Automated Medical Exams?

[lpetrich]

Forward - Preventive Healthcare, Powered by Technology - I've been some ads in Facebook for Forward, showing off its automated medical exams.

Forward's home page shows a video of someone demonstrating the system, a young man instead of the young woman of the Facebook ads. I will name them Fred and Fiona for convenience. I was unable to save Fiona's video, so I'll mostly discuss Fred's one.

Fred walked in to Forward's building, and he explained that check-in was very simple. One makes appointments with a smartphone app, then walks right in. When he mentioned check-in, he was near a table with some inset touchscreens, or at least they seemed like touchscreens.

Fred then went to a sort of open-air examination booth. He explained that it has a 3D body scanner that uses infrared cameras, and that can work to millimeter precision. Fred was wearing a polo shirt and full-length pants, and Fiona was wearing similar clothing, so the body scanner may work well with such clothes. But thicker clothing, or clothing like skirts are likely to be misleading. Fred also explained that the booth can also take an EKG.

Fred put his left hand into a slot, and inside that slot are some instruments that illuminate one's hand with red light and then get the heart rate and the blood oxygen content from that. Fred then grabbed a bar with his right hand and the booth then sent an electrical current through his body, and the booth was able to find his water fraction, his fat fraction, his muscle fraction, and then his bone fraction. I'm guessing that the booth checked Fred's body's response to a range of electric-current frequencies. Fred then got to the EKG part, which picks up electrical currents in the body. It also picks up breathing rate.

Then the body scanning. Fred stood as still as he could, while the booth rotated him about 90d leftward, then about 90d rightward. The booth also got his weight. Fred then explained that the body scanning revealed things like one's waist-to-hip ratio.

Fred then went into an exam room, and he described that Forward has a blood-testing lab on site, one that returns blood-test results in about 12 minutes. Test results like for cholesterol levels and kidney health and liver health. He also showed off an infrared vein mapper, which a medical assistant would use to find a good place to get blood from.

He concluded by discussing genetic testing, done with the help of 23 and Me. This testing can find risks of getting various diseases, like heart problems.

Not quite Star Trek, but getting there. But the automation of medical exams should make it easy to drop in and get checked.

As far as I can tell, Forward started out in San Francisco, but it now has offices in Los Angeles, New York City, and Washington DC.

I've found a few reviews.
For $149 a Month, the Doctor Will See You as Often as You Want - MIT Technology Review - "A health-care startup is using fancy digs, fitness trackers, and a membership fee to change doctor visits."
The Startup Forward Aims to Be the Apple Store of Doctor’s Offices | The New Yorker

 

[steve_bank]

There was a completion years back about developing something like a ST medical tricorder.

https://www.mobihealthnews.com/cont...-has-its-winner-work-tricorders-will-continue

Qualcomm and X Prize launched the prize at CES in 2012, licensing the word tricorder from CBS — the term originated as a handheld scanning device, most memorably a medical scanner, on Star Trek. Teams were challenged to build a real-life version of the tricorder, a device weighing five pounds or less that could continuously monitor five vital signs, diagnose 13 disease states, and be used not just by a medical professional but by anyone.

https://en.wikipedia.org/wiki/Medical_tricorder
https://en.wikipedia.org/wiki/Tricorder_X_Prize

 

[Loren Pechtel]

Except how often is there any reason to do such testing? The routine stuff is mostly bloodwork, not a physical exam. (Now, if they could build an automated blood draw machine that worked well that would be very good. Given how much variability there is in the abilities of nurses, however, I suspect matching a good phlebotomist would be very hard.)

 

[steve_bank]

Blood work
genetic tic testing
heart echocardiogram
MRI
CAT scan
X Ray

 

[Loren Pechtel]

Blood work
genetic tic testing
heart echocardiogram
MRI
CAT scan
X Ray

The OP is talking about preventative medicine.

Blood work, yes, I agree.

Genetic testing--that's a once in a lifetime thing.

Heart--doppler echocardiograms aren't preventative medicine at least these days.

MRI--not a preventative procedure at all. And you'll need a decent amount of robotics to position the braces that hold the patient in a steady position for the test duration. At current tech I doubt the robotics would be economic compared to the fairly low-paid person who does such things.

CAT--radiation here, certainly not a preventative.

Note, also, that both of these are normally handled with an operator who immediately checks the results to see if anything went wrong. I've seen the operator reshoot a CAT when my wife apparently moved.

X-ray--again, not a preventative.

 

[steve_bank]

Blood work
genetic tic testing
heart echocardiogram
MRI
CAT scan
X Ray

The OP is talking about preventative medicine.

Blood work, yes, I agree.

Genetic testing--that's a once in a lifetime thing.

Heart--doppler echocardiograms aren't preventative medicine at least these days.

MRI--not a preventative procedure at all. And you'll need a decent amount of robotics to position the braces that hold the patient in a steady position for the test duration. At current tech I doubt the robotics would be economic compared to the fairly low-paid person who does such things.

CAT--radiation here, certainly not a preventative.

Note, also, that both of these are normally handled with an operator who immediately checks the results to see if anything went wrong. I've seen the operator reshoot a CAT when my wife apparently moved.

X-ray--again, not a preventative.

Today all of the above are preventative in some way.

If you get a complete medical checkup these days that includes a heart stress test and echocardiogram. I have been a heart patient for around 3 years. My heart problem was first found in a routine echocardiogram.

If you want to get into how it works we can go over to technology.

CAT stands for computer aided tomography. It checks for cancer better than 2d x rays.

MRI is both diagnostic and preventative. There is a national service that will do an MRI for a low fee to check for certain conditions.

There are also things being done with Terahertz EM.

You can buy automated blood o2 meters and blood pressure meters for < $100. With my heart condition I check my O2 level when exercising, it can drop below 90 if I push too hard.

Ultrasound also checks arteries for clogging. A special ultrasound meter checks arteries in the feet for flow, both preventative and treatment.

CAT is a 3D x ray. Same radiation a simple x ray.

I have been through it all over the last few year. Next month I get a periodic echocardiogram to see if there have been any changes.

All of requires trained operators, but all of it is computer automated. From a PC scale computer to an embedded microcontroller.

 

[Jimmy Higgins]

I saw a documentary about something like this on TV. Some big white inflated guy could scan people.

Not quite Star Trek, but getting there. But the automation of medical exams should make it easy to drop in and get checked.

Great! Even fewer jobs in the future. Everything would be cheap if we just didn't need to hire people to do stuff!

The good news is reducing staff requirements, which can increase the capacity of an office to monitor patients.
The bad news, the fewer human beings involved in medical care, I would imagine could potentially have a negative impact for the patient. Patients like having someone to talk to.

 

[steve_bank]

It will be great. We can have sex, eat, drink, get high, watch porn, and play video games all day.

 

[Loren Pechtel]

If you get a complete medical checkup these days that includes a heart stress test and echocardiogram. I have been a heart patient for around 3 years. My heart problem was first found in a routine echocardiogram.

It's something that's done periodically for those of sufficient age.

CAT stands for computer aided tomography. It checks for cancer better than 2d x rays.

MRI is both diagnostic and preventative. There is a national service that will do an MRI for a low fee to check for certain conditions.

Correct.

You can buy automated blood o2 meters and blood pressure meters for < $100. With my heart condition I check my O2 level when exercising, it can drop below 90 if I push too hard.

Fully agree.

Ultrasound also checks arteries for clogging. A special ultrasound meter checks arteries in the feet for flow, both preventative and treatment.

I've seen them used. I'm questioning how well a computer can interpret the results.

CAT is a 3D x ray. Same radiation a simple x ray.

Here you're way off target. A CAT shoots a whole bunch of x-rays to construct that 3D image.

https://www.radiologyinfo.org/en/info.cfm?pg=safety-xray

From that chart I have 40mSv from CATs vs less than 1mSv from all other x-rays.

All of requires trained operators, but all of it is computer automated. From a PC scale computer to an embedded microcontroller.

The computer runs the machinery, the computer can't understand the images.

 

[steve_bank]

I was just talking to a social worker. She says assited care facilities wer intialy intnde for those over 65,

She says stroke and heart attck vitimes are getting younger and it is becoming a problem.

The medical pundits say it is never really too early to get your heart checked these days. People in their 20s are developing heart problems not usual seen to > 50s. Also blood sugar-A1C and cholesterol.

By the way, had a colonoscopy lately? It is not enjoyable but not too bad of an experience. Rather undignified to have something shoved up your ass.

 

[steve_bank]

I was just talking to a social worker. She says assited care facilities wer intialy intnde for those over 65,

She says stroke and heart attck vitimes are getting younger and it is becoming a problem.

The medical pundits say it is never really too early to get your heart checked these days. People in their 20s are developing heart problems not usual seen to > 50s. Also blood sugar-A1C and cholesterol.

By the way, had a colonoscopy lately? It is not enjoyable but not too bad of an experience. Rather undignified to have something shoved up your ass.

As to interpreting results it is up to the MD. The cardiologist tells te ooerator what to look at. I was told interpertaion is part subjective based on experience.

The question is back to AI. Software can implement a set of rule based analysis and interpretation. Garbage in Garbage Out applies. AI can only be as good as the basis it is designed on.

MRI and CAT is all done by digital image processing, creating a virtual 3D image by interpolating data points. Interpretation of the image is done by the MD.

There is software in which you enter symptoms and I presume parapets from blood tests and gives possible diagnoses. IIf not already I expect there will be a working biochemistry model in software that simulates organs.

Remote robotic surgery has already been done. At some point the physical skills of surgeon will be diminished.

I read sometime back about an initiative to develop an Internet protocol for home medical diagnostic systems. Video can look in ear, throat, and eyes. Blood pressure, temperature, blood sugar. There is now a non invasive method to measure blood sugar.

It is just beginning. A century from now I expect medicine to be highly automated ereducing the need for doctors doing routine and also major care.

 

[southernhybrid]

I was just talking to a social worker. She says assited care facilities wer intialy intnde for those over 65,

She says stroke and heart attck vitimes are getting younger and it is becoming a problem.

The medical pundits say it is never really too early to get your heart checked these days. People in their 20s are developing heart problems not usual seen to > 50s. Also blood sugar-A1C and cholesterol.

By the way, had a colonoscopy lately? It is not enjoyable but not too bad of an experience. Rather undignified to have something shoved up your ass.

The primary reason why younger people are having more cardiovascular problems these days is due to obesity and lack of exercise. If you don't suffer from those problems, it's a waste of medical resources to be worrying about such issues while you're in your 20s and 30s. Our healthcare system already over tests and spends on unnecessary procedures.

The worse part of a colonoscopy is the prep. The last time I had one, I was asleep and had a wonderful female doctor. It was easy. I'm going to be 70 this year and I might refuse to have another since I'm a low risk of colon cancer and I despise the over use of medical resources. If you're not at risk, there's always the colon guard test that checks for occult blood and and evaluation of your DNA. I don't know enough about it to understand exactly how that works. If you have a history of polyps or colon cancer in your family, then a colonoscopy is required.

And, robotic surgery isn't going very well at this point. There are more risks and complications associated with it. Perhaps that's due to poor training of the physicians who use that method. I've read that the training isn't very adequate in many cases and there's no nationalized standard either.

Assisted Living facilities in Georgia never had an age requirement. I worked in one for 18 years and had mentally ill patients as young as 30 something. I had patients who had early onset Alzheimer's in their 40s. Most of the residents were in their 80s and 90s, but we always had a few who were younger than 65. They usually suffered from some type of neurodegenerative disease or mental illness.

I'm old school so I do prefer human interaction when it comes to medical care. Actually I prefer the minimal amount of care at my age.

 

[lpetrich]

Forward - Home at Facebook. One can find some of Forward's promotional videos there.

On March 14 was a video announced with "Meet Forward: a new kind of doctor’s office with unlimited visits and no copays. Ever. Learn more ?" There was a gentleman who introduced himself as Nate Favini. Forward Careers - Help Build a Revolutionary Healthcare Model mentioned him as being in Forward's medical team.

In his video, he described a big flat screen that is in each examination room, a screen which shows a variety of results.

Forward - Videos has a big collection of videos that were posted on Facebook, including some by Fiona and Fred. Fiona is the eastern-Asian-looking woman with shoulder-length hair that looks light brown to blond toward its ends -- I first saw a demo of Forward's technology with one of Fiona's videos in a Facebook ad.