Born in India, raised in Kenya and now living in the United States, I have had the opportunity to observe humans interact with healthcare systems in various ways. It ultimately led me to focus on biology and anthropology during my undergraduate training at Stanford University. One consistent theme at the time was how system-centric healthcare had become. My strong family history in cardiovascular disease led me to pursue my medical school and internal medicine training at the University of California, San Francisco, and this was right around the time smartphones and wearable activity trackers were gaining popularity. The early adoption of these wearables to understand ambulatory physiology in cardiovascular diseases, made me pursue my cardiovascular diseases fellowship training at Northwestern University. During my clinical training I consistently observed that clinicians were forced to make management decisions based on snapshots observed in their clinical encounters and felt this needed to change. I worked on a cuffless continuous blood pressure monitor to get a more complete picture of a person’s blood pressure trends in my own field.
Just as I completed my training in 2016, I was diagnosed with a brain tumor. It was really this experience as a patient that inspired me to pivot entirely to the field of digital medicine. As part of my illness, I experienced unexpected seizures. Just like with blood pressure, I really wished there was a sensor or a device of some kind that could use my own granular biometrics—heart rate, blood pressure and other vital signs—to alert me when a seizure was about to happen. The experience really opened my eyes to the opportunities that wearable devices present to help patients manage their symptoms and overall health.
My cancer is now in surveillance, and I will always be at risk of recurrent seizures given scarring from surgery and radiation therapy, which continues to serve as a personal calling for me to move the needle forward for precision medicine enabled by digital technology.
The explosion in commercial sensors, such as smartwatches and fitness bands, means we have a way to gather longitudinal data that allows us to get a more complete picture of everyone’s unique physiology. Each person has their own unique baseline for vital signs like body temperature, blood pressure, heart rate and respiratory rate. By better understanding what’s normal for each of us, it becomes easier for us to detect when those metrics begin to deviate, potentially enabling earlier disease diagnosis, personalized treatment and even disease prevention.
And as mentioned with my own illness, there’s huge potential for digital devices to help improve symptom management. We’re seeing this in so many areas, including chronic pain, mental health and more recently, long COVID.
Beyond sensors, digital tools could also empower patients by giving them access and ownership of all their medical data, including biometric trends, medication history, imaging, and consultation notes through user-friendly platforms. Really, we can democratize healthcare by leveraging digital devices and engaging patients as active partners in managing their own health.
In addition to being a patient, I’m a practicing cardiologist so I have insights into the healthcare system from both sides.
The longitudinal data that can be collected in a more natural setting with wearables is so much more powerful than the brief snapshots we get from clinical encounters with patients. The challenge is getting our arms around all the different layers and streams of data and analyzing it to provide clinically relevant and helpful information back to the patient. It’s a problem waiting to be solved and that’s what I and my colleagues at Scripps Research are focused on.
The average time a clinician spends on a follow up visit with their patient is limited and that only allows for a problem-focused visit. On the other hand, wearable sensors collect large datasets of biometrics that could provide significant insight into the patient’s complete condition. How to present the data in an actionable format is a challenge we are actively working on. The vision is to empower both patient and physician to make clinical management decisions based on real world biometrics rather than the simulated situation of the clinic.
We have several exciting studies that are currently ongoing or about to launch, focused on everything from maternal health to precision nutrition and COVID-19, with the hope of expanding into mental and cardiovascular health.
We’re spearheading a nationwide collaborative effort, called PowerMom, to gain insights into the determinants of healthy pregnancies by inviting pregnant people to share their wearable data and pregnancy-related information with us via a mobile app-based research platform.
We’re also investigating how sensors can be used to predict glycemic response related to food intake by tracking heart rate, sleep and blood sugar levels among other things. This type of data can provide us with a window into metabolic health like never before. Other studies include DETECT, which aims to gain insights into early detection for COVID-19 and other viral illnesses, and we are about to launch a study investigating the physical and psychological dimensions of sleep.
Across all these studies, our goal is to engage participants as partners in our research and gather feedback from them to help improve study design, communication and guide scientific priorities.
I am an avid soccer fan and have attended three World Cups with the hopes of making it to Qatar this year. I love to travel with my family and share my love of hiking and swimming with my two little children.
I chose to continue my work at the Scripps Research Translational Institute because of its reputation as a global leader in research implementing wireless technology for precision health, with Dr. Eric Topol at its helm. This aligns well with my desire to move the needle forward for precision health enabled by digital medicine.