Blog | Friday, June 15, 2018

Heart monitors and running toilets

Our most recent water bill was about five times higher than the one for the preceding quarter, so I called the local water authority to see if there had been a mistake. With a few keystrokes, the woman with whom I spoke was able to tell me exactly which days over the previous months appeared to have high usage, and asked if we had a leaky faucet or a running toilet. Well, yes, I explained, we did have a toilet that had been running (which I have since fixed), but I was surprised that it could lead to such an outsized bill. The response was more or less, “Oh yeah, that can do it,” and the more medically resonant “We see this.”

I was disappointed that the bill was real, but also sort of impressed that the water-works was able to pinpoint my usage, so I asked her about the metering. She explained that we have a smart-meter that transmits our usage on a daily basis to the central office. When I heard that, I asked why, if they could tell we had a problem, that they didn't notify us or provide us with access to the data. Turns out they intend to make that information available to users in the near future. Cool.

Of course, it got me thinking about the other continuous monitor that transmits data on a daily basis that is literally near and dear to my heart. I am, of course, talking about my implanted cardiac loop recorder. I still find it stunning (and infuriating) that patients are not provided with access to the data being collected by their cardiac implantable electronic devices, which include loop recorders, pacemakers and implantable defibrillators. Instead, patients have to trust that someone else is diligently monitoring their device, hope that whoever is monitoring will contact them if an abnormality is detected, and forgo the opportunity to make important observations about their own health and well-being.

It is absurd that the municipal water authority has a more enlightened and modern approach to sharing data with customers than medical device companies, but they do.

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.