How AI and Digital Biomarkers are Transforming Health
In this issue:
I listened to an interview with the trainer for star quarterback Patrick Mahomes. He revealed one secret to the Super Bowl champion’s success: A good night’s sleep.
Mahomes has used the?Whoop band?to track his sleep since 2020 (he’s also an investor in the company). According to his trainer,?Mahomes has not lost a single game when he’s woken up with a good sleep score.
I was struck that a simple, wearable health tracker could play such a big role in athletic success at the highest level.
Today, digital health tools are making it easier to track sleep, mental health, respiration, even your neurological state. These measures are collectively known as?digital biomarkers.
A new class of digital health tools will be able to extract useful health information from your gait, movement and activity—even your voice.
From my work with the world’s leading healthcare companies, I’ve gotten a glimpse into the future of this technology and its impact on health. Here’s what I’ve learned—and what I’m most excited about.
What are Digital Biomarkers?
Traditional biomarkers—cholesterol levels, blood pressure, body temperature—are an important part of medical research and practice. They’re measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.
What are the drawbacks of traditional biomarkers? They can be invasive and expensive (blood tests, cerebrospinal fluid tests). And traditional biomarkers only offer a snapshot view of a patient's health status, as they can collect a limited number of measurements over time.
Digital biomarkers are different. They:
The Future of Wearable Devices
Think about Fitbit, Apple Watch, Oura Ring. Millions use these wearable devices to track their physical activity, heart rate, and sleep.
The next generation of wearable devices will be:
I’ve been working with a startup that’s building a wearable smart watch for early detection of cognitive decline or neurodegenerative disease (Alzheimer's, Parkinson’s).
The smart watch tracks your health across multiple dimensions—cognitive function, physical activity, sleep, etc.—and uses AI to predict signs of deterioration. So you can get ahead of any health issues before they get more serious.
Big tech companies are betting on wearable health technology.?Apple announced a collaboration with Biogen in 2021?for a virtual research study to investigate the role Apple Watch and iPhone could play in monitoring cognitive performance and screening for decline in cognitive health and mild cognitive impairment.
Voice, Gait, and Activity Tracking
Digital biomarkers can be classified by:
Voice
Machine Learning-based voice analysis is able to derive digital biomarkers of cognitive functioning in trauma survivors, mood disorders like anxiety and depression, and even?respiratory illness?and?cancer.
These systems are trained on large databases of audio clips to detect speech differentiators (i.e., tone, inflection, pacing, etc.); quality of the voice; as well as breathing patterns and airway issues, such as the presence of a cough.
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Several startups are developing speech tests / voice analysis technology:
Gait
New technologies are able to extract health information via gait analysis, i.e. studying the way a person walks and moves around.
A company called?Linus Health?provides iPad-based brain health assessments. In 2022 the company acquired?Kinesis Health Technologies, which has developed a range of wearable sensors to assess the physical capabilities of patients. The combination of gait analysis tools and digital brain health monitoring technologies is designed to spot Alzheimer’s or mild cognitive impairment.
Multimodal AI health solutions
Healthcare leaders believe data generated from wearable and ambient biosensors could?enable the development of?multimodal artificial intelligence solutions.?Digital biomarkers will be combined with biomedical data, electronic health records, and genome and microbiome sequencing to capture the complexity of human health and disease.?
These multimodal AI systems will be powered by data captured from digital technology, including heart rate, sleep, physical activity, electrocardiography, oxygen saturation and glucose monitoring.
AI could usher in a range of new health solutions:
Virtual Health Assistants
Today, virtual health coaches are?helping people manage diabetes, migraine, and asthma.
With the next generation of AI, we could have personalized virtual health assistants to help people manage a wide range of health conditions.
The virtual assistants would leverage individualized profiles—based on genome sequencing, continuous monitoring of blood biomarkers and metabolites, biosensors and other relevant biomedical data—to promote behavior change, answer health-related questions, or communicate with healthcare providers when appropriate.
Virtual health coaches could replace the physician as your first point of contact with the healthcare system. The virtual coach would monitor your condition in real-time and alert a doctor or nurse when it detects a problem that requires human intervention.
Hospital at home
For people living with chronic disease like cancer or diabetes, AI-powered remote monitoring could help simulate the hospital setting in a person’s home.
The combination of ambient sensors and wearables could enable early detection of impairments in physical functional status via activities of daily living such as bathing, dressing and eating.
This would reduce healthcare costs, avoid hospital-associated infections and medical errors, and let sick people enjoy the comfort, convenience and emotional support of being home with family members.
The Promise of AI in Healthcare
Technology isn’t going to replace doctors. Some parts of healthcare will always be better in person. Think about a nurse’s touch, tone of voice, empathy—the human element plays a crucial role in people’s recovery from illness. A doctor’s physical exam can detect things machines can’t.
Yet healthcare needs technology innovation to meet its growing challenges. Half the US is diabetic or pre-diabetic. Over a third suffer from depression or anxiety.
Technology is the only way we can scale healthcare to treat our growing challenges and provide the best care to those in need.
Doctors simply don’t scale the way hardware and software do.
People are more engaged with their health when they’re able to check it on their phone or smart watch. When health isn’t gated behind the walls of a doctor’s office.
The more we can take what doctors and nurses do, and migrate that into hardware and software, the better we’ll be able to deliver healthcare to the entire planet.
As always, I’d love to hear your thoughts. What do you like (or not like) about wearables and digital health technology? Where do you see the greatest opportunities?