The annual doctor visit

The following excerpts are from a Wall Street Journal piece titled: Tech Advances Put the Annual Doctor Visit on the Critical List. The gist of the article is the yearly check-up with your doctor is in for some big changes.

Mayo Clinic, in Rochester, Minn., has started sending laboratory kits to patients in advance of their physicals. Patients, especially those who live far away, can get blood drawn at a local clinic and send it back for standard lab and genetic analyses and discuss results with their doctors virtually. The future, says Carl Andersen, medical director of the clinic’s executive health program, is “bringing healthcare to patients where they are as opposed to asking them to come in.”

Mayo eventually expects to gather additional patient information remotely via smartphone and smartwatch apps, wearable sensors and blood pressure cuffs that enable monitoring of such health indicators as blood pressure, blood oxygen levels, physical activity, heart rate, heart rhythm, blood sugar and sleep quality. Doctors elsewhere have begun adopting this strategy; some experts believe it is poised to fundamentally change how the physical is done and could prompt patients to engage more proactively in their health.
“When people start using a smartphone to monitor their blood pressure, they become experts at managing it,” says Eric Topol, director of Scripps Research Translational Institute in La Jolla, Calif. Maybe “it’s only a problem on Monday morning when they go back to work.” That finding wouldn’t emerge in a once-a-year visit, but it opens options for a patient other than a prescription for blood pressure pills.

Digital stethoscopes are available that allow doctors to check heart and lung sounds remotely. Dr. Tison and his colleagues at UCSF have developed a technique using a smartphone camera and flashlight that can detect a biomarker of diabetes in patients without a blood draw. Mayo doctors have tested an algorithm that can reveal heart weakness from data obtained in an electrocardiogram long before symptoms of heart failure, heart rhythm irregularities or cardiovascular disease arise.

DNA is poised to become part of the routine physical too. As part of its blood analysis, Mayo will soon offer liquid biopsy tests, which look for evidence of cancer in DNA fragments that even early-stage tumors shed into the bloodstream. The test will search for many more tumor types beyond the screens performed for breast, lung, prostate and colorectal cancers as recommended in current health checkups.

UCSF’s Dr. Tison suggests a more dynamic approach to the physical lies ahead: Doctors will provide, say, monthly electronic reports to patients on metrics such as blood pressure, heart function, blood oxygen levels and weight, based on the data stream from digital devices. Unless an abnormal signal turns up, in-person exams—with the hands-on touch doctors and patients value—could be set for every two or three years.