All that Quantified Self data? Drowning doctors don’t want to see it.

click to enlargeOur long-time readers will remember Questions # 3, 4 and 5 of The Five Big Questions (FBQ*). They have not lost their salience as doctors are rejecting the not-terribly-accurate ‘telehealth’ data [TTA 10 May] generated by popular fitness trackers such as Fitbit, Misfit Shine and Jawbone. We do note that Apple’s Health/HealthKit has trotted out alliances with Mayo Clinic and Epic Systems (EHR) on apps and integrating data into an PHR [TTA 3 June], as well as Samsung’s SAMI [2 June] funding a University of California (UCSF) research center and (of course) Google. But this article confirms this Editor’s long-held opinion that doctors and clinicians have no interest in reviewing or storing, with concomitant privacy and accuracy concerns, the raw or even trended biometric data generated by most mainstream devices, whether fitness or clinical-grade. (So much for Quantified Selfing being the gateway to the New Jerusalem!)

This also ties into the Parks Associates research that indicates that the digital health market now and in the future resides with the ‘worried well’ [TTA 11 Aug] and the ‘worried not-so-well’. There are other factors, such as Epic’s reputation for holding patient data very closely and being a poor sharer with other systems. Data qua data does not magically transform, despite the hype. An eye-roller of a quote from the VentureBeat article:

“Doctors would love to be excited about wearables — they’re gadget guys at heart — but their day-to-day is spent battling 30 year old fax machines to get your last lab report.” says Jeff Tangney, CEO of Doximity, which makes a social communication platform for clinicians. “For a busy doctor, the ability to use email would save more lives than a Fitbit.”

Related in TTA: The Gimlet Eye’s riff on the stickiness of consumer digital devices hype versus the reality

** The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records. 

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Comments

  1. Donna, I think the piece really is a reality check on the use of the uncontrolled environment of ‘devices’. I would add the list of ‘Worried well’ and ‘Worried not well’ adding Motivated well. The quote is brilliant and most likely true in a lot of situations. I wonder if we had a situation where physicians prescribed tracking devices along the lines where ECG, BP etc are issued and are supporting a data collection exercise would there be greater acceptance. I assume this is where Mayo clinic is going….

    • Donna Cusano

      Curated apps and app prescriptions were the original idea behind Happtique. That didn’t work in practice (see the Happtique denouement here: http://telecareaware.com/?p=14713) and of course not helpful was the haphazard management of the company from the start; their parent is a buying services for NY area hospitals and an app related biz evidently was way out of their wheelhouse.

      The fail of Aetna CarePass as well is an indicator of the low perceived need and suspicion of insurers getting hold of personal data. Privacy is a huge concern beyond the QSers, who largely don’t seem to care.

      Docs do not want to be monitoring every blip nor do they have time to, and moreover, if they are supposed to be monitoring trends and there’s a failure to detect, there are liability issues (don’t tell the trial lawyers.) There has to be a way to consolidate trend data into automated, actionable notifications, because no one has time to pore over a grouping of graphs and play Trend Detective. Is there a business model in pairing data analytics with call centers? (VRI, anyone?)

      Docs also have enough trouble managing their patients who do need to be actively monitored in home telehealth programs e.g. HealthBuddy, Care Innovations Connect, Alere Connect, Viterion (very big with VA) etc. This could be where HHA (home health agencies) can serve as monitors and backup.

  2. Donna, I’ve been saying this for years to my Quantified Self friends. My family doc has hundreds of patients, many of whom are tracking this or that. But honestly, is she really going to be eagerly awaiting every mobile alert that tells her in real time that my blood pressure’s a bit high this morning, or that I haven’t taken some form of ingestible digital pill that’s supposed to improve compliance? Thanks for this reminder and a wee dose of common sense reality…

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