The frustrating story of Dr. Kanav Kahol may be one of the better illustrations of how doggedly the American medical system courts failure. While working at Arizona State University’s department of biomedical informatics, Kahol realized that that the imaging and diagnostic technologies used by most American doctors were expensive to make and hard to use. He believed he could make a cheaper, simpler version. He was right, but America has not profited by his success. According to the Washington Post, Kahol was stymied by tight funding and an American medical system indifferent about progress. So he packed up his idea and returned home to India, where he was received with open arms.There, he and a team of researchers produced the Swasthya Slate, or “Health Tablet.” The machine, built from sensors and an Android tablet, measures vitals like blood pressure and glucose levels and tests for conditions like HIV and pulse oximetry. Medical labs certified that it was as accurate as pre-existing technologies, and the Indian government has underwritten successful pilot projects using the device in the field. Where it was introduced, the device worked wonders. For example, a complicated antenatal testing process that previously took 14 days can be performed in 45 minutes using the new machine. More:
Kahol believes that, in high volumes, the Swasthya Slate can be produced for as little as $150 per unit. This will surely make a difference in the developing world, where the ratio of doctors to patients is often as low as 1:50,000 instead of the 1:1,000 that the World Health Organization recommends. But it is needed in the United States as well.Such health kits will allow doctors to diagnose and advise patients remotely, through telemedicine, which is enabled by using technologies such as Skype and Facetime. If patients can take regular tests in the comfort of their homes and upload data to the cloud, it will dramatically increase the quality of health care they receive and reduce its cost. Continuous monitoring of health data by artificial-intelligence–based apps will enable the prevention of disease, especially lifestyle disease such as diabetes and cardiovascular illness.
In the great health care debates of our time, the Kahols of the world rarely make an appearance. Would-be reformers focus far less on supporting innovators of Kahol’s type than on managing the insurance companies who set premiums, the bureaucrats who design health care marketplaces, and the regulators who set subsidy levels. Health care, more than many other policy areas, tends to be marked off as the province of the wonk. But technologies like the Swasthya Slate are not marginal to health care reform. Cheaper and more efficient ways to test and treat patients are at the heart of the project to build a better health care system. They also allow health care providers below the MD level to provide more care at a lower price.Yet Kahol was rejected by an American system resistant to innovation. If the FDA ever does approve the Swasthya Slate, it will only be after a long, tortuous process. The future should belong to Kahol, but whether and when that future comes to America depends on how able we are to encourage, support, and aggressively promote medical innovators and their products. If Kahol’s story is any indication, we’ll be waiting quite a while.