for its usefulness and ultimately become today’s universal symbol of being a physician. However, we should say that even the traditional stethoscope has become outdated with the digital overhaul that it received.

FDA-approved, CE-cleared and compatible with HIPAA-compliant apps, the Eko Core is one of the prime examples of the evolution of the stethoscope. Its latest flagship product, the 3M Littman Core can amplify heart sounds 40 times in digital mode, has active noise cancellation, works with seven amplification levels and comes with automated murmur detection. It even allows the user to fine-tune readings with settings like which organ they’re focusing on (heart, lung or other) and the position of the patient (sitting or standing). Through its app, users can even save and share what they hear, and yes, there’s even a live streaming function for telemedical purposes.

We also got our hands on the Eko Duo ECG+Stethoscope. Both devices (the Littman Core and the Eko Duo) were recently tested by The Medical Futurist, you can check the video on our YouTube channel.

The Duo is a combined digital stethoscope and wireless ECG device with automated murmurs & AFib detection, 32x sound amplification that connects to your Bluetooth device, and is FDA-cleared and HIPAA-compliant.

You can use the Duo to amplify heart, lung and bowel sounds, it automatically checks for heart murmurs and AFib in the background using Eko software without interrupting the examination, identifies tachycardia and bradycardia, and saves unlimited recordings. Fascinating, isn't it?

2. ECG device that fits in your wallet

If one asks you to picture an electrocardiogram (ECG) device, you’ll probably be thinking of a huge machine with tangled wires that are hooked to a monitor to give readings of one’s heart activity. Well, with the advent of digital health, this machine has been sized down to literally fit in your wallet.

KardiaMobile gadgets had quite an evolution, you can see how the generations followed in this picture we recently posted.

The latest, called KardiaMobile Card is a single-lead, FDA-cleared medical-grade pocket ECG that has the dimensions of a credit card. And we are not speaking figuratively here. The Card detects six types of arrhythmias, AFib, Bradycardia, Tachycardia, PVCs, Sinus Rhythm with SVE, and Sinus Rhythm with Wide QRS, and connects to your phone/tablet (above iOS  10.3.3, Android OS 6.0, and checks the list of compatible devices here) via Bluetooth. It comes with a 'membership', which gives you enhanced ECG analysis and further information about your heart health.

We recently tested the Card, the video will be out in a few days, keep an eye on our YouTube channel, if you are interested.

Meanwhile, here is the previous, but still impressive Kardia gadget we tested, the 6L, which is a 6-lead, FDA-cleared, medical-grade pocket ECG device that measures one’s heart with the ability to detect conditions like atrial fibrillation (AFib) and abnormally high/low heart rates (tachycardia/bradycardia). It beams the readings to your smartphone and the results can thereafter be stored and/or shared.

3. Blood pressure readings in 30 seconds

Another centuries-old medical device getting digital treatment is the blood pressure monitor. Invented in 1881, the 21st-century version is quite different, as the line of FDA-cleared iHealth blood pressure monitors will tell. For example, the light and portable iHealth Clear will measure the systolic, diastolic and heart rate in merely 30 seconds! It also connects to a smartphone to store results in a digital logbook and is able to compare readings to previous measurements to help make better decisions on prevention and treatment.

Manufacturers are constantly working on coming out with easier, more comfortable solutions for monitoring blood pressure, like this Omron smartwatch we tested. At the moment I feel like the goal is great, the work is necessary, but we haven't quite got there yet. In all honesty, the watch was a bit lacking.

4. Ultra-portable ultrasound

Yes, we live in a world where even portable versions of advanced diagnostic devices like the ultrasound exist. Earlier we tested the Philips Lumify and the Clarius Portable Ultrasound, two such devices that break ultrasound-based diagnosis out of the confines of the hospital so that you can literally have access to it wherever you are. These pair with a smart device to give real-time, high-resolution ultrasound images, similar to what you would expect out of traditional ultrasound.

The latest one in our possession was the Kosmos by EchoNous, so far the only portable ultrasound benchmarked against cart-based machines I could try. The AI-backed, portable device still impresses me.

This is the promise of digital health: bringing state-of-the-art medical care wherever it’s needed, rather than going to a state-of-the-art facility when one is in need.

5. Ear tech in your pocket

Ear examination can be uncomfortable for the patient and challenging for physicians in case of small or partially obstructed ear canals. But there is an app for that! Ok, not just an app, but a device and an app. The Cellscope otoscope converts a user's iPhone into a smart video otoscope, and with the app, it records & stores videos and images of the ear canal and eardrum while simultaneously syncing it to the web app for easy review.

The pocketable WiscMed otoscope aims to overcome these issues with its built-in nano camera which gives clear images of the eardrum. These can be further examined comfortably on a computer monitor, without troubling the patient, in the form of images and videos.

6. High tech eye tech

Based on an exclusively licensed MIT patent, EyeQue produces devices that democratise eye-testing tech. The Personal Vision Tracker measures an individual’s refractive status, including near-or-farsightedness and astigmatism, while the EyeQue Insight determines visual acuity. Light, affordable and accurate, they enable eye testing to be done remotely and bring it where it’s needed, once again delivering the promise of digital health.

7. The all-in-one package?

Star Trek made every physician drool over the tricorder, a device to analyze a plethora of patient parameters in minutes from a single device. The Viatom CheckMe Pro is as close as we get. This FDA-approved portable device measures ECG, blood oxygen level, body temperature, blood pressure, heart rate, step count and many other health parameters. There are other companies flirting with a similar idea like the BioSticker from BioIntelliSense and the MedWand demonstrated at this year’s CES, and we can’t wait to see them in action!

Resistance to change… but resistance is futile, or is it?

Even though those technologies are readily available, reports showed that around slightly less than half of physicians were likely to adopt select new technologies like telemedicine and artificial intelligence in the future, according to these 2019 figures. We are eagerly waiting for new statistics, as our guess is that the pandemic must have had an impact. So why is it that these devices aren’t more widely adopted?

Firstly, it’s simply because many aren’t aware of the existence of such devices. Doctors are often busy with their daily routine and keeping up with the latest research about what technologies like CRISPR can offer but don’t keep in touch with the technologies available right away. Some might even think that those devices aren’t for sale or are expensive. But in fact, they have been approved by regulatory bodies, are readily available on the market, and aren’t as expensive as their traditional counterparts.

For instance, the EyeQue Personal Vision Tracker costs $35, less than a designer frame! The Littmann Master Cardiology stethoscope costs around $225 while the Eko Core Digital Stethoscope is priced at $300. These aren’t promotional adverts but mere comparisons, and we’ll expect the price to go even lower as technology progresses.

Additionally, there still is a reluctance to adopt new technologies to perform the art of medicine, similar to what Dr Laënnec faced. Many think that these devices will put an end to this aforementioned art, when in fact, they are present to help doctors build better relationships with their patients by getting faster results with more data. Such devices need adopters to make digital health a global reality and it would be better sooner than later.

This is not a hospital-in-a-bag

As tantalising as the idea of this heading is, those devices are far from replacing hospitals altogether. The latter will still be needed so that we can get more in-depth tests like MRI scans, lab analysis, surgeries and focused attention for critical cases. And in fact, these portable diagnostic devices can help alleviate the burden on healthcare centers, allowing these institutions to focus on providing critical care when needed. Let’s see how.

The WHO forecasts that the world will be short of 12.9 million healthcare workers by 2035. With these devices, even non-physician healthcare professionals can perform basic examinations wherever they are, and send the data to physicians for detailed analysis when needed. Remote and underdeveloped regions are prime areas where digital health can show its potential.

You might also have noted that these devices not only take off the burden of the healthcare system, but they also empower patients. As such technologies become more affordable and adopted by the public, the point-of-care will shift in their direction. They will be able to better monitor their health parameters, share it with their physicians over the cloud and take subsequent actions should abnormalities be detected. These initial screenings will be done in the comfort of patients’ homes and only when suspicious signs are present will they have to be displaced to hospitals for more in-depth attention.

Digital health is bringing about a real revolution, democratising diagnosis, communication, health education and shifting the point-of-care to where it should have been all this time: the patient. Policymakers should also provide incentives for healthcare facilities and physicians to merge such devices with the normal healthcare practice, as well as raise awareness among patients about the benefits of these technologies, and incentivise them to bring their own devices and share their data during doctor-patient meetings.

It’s all possible in the 21st century and as we progress through this new decade, we are bound to see global instances of technologies disrupting the healthcare landscape for the better.