Glimpses of the future impact of DiDIY in healthcare

Digitally enabled Do-it-Yourself equipment, therapies and other healthcare procedures are becoming more and more common. Let's look at just a few, very recent examples first, and then at the questions they pose for our research.

SAVING EYESIGHT WITH A 3D PRINTED EYE EXAMINATION KIT

Hong Sheng Chiong, ophthalmologist, believes that “sight is one of the most important sensory perceptions”. Therefore, he founded oDocs Eye Care, a group that creates open source medical equipment for eye diagnoses that is very accurate, inexpensive and can also be manufactured and used "in the most inaccessible places". One of the results is the open source 3D printed device in the picture above, which is "capable of achieving a 40 degree field of view with 10 times magnification", at the cost of 50 USD and 4 hours for manufacturing. (full article here)

Patients monitoring their vitals on their own, in their home

The MediPi is a Raspberry Pi powered device that allows patients to monitor their vitals on their own instead of having a nurse come to the home or having to make frequent trips to a hospital. It features a blood pressure cuff, a finger oximeter, diagnostic scales and instructions on how to use each part of the kit and how to record measurements taken. The cost (for the prototypes, that is before mass production) is 250 GBP, against up to 2000 GBP/year for current commercial devices. Data are encrypted and sent to the doctor or hospital directly throught the device. MediPi is being trialled this year with heart failure patients in an NHS trust in the south of England. (full article here)

Consumer electronics (and DiDIY) against commercial hearing aids

In the USA, and in many other countries "commercial hearing aids cost an average of nearly $2,400 each, or close to $5,000 a pair, according to a White House advisory group, and Medicare does not pay for them, nor do most insurers". That's why "the audiology profession is obviously scared right now", by unregulated consumer devices that are much less expensive and can be used without any help by an audiologist. It seems very likely that such devices may be soon be designed and manufactured, if they already aren't, in true "Digital DIY" (DiDIY) style. (full article here)

Meanwhile, "professional" healthcare providers...

The Dubai Health Authority recently announced plans to offer 3D printed artificial limbs by 2025, at costs just above 100 USD., plus"ceramic teeth in less than 20 minutes, use 3D printing in orthopedic surgeries and create 3D printed casts, which will speed the healing process of patients by 40 to 80 per cent". In Singapore, a team of engineers has developed a technology to 3D print "customised pills on the spot", each with a shape that makes it possible to release drugs at a different rate. (full article here)

What does this mean?

Low cost, DiDIY-fashion manufacturing of objects like the MediPi, the low cost eye examination kit or certain hearing aids is already possible because those products were born that way. But even services like those planned in Dubai and Singapore are not so far from the reach of single doctors, or at least of small, independent and low budget organizations in every country of the world, as long as they have access to a makerspace and to assistance from a DiDIY expert. What does this mean? The first, obvious issues to consider are:

• quality control of the DiDIY products and services. It cannot be excluded, at least in certain cases, that services and products that are really custom-made to match the specific needs of a single patient and laboratory will be of greater quality, for that specific patient or laboratory, than mass-produced ones
• information: at the same time, and as a minimum, much more awareness is needed about f the possible risks implied by, so to speak, "work" on people's bodies with DIY objects, together with rules on how to make that awareness possible. Possible examples are:
  • definition of new certification procedures and services for medical equipment that make them affordable also for non-industrial products
  • clear rules that define what professional tools a healthcare professional, e.g. a dentist, may self-produce, or commission to a makerspace, how they should be certified, and how her patients should be informed that their dentist is using non-commercial tools
  • definition of if and how the usage of these tools should be documented, in each patient health record, in order to give doctors that see a patient for the first time the best possible picture of how she was treated before.
• impacts on the job market: the MediPI, which directly reduces demand for nurses visiting patients, is the easiest example, but the same may be said for every service
• isolation/alienation, due to healthcare (self)provided via machines, without human contact (see previous points)

Of course, most if not all these issues already exist, or will exist, even without any DiDIY, just because of commercial offers of the same types and globalization that drives down prices (i.e. room for quality control..). But DiDIY greatly increases the scale at which this can happen, making it harder to monitor and prevent misuses, but also bringing more benefits to many more patients. In other words, it seems very, very likely that much more "DIY" healthcare with DiDIY tools will happen. Both in "developing" countries and in poor, underserved areas of richer ones, the choice between "DIY" care and no care at all, for lack of money and/or personnel, will become more and more a non-issue, as awareness of the possibilities of DiDIY, and access to it, increase.