Thank you. Alright, we're going to start with an exercise. Raise your hand if you know how
many steps you took yesterday. Come on! Okay, so fair number. Raise your hand if you know
your average blood pressure over the last month. Okay, so, some people in the room - good.
Maybe a bit less. And raise your hand if you know how to read your own electrocardiogram
- EKG? Okay, so a few select maybe Stanford med alums in the room. We have unleashed the
most powerful tool in medicine to date. The digitally empowered patient. These patients
have over 30,000 mobile health apps and 115 wearable sensory devices at their finger tips.
But these are not all created equally. I see them on a spectrum. On the one hand, products
that require very little interpretation and on the other hand products that require some
more. So on this end you have your exercise tracking devices and mood diaries. These are
great tools and probably no one's going to die if they don't take enough steps in any
given day. Moving towards the middle, we have apps that start to offer some medical advice.
So prenatal tracking apps, apps that monitor and diagnose psychiatric conditions, and then
on this end you have more of your medical devices - so these are handheld electrocardiograms,
handheld ultrasound, at home blood tests that are starting to come on the market. Now the
food and drug administration has corralled all of these products into a regulatory grey
zone. So they call the medical devices but they're not subject to the same rigorous standards
that traditional medical device - such as a hip replacement or cardiac stint - would
be subject to. So companies don't have to spend hundreds of millions of dollars on clinical
trials proving that their product is safe. Well, what are some safety concerns with these?
Well, patient confidentiality - they can be hacked. Misinformation. And something I'm
actually an expert in: hypochondria. Or rather, cyberchondria. Why am I an expert in this?
Because I'm in medical school. So you start medical school - I started - cardiology block.
Learned about the human heart. I thought I had a heart murmur that would stay with me
forever and I had my friend check it out and it was fine. It was normal. In fact, we did
infectious disease: I thought I had picked up a parasite on my study abroad trip in undergrad
but I didn't have that. And on our neurology block I had stayed up too late one night - probably
had too much caffine, fingers started twitching a little bit - and I thought I had Lou Gehrig's
Disease. It's funny but in the moment it can actually be very scary. Now, I wasn't alone
by any stretch of the imagination. There's a name for this phenomenon: they call it "medical
student syndrome." And studies have shown that up to 80% of medical students suffer
from this and it's actually a normal perceptual process. So an increased area of focus on
a particular part of the body can start - the person can start to manifest disease that
is not actually real. On the first day of medical school, we all took the Hippocratic
oath which includes the adage first to "do no harm." Now, if you think about these products
and the FDA is not going to fully regulate them and there's a lot of valid arguments
that they shouldn't and the physicians who have vowed to protect patients are not necessarily
involved and there are potential problems that come out of them. Who is left to protect
the patients? Well, at the Graduate School of Business I have a lot of friends who are
aspiring health tech entrepreneurs and I tell them that they should probably take their
own version of the Hippocratic Oath because they are the ones creating these devices.
Well, that's not going to happen over night. So I think it's actually going to be up to
you guys: the consumers. In every good market, the consumers have the power to choose. So
I'm going to leave you with three things today: 1) Cyberchondria happens. It happens to the
best of us. You're probably fine. Most people are mostly healthy most of the time. 2) Choose
wisely. Choose products based on sound clinical research and if they do end up towards that
end of the spectrum that require medical interpretation, make sure that there's a feature built in
where you can get your questions answered. You should be able to press a button and talk
to a nurse practitioner or talk to a doctor. And finally, if all else fails, and you find
yourself in the middle of the night worrying about some malady because you bought some
gizmo that's telling you about some organ that you probably didn't know you had before
- don't hesitate to call your doctor! The perspective that comes from spending tens
of thousands of hours studying this information and taking care of patients cannot be programmed
into an app. Thank you.