Can Digital Health Ensue A Sustainable and Bright Future?
The COVID-19 pandemic has had a serious global impact. Owing to the need for distancing, demand for telemedicine surged. Some countries responded flexibly, but others struggled. However, it should be noted that telemedicine services have some limitations, such as being unable to touch patients, which is vital for assessing rigidity and balance problems in people with Parkinson’s disease (PwP).
Digital transformation (DX) in healthcare is key to building a sustainable society that is resilient to crises such as pandemics. Digital health (eHealth) provides health services that use digital technology to improve people’s health and well-being. These technologies include information communication technology (ICT), wearable devices, smartphone apps to monitor movement or biological data, and artificial intelligence (AI) which enables data-driven medicine.
Parkinson’s symptoms may fluctuate within a day, day by day, and may progress over time. Therefore, wearable devices can continuously and objectively monitor changes in a patient’s daily conditions outside of a hospital through 24-hour continuous monitoring. The Apple Watch offers a movement disorder API that can distinguish between tremors and dyskinesia and monitor them separately1). Additionally, smartphones can record personal health data and patient-reported outcomes. Furthermore, digital recording of an individual’s movement symptoms is expected to serve as a digital biomarker and become the basis for personalized medicine in the future2).
AI refers to computer programs which imitate human intelligence. The foundation of AI is machine learning, including both supervised and unsupervised learning. The development of deep learning has dramatically improved AI capabilities: AI has beaten human champions in games such as chess (Deep Blue, 1999), shogi (Ponanza, 2016), and go (AlphaGO, 2017). Furthermore, AI has been used in medical applications for diagnostic imaging, and research is underway to treat neurological disorders. Technology has been developed to automatically determine tremors by simply holding one’s hand over an infrared motion capturing device3). Digitization in medicine will allow the accumulation of big data and its analysis through AI. In addition, AI-chatbots, such as iPhone’s Siri and Amazon’s Alexa, may help people with Parkinson’s by inquiring about their conditions instead of healthcare providers4). AI chatbots can also be used in speech therapy, thus saving time for physicians by organizing a vast amount of information traffic and allowing them to focus on meaningful information, or by interviewing and rehabilitating patients instead of doctors and healthcare professionals. As a result, it may be possible for physicians to concentrate on primary tasks which only they can perform: listening to, sympathizing with, touching and examining, and healing patients.
Jules Verne said, “Anything one man can imagine, other men can make real.” Many scientific fiction movies show that “future technology” can be used to provide healthcare. For example, Marty’s children enjoyed virtual reality content using a head-mounted display in Back to Future II. In Star Wars, the Jedi Council used a 3D hologram teleconferencing system. In fact, we have already invented such evolutionary technology using mixed reality, which enables three-dimensional video calls, facilitating online medical treatment as if the patients were sharing the same space as the doctors5). Use of these technologies is expected to lead to a revolution in which various medical professionals can collaborate across professional boundaries and provide more effective medical care using fewer resources. In addition, a paradigm shift may occur where patients do not visit a hospital after developing a disease, but manage their daily health using wearable devices and smartphone apps, consult online when the devices highlight a problem, and visit a hospital only when they need face-to-face medical care.
However, we still need to discuss the advantages and disadvantages of using this technology. For example, the privacy and security of personal health data are major concerns. We have to keep our eyes on the development of technologies to prevent a future like that shown in The Terminator.
In the upcoming 6th World Parkinson Congress in Barcelona, Spain, we will host an exciting seminar, “Cutting-edge technology driving an era of digital health for PD,” covering these topics. The three distinguished speakers will provide insights into current technologies. We look forward to meeting you and enjoying this discussion.
References
1) Powers R, Etezadi-Amoli M, Arnold EM, et al. Smartwatch inertial sensors continuously monitor real-world motor fluctuations in Parkinson's disease. Science translational medicine. 13(579), 2021
2) Sieberts SK, Schaff J, Duda M, et al. Crowdsourcing digital health measures to predict Parkinson's disease severity: the Parkinson's Disease Digital Biomarker DREAM Challenge. NPJ digital medicine. 4(1):53, 2021
3) Vivar G, Almanza-Ojeda DL, Cheng I, Gomez JC, Andrade-Lucio JA, Ibarra-Manzano MA. Contrast and Homogeneity Feature Analysis for Classifying Tremor Levels in Parkinson's Disease Patients. Sensors (Basel, Switzerland). 19(9), 2019
4) Ogawa M, Oyama G, Morito K, et al. Can AI make people happy? The effect of AI-based chatbot on smile and speech in Parkinson's disease. Parkinsonism & related disorders. 99:43-6, 2022
5) Sekimoto S, Oyama G, Chiba S, Nuermaimaiti M, Sasaki F, Hattori N. Holomedicine: Proof of the Concept of Interactive Three-Dimensional Telemedicine. Movement disorders : official journal of the Movement Disorder Society. 35(10):1719-20, 2020
Genko Oyama, M.D., Ph.D., FAAN is an associate professor, Department of Neurology, Department of Neurodegenerative and Demented Disorders, Department of Home medical care System based on Information and Communication Technology, Department of Drug Development for Parkinson's Disease, Juntendo University Faculty of Medicine Courtesy associate professor, Department of Neurology, University of Florida. He was a committee member at the 5th World Parkinson Congress in Kyoto, Japan. Dr. Oyama will be moderating at the WPC 2023 Congress in Barcelona. View the Scientific Program here.
Ideas and opinions expressed in this post reflect that of the author(s) solely. They do not necessarily reflect the opinions of the World Parkinson Coalition®