My father has a story that he loves to tell about seeing Isaac Asimov speak at his college in the year 1970. Asimov gave a lecture entitled The World in 2070. Asimov opened by quoting another lecturer, a frenchman from a hundred years ago speaking on the world in 1970. My father doesn’t remember the whole lecture, but he remembers this one telling quote given by the frenchman. “In 1970 balloon travel will reach speeds of greater than 500 miles per hour.” Now, amongst the two of us the phrase “making the balloon go faster” has come to means trying to imagine the future using a paradigm that is firmly rooted in the present.
Why do I bring this up? Becaues these days, the medical world is full of people trying to make the balloon go faster. It’s not surprising, with the crisis that healthcare is going through in terms of prices, labor, and what not. But even more specifically, medicine is going through an information crisis. In the world of drug discovery innovation is outpacing our ability to keep up with it. The FDA is behind in the approval process and new drugs are often fraught with side affects that were missed during clinical trials. In some cases, especially with generics, the delay is so long drugs are obsolete by the time they hit the market.
Part of the big issue is the FDA mandated clinical trials that take up approximately 29% of drug development costs. In fact, clinical trials in general are something of a sacred cow for the medical world. A sacred golden cow, with a cost of at least $15,000 per patient, depending on the level of the trial.
With these time and money costs it’s no surprise that the NIH included a call for research into technologies to ease the process of clinical trials in the recent set of “challenge grants” it’s releasing as part of the economic stimulus. The company I work for has considered applying for that grant in specific, since we already have a technological framework that could handle clinical trials easily. However, even if we make a difference in the short term, I’m wondering if it’s all just another incremental speed increase for the medical balloon.
If clinical trials are the balloon, what is the airplane? My father and I had a lengnthy discussion about this on Sunday, and hit upon the idea of a large databases containing patient reported information on health and wellbeing, collected though a community based website. Our thoughts were based on the fact that other industries are coping with information overload using two strategies, crowdsourcing, and google style data aggergation. Here seemed to be a solution that combined the both into a powerful package for research and patient empowerment.
Satisfied that we had a brilliant original idea, we parted ways. Then the next day my father emailed me a link to Patients Like Me a website that did exactly what we were describing. Then the day after, I came across a website called Cure Together, proving that there is no such thing as a brilliant original idea, especially if it involves the Internet.
I haven’t had a chance to really look into either of these sites, though I was fortunate enough to get a follow on twitter from the Co-founder of Cure Together, so I hope to do a follow up post on them. But at face value, they’re exactly the sort of solution my father and I were thinking about.
It all points to a very interesting world where drug development and testing could take radically new paths. But even more importantly it points to a world where medicine is on-going and patient centered. Instead of reporting on going progress with a disease only in the doctors office, with the clinician in front of them, patients will report in real time, giving more copious and more accurate information through the web, smart phone, or even a normal phone, via IVR. It’s a very compelling vision, and one likely to cause a serious shake up in the healthcare world.