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Future Care: Sensors, Artificial Intelligence, and the Reinvention of Medicine by Jag Singh takes a look at the current status of sensors and electronic medical records and shows us the future of health care where the focus is on staying healthy rather than treating disease. There are some barriers to a future that features continuous monitoring and treatment of our entire body by unobtrusive wearables and Jag lets us know what they are. If you have a body that you want to keep healthy, this book is for you.

You can start with his interview by his son on Good Morning America. The future of medicine and health care in a post-pandemic world

Introduction

• Jag tells of his experience being hospitalized with a serious case of COVID-19. Here he saw first hand the trend toward more virtual care even in the hospital and more so once he was sent home. The future of health care is virtual. It was already on the way, but the pandemic jump started the trend. There is more focus on wellness and prevention as well with a shift in hospital care to the home.
• Compared to other developed countries, healthcare in the US features lower quality and less cost-effective care. Cost for drugs, devices, and procedures are mush higher and people are less satisfied. At $4 trillion a year, health care accounts for one fifth the US GDP. The conversation is around data, wearables, sensors, and AI. As the number of older people grows we are looking at a tsunami of sicker and older patients.

Part I: Sensors

1. Making Sense of Sensors

• Our body has sensors for every sense and virtually every cell. We also have many digital sensors that can be worn or implanted. The goal is to use such sensors to self-monitor and self-correct our bodies from disease states and to avoid invasive procedures provided by surgeons. As sensors advance, they can provide continuous information and take action as needed. This is important as necessary medical interventions do not line up with trips to the doctor.

2. Doc-In-The-Box

• Modern smartphones have joined a host of wearable sensors that continuously gather data and transmit it for analysis and informing the owner. They already make for excellent heart monitors. The competition in this market is pushing innovation at a rapid pace.
• While implants are part of this market, the developmental emphasis is on non-invasive devices. These devices don’t lie, unlike patients, and are far superior to patient memory. Other key issues are the integration of these devices into the larger health care picture and the affordability that can take them beyond the well off early adopters.

3. The Failing Heart, The Dying Patient

• Heart failure affects more than 6.5 million Americans at a cost of $40 billion a year and growing. Many only see a doctor after they go to the emergency room due to a significant cardiac event and most never bounce back to where they were before the event. Virtual sensor care offers hope and some of the technology is already here in the form of implantable pace makers and defibrillators.
• A common cause of setbacks is failure to adhere to medicines and procrastination. To prevent the time lag between a sensed event and treatment, some devices can alter medication doses in real time. This is already possible for insulin, blood pressure, and pulmonary artery pressure. Some sensors can report problems to patients who can then take action as long as they are properly educated. This kind of care is totally personalized and can dramatically lower hospital admissions and damage to the heart.

4. The Smartwatch Era

• Each year, more of us are wearing devices such at Apple Watches and Fitbits that can continuously monitor many bodily functions. Both have already been part of large clinical tests. While they pick up a lot of symptoms, their primary short coming seems to be too many false positives. If they were used to alert doctors these false positives would be enough to overwhelm our medical system.
• Since everyone expects such wearables and the algorithms that analyze the data they generate to improve, it’s a matter of time until they are integrated into personal care. They have already saved lives by calling emergency help after detecting falls. They can also monitor sleep quality. Continuous reporting to a health care system can make for privacy issues and there is also the matter of equity as many people can’t afford them.

5. Continuous Care and Novel Sensors: A Recipe for Health

• Many sensors that continuously monitor our body’s fluids and rhythms are already available. Most report directly to smartphone apps but have yet to be integrated with our electronic medical records (EMRs). Common diseases that are already being continuously monitored include asthma, diabetes, a-fib, and diseases where electrolyte balance is an issue. With non stop feedback patients can take charge of their health. Sensors that prevent trips to the doctor can disrupt the health care system’s revenue stream.

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Verified: How to Think Straight, Get Duped Less, and Make Better Decisions About What to Believe Online by Mike Caulfield and Sam Wineburg should be the textbook for any course in high school and college that deals with verifying information on the Internet. Its lessons are easy to absorb and remember, which means that it lives up to its lofty title. Get your copy today.

Introduction

• Prior to the arrival of the Internet, the information we received was already processed by society’s gatekeepers and niche information was seldom available. The Internet was supposed to change all that. While we know that much of what we find on the Internet is false, the skills we inherited from the pre-Internet age are not much use in separating truth from fiction. This well researched book may not protect you from all errors of judgement, but it should make such errors fewer and farther between.

1. Get Quick Context: It Can Take as Little as Thirty Seconds, Seriously!

• Most hoaxes can be quickly disposed of with a simple Internet news search. As you face claims of fact there are three contexts that you should consider. They are the source, the claim itself, and your own level of expertise on the matter. As you reason about a specific piece of content there are certain things to do that involve the acronym SIFT. The first is STOP and ask what you know about the claim. Next INVESTIGATE the source to see if it’s trustworthy. Proceed to FIND other coverage. Finally, if possible, TRACE the claim to its original source. The authors give several examples and warn that just because a claim seems far fetched doesn’t mean that it is.

2. Cheap Signals: Or, How Not to Get Duped

• A cheap signal is one that costs little or nothing and is easy for any con artist to produce. Just because a website has a snazzy look and is well written means nothing. Some legitimate sites may not look totally professional. CRAAP is an acronym for the things you should consider as you evaluate a site. Currency deals with when the content was posted. Relevance deals with how the topic fits with what you are looking for. Authority deals with the credentials of the author. Accuracy means you can verify the information with another source. Purpose deals with the aim of the organization publishing the site.
• Even if a site passes all five CRAAP tests, it still may be a front for an industry promoting its products. It may be a wolf in sheep’s clothing. You should always read the URL of any new site you visit. It can help you spot imposters. The suffixes are important. Dot-com sites are supposed to be commercial and usually try to sell you something, but that is not always the case. (Doug: My site is a dot-com but I’m just providing free resources like this summary.) Dot-orgs are supposed to be non-profit organizations, but beware. Pretty much anyone can get a dot-org site. Also, beware of data bases where anyone can add a record.

3. Google: The Bestie You Thought You Knew

• In 2014 Google started putting descriptive search results at the top of the results page. They called it a featured snippet. Google says that they create the snippets from trusted sites based on the keywords in your search. They are very helpful when things are clear, but may not be when things are vague or complex. The keywords you select are important and you usually need several good ones in a search to get good results. Featured snippets may not provide the best answer.
• Google is not neutral. It tries to give you what you want. Try to avoid searches that broadcast your preferences. Choose neutral search terms that don’t contain words like good or bad. Try searching “are soda taxes a good idea” and “are soda taxes a bad idea” as a example of how this works.

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