Blog | Monday, September 10, 2018

Do it yourself


In one of my earliest blog posts, I told the story of a patient of mine who asked if she could use an app on her smartphone to monitor her heart rate, and wrote: “Patients monitoring themselves! Cell phones transformed into medical devices! How cool is that?”

Since then, I have become more committed to the principle that patients should be the owners of their medical data and empowered to collect and manage it, and the technology to facilitate their ability to do so has improved remarkably. I recently purchased some of that new technology myself, and it goes well beyond what I was thinking was possible when I got excited 5 years ago at the prospect of self-monitoring heart rate.

This is a picture of my wrist with my new Apple watch, equipped with the Kardia band and yes, that is my ECG.

It requires an app on my phone, an Apple watch, and the band ($199 retail), but all it takes to record a single lead ECG is holding my other thumb over the metallic contact on the watch band. Once recorded, I can retrieve my tracing (30 secs of data) from my phone, annotate it, email it or archive it for future reference. I have taken tracings at the gym (sinus tach) and under a variety of conditions, and have been impressed by the quality of the tracing. Did I mention that it also provides a machine reading of the rhythm?

I have no financial interest in the company that sells this, but I am very impressed, and I am convinced that this kind of technology will only become better and more pervasive. In fact, we are in a moment of great transition. Diagnostic tools and the data they generate are no longer “doctors' toys.” They are consumer products, and we as medical professionals must learn to adapt to this new reality by becoming better partners with our patients; we must learn to encourage, advise and interpret instead of dictate, order, and pontificate.

I think this will be better for us and our patients.

What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of Northwell Health Physician Partners, and a professor of cardiology and professor of occupational medicine, epidemiology, and prevention at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. He is board certified in internal medicine and cardiovascular diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining Northwell Health. He is married with two daughters and enjoys cars, reading biographies, and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.