Tech in Cardiology
On a recent flight from San Francisco, I found myself sitting in a dreaded middle seat. To my left was a programmer typing way in Python, and to my right was an oncologist flipping through a slide set on chemotherapy trials. While this may sound like the beginning of a bad joke, I remember this moment because it got me thinking about the influence of tech on medicine. The purpose of my trip, by the way, was to interview for a fellowship position in cardiology, a specialty with arguably some of the most impressive tech.
Not to discount advances in medical devices (e.g. leadless pacemakers, bioprosthetic valves), the emergence of consumer-facing wearable devices is as trendy as ever. Google recently collaborated with AHA to build its fitness app (Google Fit), which uses algorithms to quantify physical activity in terms of “heart points.”1 The Apple Health app now incorporates EKG capabilities, allowing patients to record episodes of arrhythmias—something I have certainly witnessed in cardiology clinic.2
Big data is an increasingly prominent component of clinical research, and a number of joint ventures with medical and tech leaders have emerged. One Brave Idea3 is a research collaboration between AHA and Verily (Alphabet’s life sciences division) which uses genomics to study coronary artery disease. Meanwhile, Verily’s Project Baseline4 is a massive longitudinal observational study—a modern version of the Framingham Heart Study.
AI could eventually play a prominent role in medical diagnosis and decision-making. The Stanford Machine Learning Group5 has developed a neural network that outperforms cardiologists in diagnosing arrhythmias on EKG—a significant improvement on existing algorithms which are often unreliable. AI also carries vast potential in radiologic interpretation. Already, Veril is using machine learning to interpret retinal images not only to detect diabetic retinopathy and macular edema but also to extrapolate information about cardiovascular risk.6
Electronic medical records represent an obvious space for tech innovation. Fast Healthcare Interoperability Resources (FHIR) are making it easier to share health information across our disjointed EMR systems. Providers are now able to push health data directly to patients’ iPhones using Apple Health Records.7 One can only speculate whether we will see a legacy software giant compete directly in the EMR space.
Cardiology and the rest of medicine has long excelled at basic science and translational research, but digital tech is increasingly creeping in. We are in a tech zeitgeist, and this is good for both patients and providers.
John Chen, MD is an internal medicine resident at the Emory University School of Medicine and Grady Memorial Hospital in Atlanta, Georgia. After completing residency, he plans to pursue fellowship training in cardiology. @JohnChenMD