Here’s another device you probably don’t need. Or do you?
That’s the question Austin Frakt, who writes for the New York Times, tried to answer for himself when his cardiologist told him that one of his heart’s chambers sometimes pumped when it shouldn’t. The doctor had been “99.9% certain” that it wasn’t worrisome, and doctor advised against additional tests and visits.
But even though he’s a health economist, and knows that many commonly prescribed tests aren’t necessary, Frakt is only human. “As a patient,” he acknowledged in his story in The Times, “I’m not confident I know which ones.”
His heart palpitations persisted, and so did his concern. “Was I the patient for whom additional tests would be beneficial or wasteful?” he wondered.
He opted to try the monitor. That involved attaching electrodes to his chest so that his heart’s rhythm could be relayed over wires to a recorder on his belt. It wirelessly communicated the heart data to his physician, continuously monitoring for electrical signals of a heart attack.
As Frakt wrote in The Times, “Some [technologies] are valuable for some people but are used in a great many more for whom it is wasteful. When applied to the population with the right risk factors, various tests of the heart can save lives. When applied to a population at very low risk, a great deal of it does little but add to our health care bill, waste patients’ time and lead to unnecessary procedures, which carry their own risks.”
Although Frakt was amazed by his hear monitor’s wizardry, that didn’t overcome the unpleasantness of wearing it. The wires tickled his torso and made his clothing look bulky. The belt recorder poked him in the waist and impaired his range of motion. Not to mention the weird looks he got when somebody noticed the monitor.
“It was hard to forget I was a patient,” he wrote. “I felt tethered to, not freed by, technology. These inconveniences were like small physical and psychological co-payments, increasing the cost of the test to me, the patient.”
If you have an increased risk of heart problems, if you have a history that demands you carefully monitor your heart’s health, these are minor inconveniences, and maybe the monitor is a useful health-care tool. But if you’re not a heart patient or strong potential patient, really, is this something you want to pay for, be inconvenienced by and possibly stress out over its presence?
For Frakt, although the financial cost of the device wasn’t a concern, the psychological cost was too high, given that he wasn’t sure that he needed monitoring around the clock. “Within a day,” he wrote, “I unplugged and immediately felt liberated.”
As it turns out, his condition was benign.
But as the physical, mental and financial burden of collecting data about the human body declines, more people will use technologies like the heart monitor. Some are curious, some just like new gadgets and some are the “worried well,” people with no reason to suspect illness lurks, but still worry about it anyway.
The popularity of fitness monitors attests to our cultural embrace of little tools that are all about me me me, even when there’s no medical reason for constant monitoring. And even though a lot of health data trackers now on the market aren’t always reliable, Frakt said that widespread monitoring eventually might enhance researchers’ ability to understand the early cues to potential problems. “It might save lives,” he said.
Today, wearable heart monitors for stroke patients are useful in diagnosing irregular heartbeats and alerting doctors to the need to intervene. Implantable defibrillators are proven tools to decrease risk of mortality for some patients with heart failure by shocking their hearts back into normal rhythm.
“But,” Frakt wrote “[t]hese examples are for technology targeted to specific groups with significant heart problems, the people we know will benefit most. What happens when millions of healthy people start recording their hearts’ rhythms just because they can? Even though the devices that enable this may be cheap, collectively we may pay a lot if doing so leads to over-diagnosis and unnecessary procedures. People who need wearable health monitors the least may be among those most likely to use them.”
Frakt isn’t just an economist, he’s a bit of a poet. Regarding our attraction to new technology, he concluded in his story, “Each time it feels right, but so often it doesn’t last. It’s like falling in love.”