Cutting through the hype – will a “medical tricorder” really replace doctors?

The Scanadu Scout is the forerunner in the race to invent the “Medical Tricorder”, the handheld scanner from Star Trek that space-age doctors use to gather data on a patient.

This past May, Scanadu put the device up on Indiegogo, a crowdfunding website, asking for $100,000 for its development.  The Scanadu Scout is a small handheld device that will let anyone measure their own “medical-grade data”—heart rate, body temperature, oxygen saturation, respiratory rate, blood pressure, ECG, and “emotional stress”—in under 10 seconds by placing it against their forehead.  It will then send all this information to a smartphone for record keeping.

Support for the Scout is remarkably strong—it has raised over $1,200,000 to date—and the crowd has imagined bolder and bolder uses for the Scout.  The original description on Indiegogo pitched the Scout as a consumer product along the lines of Lark, Basis, and the Jawbone UP. In this original vision, the Scout would be a device for the “quantified self”—the idea being that by knowing more about your own vitals, you can make healthier decisions.  But subsequent news articles highlighted other uses, such as disease management.  Here, the device would send valuable data to your doctor, who would review the results and provide recommendations.  Some even herald it as a diagnostic device that would allow patients to diagnose themselves, thereby avoiding visits to the doctor.

Why was the Scout so successful at raising funds?

I don’t think it’s because the device is as medically promising as some claim.  On their own, vitals rarely suffice for making a medical diagnosis.  Their significance is vague.  It is possible to have abnormal values and be perfectly healthy.  It is also possible to be very sick and have completely normal vitals.  If you use the Scout to decide whether or not you seek medical attention, you might stay at home with a normal temperature when you are actually ill and should go see the doctor.  Put another way, we don’t know if a temperature of 37.9C means you have the common cold, lymphoma cancer or nothing at all—and you could be a healthier, less anxious person for never having known your temperature to begin with.

Instead, I think the Scout’s popularity comes from its promise to satisfy the desire we have to be informed about our own health—it was, after all, a disempowering lack of knowledge about his son’s traumatic brain injury that got Walter de Brouwer thinking about the Scout in the first place.  Putting medical-grade data in your hands sounds empowering.  It sounds like the data would give us a better understanding of disease, which could help us take better care of ourselves.

And there is some truth to this.  A pilot trial in the NICU of Toronto’s Mt.Sinai hospital showed how clinical outcomes and patient satisfaction improved through teaching parents to read vitals and observe their premature babies.  Another meta-analysis in the BMJ found that blood pressure dropped a little when home blood pressure monitors were used daily.  More broadly, the Internet has become a resource for patients to look up more information on their diseases and ask their doctors relevant questions, transforming the classic paternalistic physician-patient relationship.  And the Scout is the next logical step: giving patients access to some of a doctor’s tools.

But before we get caught up in the hype, it is important for us to remember that there is a large gap between a mass of undistilled medical data and how that data is interpreted and communicated by a good doctor. We can fantasize about future versions of the Scout capable of analyzing every aspect of our bodies, but if the device cannot interpret that data for patients reliably, reassuringly, and in a way that makes sense to them, we may not be contributing to better health. So hopefully when Scanadu does test a prototype amongst consumers, they will focus their research just as much on how the technology affects the relationship between doctors and patients as on the technology itself.

What excites me about the Scout isn’t that it will replace doctors – it can’t – but it could help patients work with their doctors to better understand and improve their health.