Everyone in health IT is looking at the proliferation of mobile devices and wireless communications capacity and they are salivating. Now, they say, we are finally going to be able to monitor the vital signs, activity levels, food intake, lifestyle habits of patients and use all this information for prevention. Remote monitoring will bring about the Holy Grail in prevention. And prevention will lower costs.
Not so fast, Kimo Sabe.
For my birthday this year, I got an iPod Nano Watch. The new Nano has a pedometer built in and it uploads your data to Nike. I have been wearing it every day, even though that means I have to charge it every night (this is decidedly sub-optimal for a watch). Faithfully I count my steps and upload them. Rarely do I have get to 10,000 steps a day, except at BlogWorldExpoNY, where I went over the top twice. Most days a dog walk and a trip to the gym put me at 6,000 or so steps.
The Nano Watch replaced my Fitbit, which I wore faithfully all last year. The Fitbit was more complicated and gave me even more information. It tracked my activity, and if I wore it at night, it tracked my sleep patterns and told me how effectively I was sleeping. I also could log my food.
For months I found out that I have a banana and a frappacino for breakfast, some other kind of fruit in mid-morning, along with a diet Coke right before lunch. I then have a salad of some kind or a sandwich on one piece of bread for lunch, fish and a vegetable for most dinners, 2 glasses of wine, and about half a chocolate bar (dark) after dinner. Every once in a while it varies, but most days, that’s it. Oh, and I sleep at 97%.
I gave up the Fitbit because I had the knowledge. And what did I do with it?
The same thing I am doing with the data I am uploading to Nike. Nothing.
Why? Because now I have to make real changes, and the biggest thing I’ve learned from all these monitoring devices is that I AM NOT WILLING TO DO THAT!
There are certain things all the remote monitoring in the world won’t fix. I’ve read about the applications that will tell doctors whether I have taken my pills, too. But if I don’t want to take them, can’t I still refuse the reminder phone call? Or even thank the (probably robo-) caller, hang up and do nothing?
The technology, as usual, is far ahead of the user. And until it gets into our heads and convinces us that we MUST change, we probably won’t. This is the saddest part of all the talk about invoking “prevention” to lower healthcare costs. All of that requires participation by the patient. It’s not dictated by the provider, the payer, or least of all by the health IT product manager.
Anybody want a Wakemate? I have one of those, too.