SCPKU faculty fellow speaks on innovation in mobile healthcare


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Robert Chang, Assistant Professor of Ophthalmology at Stanford University Medical Center and SCPKU Faculty Fellow, gave a public talk at the center earlier this month focused on mobile healthcare innovation and the growing adoption of smartphones as medical devices.

Life expectancy worldwide made huge gains in the last century alone which has created an increasingly heavier burden on our health systems.  The world has seen a rise in age-related chronic illnesses, unique challenges for less developed nations, an increased need for specialized health care workers, and alarming health care cost increases.  These challenges have created opportunities which have spurred innovation in mobile healthcare solutions and the use of smartphones as medical devices to improve the delivery and cost of healthcare.

Chang highlighted Apple’s plans to penetrate the mobile healthcare market including rumors that the company will be releasing a new “iWatch” in October.  At its Worldwide Developer Conference in early June, the company also announced a new iOS 8-based health app and HealthKit framework for tracking personal health and fitness data.  Chang believes these represent important steps in digital health, signaling strong interest in major high-tech players to develop digital healthcare “hubs” and solutions for effective disease monitoring and management.

The current trend within the healthcare technology space is the general population’s use of smartphone sensors to self-track health and fitness data including heart rate, sleeping patterns, activity level and calorie consumption.  Over time, Chang sees the industry moving towards more wearable devices that are more fashionable, invisible and intuitive. 

Within the field of ophthalmology, eye disease diagnoses have typically been done with expensive, bulky equipment.  This limits the ability to deliver effective and efficient eye care in remote patient situations and/or where eye specialists aren’t readily available.  Ophthalmology is well-suited for telehealth and the use of mobile devices to facilitate remote triage. As mobile medical devices, smartphones are ideal given their broad market adoption and processing power and the ubiquity of the Internet.  Currently,  however, cost-effective adapters are needed to accompany a smartphone solution as the smartphone alone is insufficient to capture enough detail inside the eye for effective diagnoses.  As an ophthalmologist with a special interest in healthcare startups, Chang is working with a Stanford-based team to develop the EyeGo, a custom iPhone attachment and adapter coupled with a HIPAA-secure app to facilitate taking pictures of both the front and back of the eye to support remote triage and more efficient physician to physician communication.  While his initial platform is iPhone-based due to the phone’s ubiquity in the Silicon Valley, he eventually plans to port his solution to an open systems platform.

Chang closed his talk by re-emphasizing his point about wearable mobile healthcare becoming more invisible and intuitive.  “The lines are blurring between man and machine,” he said. He cited the “Turing Test,” an experiment developed by famed mathematician Alan Turing to create an artificial intelligence (AI) design standard for the tech industry.  “Can you design an AI where the AI can talk to a person but you can’t tell the difference between the computer and the human?” he challenged.  In order to pass the test, one must fool at least 33% of the judgment panel into thinking the AI is the real person.  Chang believes that mobile health technology can be successfully integrated into the medical field and that we will get to the point where people are completely comfortable interacting with the technology   “This is the next level in the wearable healthcare revolution  -- it will be like you’re talking to your doctor and you won’t be able to tell the difference,” he said.

Chang is a clinician-scientist with an active surgical practice and an interest in early stage medical device development and healthcare IT startups. He has received numerous grants and fellowships In recognition of his focus on patient care, physician innovation, biodesign, and design thinking.  Chang’s clinical research revolves around understanding the association between myopia and glaucoma.