Sure You Can Track Your Health Data, But Can Your Doctor Use It?

Jan 19, 2015
Originally published on January 21, 2015 7:10 am

Dr. Paul Abramson is no technophobe. He works at a hydraulic standing desk made in Denmark and his stethoscope boasts a data screen. "I'm an engineer and I'm in health care," he says. "I like gadgets." Still, the proliferation of gadgets that collect health data are giving him pause.

Abramson is a primary care doctor in San Francisco and lots of his patients work in the tech industry. So it's not surprising that more and more of them are coming in with information collected from consumer medical devices — you know, those wristbands and phone apps that measure how much exercise you're getting or how many calories you're eating.

The "wearables" market is growing fast. Credit Suisse estimates it's already worth between $3 billion and $5 billion. Add to that nearly 50,000 health apps, and you have a booming new digital health industry aiming to transform health care in the same way Amazon took on publishing.

Abramson says all the information these devices collect can be overwhelming. One of his patients arrived with pages and pages of Excel spread sheets full of data — everything from heart rate to symptoms to medications. Abramson says he didn't know what to do with it all.

"Going through it and trying to analyze and extract meaning from it was not really feasible," he says.

To Abramson, the spreadsheets just didn't say all that much. "I get information from watching people's body language, tics and tone of voice," he says. "Subtleties you just can't get from a Fitbit or some kind of health app."

Despite this reluctance on the part of doctors, technology startups are actively trying to insert their products into the doctor's office.

Doctors get pitches from entrepreneurs almost daily, says Dr. Michael Blum, a cardiologist at the University of California, San Francisco. "Their perspective is, 'You old doctors have kept things the same as they are for 50 years. We've got new technology and it's going to disrupt health care,'" he says.

Don't get him wrong. Blum thinks health care needs an update, for sure.

The problem is, just because a device looks shiny and new doesn't mean it's useful. FitBits and Apple Watches aren't regulated by the Food and Drug Administration. In fact the FDA doesn't intend to regulate what it calls "low-risk devices" that are only intended to promote general wellness, like weight loss, physical fitness or stress management. Only medical devices that are intended for use in the diagnosis or treatment of disease need FDA approval.

Blum says, "We can't make the leap that just because the data from these low-risk devices is coming in digitally doesn't mean that it's accurate." He says validation studies are needed.

Often that task falls to doctors and hospitals. At UCSF, Blum now heads an entire new department created to sort out which technologies are game changing and which are dead ends.

Other health care groups are following suit, running pilot studies that give devices to people with certain illnesses to see whether they help.

Bret Parker is taking part in one such study for Parkinson's disease. He's 46 years old, lives in New York City and has blogged about his illness. "When I heard there was a trial that involved a wearable that would help me better manage my symptoms and my condition, I said to myself, 'Well, that's a pretty cool thing. I've got to try that.' "

Parker enrolled in a pilot study to see whether an activity tracker made by Intel would be useful to track the severity of his tremors. It creates a digital diary showing how tremors respond to minor changes in diet, sleep patterns or what time of day Parker takes his medication.

Parker says in the early stages of his disease, he didn't pay close attention to those kinds of details. But as the Parkinson's progresses, he believes he'll have to change his approach.

"This is going to be a battle between me and Parkinson's in the years to come," he says. "As it advances, it means I've got to be better and smarter at my role in it."

He hopes the wearable will help him do that.

Copyright 2015 KQED Public Media. To see more, visit http://www.kqed.org/news.

Transcript

DAVID GREENE, HOST:

And I'm David Greene. Good morning. Today in Your Health, a new procedure to help maintain weight loss, but first - wearable technology; maybe some of you have been trying it out. These are gadgets that collect health information, everything from how much exercise we're getting to how stressed we are to how many calories we're consuming. The aim of these products is to transform health care in much the same way Amazon took on traditional book publishing. So let's hear how doctors are reacting. Here's Amy Standen, from member station KQED, in San Francisco.

AMY STANDEN, BYLINE: Let's be clear here that Dr. Paul Abramson is no technophobe. There's the hydraulic standing desk from Denmark and the stethoscope with a data screen.

PAUL ABRAMSON: I'm both an engineer and I'm in health care and I like gadgets.

STANDEN: Abramson is a primary care doctor in San Francisco, where he sees patients from the tech industry. And more and more, he says, people are coming in with data collected from consumer medical devices; sometimes, a lot of data.

ABRAMSON: Everything from heart rate to symptoms to medications to a variety of things.

STANDEN: Like the patient who came in with pages and pages of Excel spreadsheets.

ABRAMSON: The thought of going through it and trying to analyze it or extract meaning from it was not really feasible.

STANDEN: To Anderson, the spreadsheets just didn't say all that much.

ABRAMSON: I get information from watching people's body language, from observing their minor tics and their tone of their voice.

STANDEN: Subtleties you just can't get from a Fitbit or some kind of health app, but despite any reluctance on the part of doctors, technology startups are actively trying to insert their products into the doctor's office. Michael Blum, a cardiologist at the University of California, San Francisco, says he gets pitches from entrepreneurs almost daily.

MICHAEL BLUM: Their perspective is, you know, you old doctors have kept things the same as they are for 50 years. We've got new technology and it's going to disrupt health care.

STANDEN: Don't get him wrong here - Blum says health care needs a high-tech update, for sure. Doctors can benefit from more granular data about how their patients are doing. The problem is just because a device looks shiny and new doesn't mean it works. Fitbits and Apple Watches aren't regulated by the FDA.

BLUM: We can't make the leap that just because this data's coming in digitally it's accurate. We can't make that leap. We have to do the validation studies.

STANDEN: And often that task falls to doctors and hospitals. At UCSF, Blum now heads an entire new department created to sort out which technologies are game changing and which are dead ends, and other health care groups are following suit. It means running pilot studies, giving devices to people with illnesses and seeing whether they help.

BRET PARKER: When I heard that there was a trial that involved a wearable that would help me better manage my symptoms and my condition, I said to myself, well, that's a pretty cool thing. I've got to try that.

STANDEN: Bret Parker, who lives in New York City, has Parkinson's disease, and because there is no cure for Parkinson's, his attitude, for a long time, was to ignore it.

PARKER: My feeling was don't worry about things that you can't control and that aren't affecting you that badly. I'd rather just, in a sense, just live my life and not think about it.

STANDEN: But as his disease has progressed, that's changed. It's become important to pay attention to small details, like are the tremors worse when Parker gets less sleep or eats differently or takes his medicine at a certain time of day? So the pilot study he's taking part in looks at whether a wearable activity tracker, made by Intel, can answer those kinds of questions by picking up and creating a digital diary of his tremors day and night.

PARKER: This is going to be a battle between me and the Parkinson's over the years to come. And as it advances it means I've got to be better and smarter at my role in it. You know, it's one thing to be passive when it's not a big deal. I'm going to have to be more active is the condition gets worse.

STANDEN: The results of this Parkinson's pilot are due later this year. It's one in a slew of studies to see whether consumer health tools will amount to more than just trendy gadgets. For NPR News, I'm Amy Standen in San Francisco. Transcript provided by NPR, Copyright NPR.