Medicine Unplugged: The Future of Laboratory Medicine

We live amidst a digital revolution occurring in mobile healthcare. The remarkable and explosive progress in wireless medical devices has been catalyzed by the software of apps and the hardware of “adds.” Wireless diagnostics tools such as the AliveCor smartphone-enabled electrocardiograph, the vScan pocket ultrasound, and the CellScope smartphone-based otoscope are poised to deliver diagnostic information faster, cheaper, and at the point-of-care (POC).4 Leveraging the power of >6 billion active cell phones, a number far greater than the number of toothbrushes or toilets in the world, these devices can be used anywhere there is a mobile signal, thereby achieving a “flattening” of the Earth with respect to access to mobile-health technologies (1). Now, the convergence of smartphones and innovative biosensors based on microfluidics and microelectronics is tackling the next big challenge for wireless health: portable biochemical analysis in the form of a handheld lab-on-a-chip (LOC). Capable of accommodating a wide range of testing modalities—from analytical chemistry to microscopy to POC genomics—LOC systems represent a new model for laboratory medicine, in which a smartphone-enabled portable laboratory is brought to the patient instead of the patient being brought to the laboratory. We examine recent advancements in mobile diagnostics enabled by microfluidics and LOC technologies for POC clinical testing. Vinod Khosla, the prominent venture capitalist, recently opined that in the future a combination of innovative algorithms and next-generation diagnostic devices could replace 80% of doctors (2). This radical prediction reflects the fact that the current wireless health ecosystem is home to a growing network of distributed health data procured by an array of diagnostic devices. Aggregation and algorithmic processing of the data will ultimately be necessary to create artificial-intelligence and decision support for patients and the medical community. Consequently, there is enormous interest and investment in wireless diagnostics, as exemplified by the …