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E-patient Update: Remote Monitoring Leaves Me Out of The Loop

Posted on May 24, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As some readers may recall, I don’t just write about digital health deployment — I live it. To be specific, my occasional heart arrhythmia (Afib) is being tracked remotely by device implanted in my chest near my heart. My cardiac electrophysiologist implanted the Medtronic device – a “loop recorder” roughly the size of a cigarette lighter though flatter — during a cardiac ablation procedure.

The setup works like this:

  • The implanted device tracks my heart rhythm, recording any events that fit criteria programmed into it. (Side note: It’s made entirely of plastic, which means I need not fear MRIs. Neat, huh?)
  • The center also includes a bedside station which comes with a removable, mouse shaped object that I can place on my chest to record any incidents that concern me. I can also record events in real time, when I’m on the road, using a smaller device that fits on my key ring.
  • Whether I record any perceived episodes or not, the bedside station downloads whatever information is stored in the loop recorder at midnight each night, then transmits it to the cardiac electrophysiologist’s office.
  • The next day, a tech reviews the records. If any unusual events show up, the tech notifies the doctor, who reaches out to me if need be.

Now, don’t get me wrong, this is all very cool. And these devices have benefited me already, just a month into their use. For example, one evening last week I was experiencing some uncomfortable palpitations, and wondered whether I had reason for concern. So I called the cardiac electrophysiologist’s after-hours service and got a call back from the on-call physician.

When she and I spoke, her first response was to send me to my local hospital. But once I informed her that the device was tracking my heart rhythms, she accessed them and determined that I was only experiencing mild tachycardia. That was certainly a relief.

No access for patients

That being said, it bugs me that I have no direct access to this information myself. Don’t get me wrong, I understand that interacting with heart rhythm data is complicated. Certainly, I can’t do as much in response to that information as I could if the device were, say, tracking my blood glucose levels.

That being said, my feeling is that I would benefit from knowing more about how my heart is working, or failing to work appropriately in the grand scheme of things, even if I can’t interpret the raw data of the device produces. For example, it would be great if I could view a chart that showed, say, week by week when events occurred and what time they took place.

Of course, I don’t know whether having this data would have any concrete impact on my life. But that being said, it bothers me that such remote monitoring schemes don’t have their core an assumption that patients don’t need this information. I’d argue that Medtronic and its peers should be thinking of ways to loop patients in any time their data is being collected in an outpatient setting. Don’t we have an app for that, and if not, why?

Unfortunately, no matter how patients scream and yell about this, I doubt we’ll make much progress until doctors raise their voices too. So if you’re a physician reading this, I hope you’re willing to get involved since patients deserve to know what’s going on with their bodies. And if you have the means to help them know, make it happen!

ONC Encourages Emergence Of E-Patients

Posted on February 15, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Throughout the Meaningful Use rollout, there’s been discussion of how to best use all of these new health IT toys to get patients more engaged in their care.  But as far as I know, the following is the first time ONC has officially launched an initiative to cultivate the emergence of health IT-smart e-patients.

In a new article in Health Affairs, ONC national coordinator for  health IT Farzad Mostashari has shared plans to use health IT to reach patients and encourage their involvement with their care. The ONC is already working with 17 Beacon communities to test ideas such as text-messaging for diabetes risk assessment, but the idea now is to expand things to much higher level.

ONC now hopes to encourage patients to participate in e-patient activities such as secure e-mail messaging with doctors, use of EMRs that patients can add to and transmit, as well as use of mobile health apps for chronic disease monitoring and wellness promotion, reports Politico.com.

I’m excited to see ONC jump on this bandwagon enthusiastically. While there is an e-patient movement afoot, and a growing list of doctors interested in “participatory medicine,” it’s unlikely that the run-of-the-mill patient with few self-advocacy or technical skills would get involved on their own.

And the truth is, if ONC truly wants to build a nation of engaged patients, Meaningful Use requirements are too modest by far. Sure, there’s new requirements afoot that will make it easier for patients to e-mail doctors and transmit their health information, and that’s fine. But the truth is that few patients will take advantage of these features without a great degree of encouragement.

As something of an e-patient myself, I’m eager to see the movement blossom, as I believe it’s good for both the clinician and ordinary citizens receiving medical care. Let’s see how much effort Dr. Mostashari and his team put into cultivating patient engagement.