When Apple announced last summer that the latest version of the Watch allows people to take their own electrocardiograms (EKGs) as often as they wanted, I was intrigued. After all, knowing more about your health is usually a step forward.
When Apple explained that people could send those EKG readings to their doctors in PDF format, though, I envisioned chaos in the healthcare system.
Just imagine generating your own EKG every hour, just because you can. It’s groundbreaking technology, no question. But then imagine sending every one of those EKG readings directly to your primary care doctor or your cardiologist—just because you can. There are some questions to consider before you, as a consumer, unilaterally make that choice.
Does your doctor want to see your EKG reading every hour? In some cases, if you have a known or suspected history of cardiac concerns, your doctor might find that very helpful. But that’s the exception. Normally, a stream of unnecessary and unrequested EKGs flowing into a practice would either tie up valuable staff time or be ignored altogether.
How is your provider tracking all of those EKG readings? Even if the readings go directly into your doctor’s electronic health records (EHR) system, your doctor and their staff might not see them. The volume is too much to handle. So, it’s possible that no one would even be aware that your 400th EKG reading differs from the 399 that preceded it.
Who can see your personal health data? One of the biggest concerns among health consumers—like yourself—is the security of private information. If EKG readings and similar data points go from your device to your doctor by email, your data is not secure. You may have no knowledge of who is checking the email—and the EKG readings may never make it into your provider’s EHR if there’s no system in place to process the email attachments.
Let’s think this through. Inundating doctors with unnecessary EKG readings every hour—for example—swamps providers who already say they feel like they’re drinking from a firehose of data. However, if you arrive at the emergency department (ED) complaining of chest pain, the team there might really appreciate the availability of those EKG files to see how their reading compares to yours.
If you’re not in any shape to pull up your most recent readings from the device on your wrist, then the provider treating you isn’t likely to look for information there. Instead, the team will search for you through their community health information exchange (HIE)—like Hixny in our region—to see what their peers have already recorded in your records.
The fact is, most consumer-directed tech like the Apple Watch is designed to let you, the consumer, take a more active role in your health, but not in your healthcare. The exponential increase in the volume of data per person generated by wearables and similar technology is mostly just noise when it’s dumped into unprepared health information technology systems.
The challenge is that, within that gigantic volume of data, there is information that’s valuable to the right healthcare providers at the right time—such as in the ED or when you and your provider are monitoring a known condition.
For example, new blood glucose monitors and smart blood pressure cuffs are already in the market. While they are likely to be used in collaboration with your provider, they will also contribute to the continued proliferation of data generated by devices outside the traditional healthcare setting.
You see where I’m going with this. Even as consumer-directed technology makes the move from health to healthcare, there is still a need for a centrally available, comprehensive patient record. There needs to be a way for both you and your providers to contribute information and retrieve information, in whatever way and at whatever time and place it’s needed.
HIEs are the most logical point of connection for all involved, since they’re accessible to all providers (to whom you’ve given consent, at least in New York) and to you, the consumer. Plus, HIEs are developed to be bidirectional—to take information in as well as feeding it out.
I’ll be coming back to this topic throughout the year. After all, your engagement in your community HIE will continue to evolve—and so will the tools that facilitate that engagement.
For now, though, as you hear more about the growth of wearables, take a moment to consider whether the functionality gives you greater control over your daily health, or whether it truly delivers the ability to be more engaged in your healthcare. What would make these data streams and the information they contain more actionable to providers within the healthcare system?