Playing Doctor

Fingertip Pulse-Ox MonitorI recently became concerned that I might have sleep apnea, a sleep disorder characterized by abnormally low breathing or missed breaths during sleep. Although an individual with sleep apnea is often unaware of having difficulty breathing, even after they awaken, the condition can cause the daytime sleepiness and fatigue associated with any type of significant sleep disturbance.

My doctor prescribed an overnight stay in a sleep lab, which is just what you might imagine: you try and get a good night’s sleep in a hospital bed connected by a sheaf of cables to a stack of electronic equipment standing sentinel over you, monitoring your heart rate, blood oxygenation, and a host of other vital signs. In addition to measuring your vitals, this equipment keeps a log so that doctors can review what’s been happening.

This didn’t sound like much fun. Fortunately, the electronics revolution that has turned your cell phone into a computer/camera/navigation/videophone has dramatically reduced the size and cost of medical instruments as well. The monitor shown here fits over the end of your finger, is battery powered, logs up to 40 hours of data, and can be connected to a laptop via USB for data analysis, reporting, and battery recharging. It also sports a fully graphical display and built-in alarms if any of the patient values go too high or too low. But the best feature may be the cost. Instead of costing thousands like their rack-mounted counterparts, even the best of these devices can be had for well under $100.

As an experiment, I ordered one from Hong Kong, slipped it over my finger, and generated pages of data while I slept in my own bed. Next time I see my doctor, I’ll have the data she needs for a meaningful analysis at a fraction of the cost of a sleep study and with zero interruption of my life. Plus the data is more accurate because it reflects my behavior at home, sleeping in my own environment, instead of an institutional lab.

Inexpensive medical equipment like this will recast the very structure of medicine. Big medical institutions in this country aren’t likely to change how they do things right away because of the costs associated with organizational change. But emerging economies, remote settlements, and mobile care providers will be revolutionized. Mobile medical providers and rescue workers can carry one of these devices on a lanyard around their neck, providing valuable data at the point of care. Four of these devices plugged into an inexpensive laptop can turn a tent into a multi-patient ICU.

Perhaps the biggest revolution in health care will happen right in your own home. In the near future, every home medicine chest will contain devices like this, just as they carry thermometers today. When your child has an asthma attack or an allergic reaction to a bee sting, devices like these will provide an accurate, unemotional assessment of the patient’s status, making it easy for the doctor on the other end of the phone (or website) to decide if they need an ambulance, a clinic visit, or a couple of aspirins and a good night’s sleep.