New House Call Protocol: Intel’s New Online Medical Management of Chronic Diseases

November 10th, 2008 · No Comments

We have come a long way since the 1950’s. I remember when I was eight years old in Yonkers, New York; my mom would call Dr. Ahouse when I was sick. This tall elderly, soft-spoken man with a black bag would come into my room and sit down on my bed. He had with him a stethoscope, otoscope, tongue depressors, flashlight, a variety of medicines, band-aids of different sizes, syringes with needles and a lollypop. Of course, the last item was the most important but I had to earn it by cooperating; so I would stick out my tongue as far as it would reach and loudly say, “A-a-a-a-a-h.” The penicillin injection wasn’t great, but the doctor was good at distracting me with a funny story. The basic accoutrements haven’t really change since then, except that Dr. Ahouse brought something that doesn’t exist anymore; the personal touch with deep caring and concern for his patients as whole persons. He knew everyone in the family and after the treatment he would spend a few minutes at the kitchen table over a cup of coffee, asking my parents how their lives were going; all for only four dollars and if you didn’t have the money he could wait until pay day.

Today, medical science has evolved so that we don’t have doctors-patient relationships anymore; we have provider-consumer associations. Physicians for the large part don’t look at us as people anymore, they only see a bag of organs and systems and they work at fixing the symptoms, with the underlying causes remaining elusive, not understanding the dynamics of environment, emotional responses and socioeconomic conditions playing a major role in disease progression and healing. Thus, the medical process has focused itself mostly on vital signs, blood test results, x-ray pictures, complaints of symptoms and history of illness. Never mind about stress from concerns over a wayward child, divorce, job loss and the like; if you can’t fix it with drugs and/or surgery, it stays somewhere in the background, while the provider gives his consumer a prescription for Prozac or some other expensive mind altering chemical, depending on which company paid for his last cruise.

Hence, now that Intel has announced its FDA approval for two-way laptop online communication for in-home medical management of chronic diseases, I’m not impressed. According to Cnet News, The new Intel Health Guide collects vital signs, blood sugar levels and other data and allows for remote interactions between consumer and provider. The doctor can see the information on his/her computer screen and have a video conference conversation with the customer. Undoubtedly, this is all very exiting for the health plan HMO’s who hope to reduce the number of office visits on a large scale. However, this new system, while it can conceivably be of great benefit for people who are on hi-tech maintenance with intravenous infusions or life support equipment, will create a greater divide between the provider and consumer. Furthermore, it will only present a small part of the clinical picture because without the physical assessment, the provider will miss being able to detect early trouble signs while the consumer is still feeling okay.

In conclusion, we cannot afford to listen to the manufacturers in terms of the extent to which we apply any new technology. Obviously, the corporate maker of any product is concerned only with maximizing sales. The provider-consumer association needs to revert to its origin as a doctor-patient relationship. You cannot replace the personal touch with machines. It doesn’t work and will lead to more misdiagnoses and a false sense of security in someone who is headed for a life-threatening crisis. The Intel people themselves recognize the shortcomings and dangers of their new system with their disclaimers shifting all the blame on the patient if something goes wrong and the person stays home instead of urgently seeking medical care.

Other sources:

The Wall Street Journal

EE Times