New Screening and Assessment Tools We’re Excited About
Innovative medical screening and assessment tools continue to become available as technology advances at a very fast pace.
At Private Medical, we’ve found it helpful and challenging to stay on top of all the new technological innovations. Our dedicated team of eight physicians and nurses serve on our Innovation Council to diligence each new product/service. If they pass scientific muster and are useful to doctors or patients, we send them to our clinical tools team for workflow integration.
Today, I’ll share some recent and up-and-coming innovations we’ve researched so you can evaluate whether they might be helpful to your patients as well.
How We Use Screening and Assessment Tools
As physicians in the concierge space, part of the value we bring to our patients is the desire and ability to sit and listen to them.
In my practice, rather than having blanket testing for everyone, we consider each individual, along with their goals, concerns, and states of health. Together, we determine the best path forward and which medical screening and assessment tools to prioritize.
People want different things when it comes to the medical tests that make sense for them. Many tests cost extra money, and the value has to be evaluated in the context of preference and personal concern. For example, if a patient has a family history of cancer and is anxious about it, I’ll likely recommend one of the new cancer screening tests at a reassuring frequency — but I’ll steer clear of tests with higher false positive rates.
While we don’t use every test for every patient, having a robust menu to pull from as each situation warrants has been incredibly useful.
What’s Already Available?
To start, it’s worth briefly mentioning some of the newer technologies that are already available and of which you may already be aware.
Cancer Detection
- Full-body scans
- Cell-free DNA testing
- Computerized mole mapping
- Digital dermatoscopy
One-Time Baseline Tests
- Pulmonary function studies
- Brain function and imaging tests
Cardiovascular Testing
- Carotid intima-media thickness (CIMT) test
- Cardiac CT calcium score (also using AI)
New Screening and Assessment Tools
Now let’s get into the up-and-coming tests that are either still in the development and approval process or are relative newcomers without widespread adoption (as of now). Many of these new screening and assessment tools fall broadly into one of the following categories: blood, breath, urine, apps and wearables.
For full transparency, I want to say that as someone who believes strongly in medical innovation and works to further it, I’m aware of some of these newer tools because companies approach me for advice. That said, I truly believe every tool I mention here holds genuine potential for benefiting physician care and patient health.
Blood Tests
Proteomic Tests
Current protein testing — albumin, creatinine, BUN — typically gauge levels of a handful of proteins, but some 14,000 (or more) proteins make up the human proteome.
In the relatively new field of proteomic testing, blood tests can now detect thousands of proteins. While analyzing these thousands of proteins would be difficult for humans, proteomic tests use AI to reference existing bio-banking studies and detect known patterns and biomarkers in the bloodstream.
For example, if a patient has liver disease, their protein makeup looks a certain way. And their protein analysis looks completely different from a patient with heart disease. Proteomics can detect disease in its early stages and illuminate the body’s response to treatments and medications.
Proteomic tests are still emerging, but even in their fledgling stages, they can evaluate cardiovascular risk, VO2 max, bone density, fatty liver, and visceral fat. Proteomic tests are, in essence, potentially capable of replacing DEXA scans, calcium scores, and VO2 max tests, among others — all with a simple blood draw.
As technology continues to improve, it’s expected that proteomic tests will be able to assess the internal organs in even greater detail.
Metabolomic Tests
Metabolomic tests measure the body’s metabolites — the “exhaust fumes” of the body — to reverse-engineer what’s going on inside internally. Helpful for gauging what I like to call epigenetic velocity, metabolomic tests can give patients an understanding of their general inflammation and metabolic markers, or in other words, of how fast their various parts and systems are aging.
Because low-grade inflammation is a key driver in aging, metabolomic testing could open up a whole new world of information we as physicians can use to improve patient health and longevity.
Pharmacogenomic Tests
Since they measure how fast a patient metabolizes medications, pharmacogenomic testing can help our understanding of drug efficacy and interactions and influence how we prescribe medications.
These tests are at a stage I’d describe as “good but getting better.” In their current state, pharmacogenomic testing can help us choose the best blood thinner for a given patient or inform how we prescribe SSRIs for depression and anxiety.
Worth keeping an eye on; these tests are only getting more interesting with time.
Breath Tests
Owlstone Medical, a UK-based research company, studies the breath. Their device — a sort of medical breathalyzer — measures 70,000 different volatile organic compounds in the breath with the aim of early detection and precision medicine.
Similar to metabolomic tests, these breath biopsies can reverse engineer various conditions and states of health in the body. In particular, they can measure liver and gut health, and the hope is to proceed to early cancer detection, treatment response prediction, and hazardous exposure monitoring.
Urine Tests
Urine tests could become easier and more accessible for patients. Though not widespread yet, various smart toilet seats can measure the components in a person’s urine, detecting hormonal fluctuations, ketones, vitamin balance, and more. This kind of at-home testing can be especially helpful for patients with mobility issues.
Some of these technological toilet accessories aren’t yet available in the U.S., though at least one has received FDA approval.
Wearables and Apps
Several exciting wearables are already on the market, and others are coming our way.
Aktiia
This watchband-like wearable measures blood pressure whenever the wearer is still. Aktiia is already approved and being used in Europe but is not yet commercially available in the U.S. However, it is available for investigational use.
Oura
Oura has been around for about a decade, but its sleep-monitoring ring continues to improve. The ring, with its app, provides a daily sleep analysis, heart rate monitor, and health recommendations. Though not new to the market, how we interact with the product is changing.
I’m hopeful Oura will develop a physician dashboard to improve doctors’ visibility into their patient’s health data. If you’re a ROAMD physician interested in helping with this project, please get in touch via the network.
Sparta Science
Sparta Science has developed a device that measures thousands of musculoskeletal strength and health data points. The device is a force plate that people jump on and measures vital signs associated with movements, such as balance and force.
It’s also proving useful in mild traumatic brain injury measurement.
Eye-Sync
NeuroSync developed the Eye-Sync, a virtual reality wearable that measures a patient’s eye movements. It then compares the movements to the unique movement patterns associated with conditions such as concussion, sleep deprivation, ADHD, and neurodegenerative disorders. It is now FDA-cleared in the U.S. and takes about a minute to provide results.
TimeShifter
A number of apps for managing jet lag and shift work exist, but we think TimeShifter stands out from the bunch. Though not a diagnostic tool, it’s a useful health aid you might suggest to patients struggling with unusual work schedules or frequent travel.
Mixed Reality and Advanced Visualization Tools
Our patients may also receive benefits from advanced visualization tools. BrainKey, started by two Stanford scientists, offers a 3D graphic visualization of a patient’s brain based on MRI results. These can illuminate brain structure, blood vessel health, aneurysms, cysts, or anything that shouldn’t be present.
This personalized map of the brain allows physicians to see different structures and areas of patients’ brains and gives an overall sense of brain age and health. This establishes an excellent baseline of brain health and can result in patients changing their habits. Because patients have a more concrete idea of their current brain health and trends, BrainKey visualizations can improve their behaviors.
Final Thoughts on New Screening and Assessment Tools
As new and emerging blood, breath, urine, and wearable tests hit the ground, I predict we’ll discover as yet unimaginable insights into body functions and trends. Such tests can be especially effective in the concierge medicine space, where we’re positioned to listen to our patient’s needs and fully advise them with individualized care.
Because we strongly believe in staying up to date with medical innovations, my practice, Private Medical, created an Internal Innovation Council. We apply a formal process to carefully research and vet new medical screening and assessment tools and companies.
If you’ve found an innovative screening or assessment tool you’d like our team to review, I invite you to contact us via ROAMD.
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Dr. Jordan Shlain is the founder and managing partner of Private Medical, a referral-only private practice office in San Francisco, Silicon Valley and Los Angeles established in 2002. Private Medical was recently highlighted on the front page of the New York Times Business section as the best-in-class medical practice for individuals and families that value health as their most valuable asset. Their twenty-one physicians integrate internal medicine, pediatrics, naturopathic & gynecologic medicine to ensure a highly personal medical experience that emphasizes proactive prevention, surveillance and rapid response teams during crises both big and small. Dr. Shlain is an active advisor to many Silicon Valley companies that help solve real problems for real doctors.
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