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Technology in the hands of patients changes the practice of medicine

Dennis Thomas O’Connor, now 75 years old, talks about the health problems he’s had. They include heart disease, prostate cancer and being seriously overweight. But he was lucky to meet the right doctor and learn about the tools he could use to take control of his health.

“It gave me a sense of empowerment and gave me a sense of knowing what to do and think about my health. And getting this feedback on a constant basis,” O’Connor said. “I’m no longer in denial. I no longer ignore symptoms. Just the opposite.”

O’Connor’s tool kit includes a Fitbit, an Oura Ring that monitors sleep and body temperature, an Apple Watch and a Kardia monitor, which can give his heart an EKG at home. He monitors his health every day and looks at the graphed data, from his monitors, that ultimately show up on the computer screen of his doctor.


His doctor is Michael Kurisu, founder of a virtual clinic called Measured Wellness, which he runs out of his Carlsbad home. He remembers when he started seeing patients.

“So the typical patient from that small cohort that started, the medical system had no answers for them, and they kinda had to go do it on their own, whether they were dealing with different kinds of cancer or other chronic illnesses,” Kurisu said. “They’re just meeting roadblocks in the traditional medical world and they wanted to learn more about themselves.”

When he talks about patients, Kurisu describes their relationship as a partnership. It’s not a hierarchy with the doctor at the top. He said his patients share a strong motivation to take charge of their health, and it’s not incorrect to call it do-it-yourself medicine.

“You know, it’s like the Home Depot,” he said. “I’m not going to get the plumber to come. I’m going to learn how to do this myself and there’s a lot of learning.”

That’s one way to look at it.


Benjamin Smarr, a professor of bioengineering and data science at UC San Diego, compares it to the Protestant reformation and one of the reasons they split from the Catholic Church, which only published the bible in Latin that only the clergy understood.

“Which meant you had to ask the priest, you know, ‘what I should do?’ And Protestantism came out of this idea that if the Bible was translated into the vernacular, locally everybody could read the bible and figure out what to do as a community. I think this is a really interesting parallel to what we’re seeing in medicine these days,” Smarr said.

Students in Smarr’s lab have analyzed some of the data collected by Kurisu’s patients. They look for patterns and spikes that could indicate poor health.

Smarr said medicine’s old priesthood, the doctors, are entering a new relationship with patients. And he hopes that relationship will be supportive and respectful.

“The expectation that a doctor just magically knows the right answer for everything is totally unfair. That’s not how we treat any other person,” he said. “Expecting that they have an expertise and they can contribute, and together we can augment and make a better decision; I think that’s a much healthier relationship.”

A new landscape for doctors and patients

Kurisu said the amount of data being generated by patients and their health apps is becoming a part of medicine that requires a lot of attention. While musing on the subject he said that maybe data analysis should become a new medical specialty.

When you are monitoring your health hour by hour, the effects on your body can be known very quickly.

“You can see how certain foods affect you,” Kurisu said. “You can eat pizza and see what happens to your blood glucose.”

Stress is often seen in patient graphs.

“The third Tuesday of every month, one of my patients; all of his data was just crashing all the time. And it was like wow, ‘Your heart rate’s going down. Your glucose is all over the place. Your sleep was terrible!’ It became a pattern and so I was like, ‘Well what happens Tuesdays?’”

The patient said that is when his mother-in-law comes into the house to take care of the kids.

Patients who monitor themselves have to make the time to do it and they have to be motivated. Kurisu’s patient, Dennis O’Connor, said he wasn’t always motivated. But that changed after he had a heart surgery and had to get two stents put in his arteries.

“I was near dying, and two years before that I had prostate surgery. I’d been hit with the spear of death, and that did wake me up,” O’Connor said.

That’s when he started really looking at his health, using today’s technology. And since then he says he’s lost 65 pounds.