Old school

Got a holter monitor on today, on account of the screwy stuff my heart is doing.  Maybe just POTS gone wild, but I need to make sure I’m not ignoring a potentially bad rhythm.  So 24 hour monitor it is.

While the monitor which records the signals from the leads has seen significant improvements since the last time I had any sort of prolonged monitoring device, the human data recording side has NOT.  I.e. there is still a crappy photocopied piece of paper that they hand out and tell you to record your activities, medications, and symptoms on.  Why is this not electronic?  Why is there not a “holter app” produced and distributed by the company that makes the monitor, that pairs with it via blue tooth and where you can record this stuff instead of scrambling for a sheet of paper and pen while short of breath and trying to remember to also push the button on the monitor?  Hell, I’d even take just an electronic log that DOESN’T pair with the monitor but at least gives you the freedom to program and then select symptoms with just a few taps.  It could be set up to do languages other than English on the patient side, to read items out loud or enlarge the font for patients with vision problems.  It could even prompt you to enter in activity if you haven’t tapped in a while, so the docs who are going to have to read and interpret your monitor’s data will have a better sense of whether you are at rest or not.

We have this technology.  For the love of god, why isn’t it in use?

I suppose one answer is that most cardiac patients are elderly and will be like “you want me to do what now?”  But most elderly cardiac patients also are not going to be able to easily read this tiny, degraded print on the paper log they hand out, or have arthritis and are gonna have a hard time writing legibly in those tiny little rectangles they give you to record your symptoms and activities.  How about for people without a mobile device, they give out a tablet where patients can tap in their symptoms?  It would be SO EASY.

I think another and more on target answer is that the human factor side of medicine is not always given the attention it deserves – not in a real, practical sense.  It’s so very reductionist and so very medical to ignore the patient side of things, to just say “now you need to make sure you do this difficult and pain in the ass thing over and over so that this test/treatment/whatever will work right…” and then just leave it at that.  We know that if you want better results, you need patient compliance with so many things because technology is only going to get you so far and very few tests and treatments are 100% patient-proof.  So acknowledge this, and incorporate it into the new designs. Sure, a smaller, more compact monitoring unit is going to help.  But how much better if in the next generation of at home monitoring devices (blood sugar monitors, BP, cardiac, EEG, the various gastric things they can now send you out with) used this spiffy new technology to make it easier for the patient to record their side of things?

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  1. Ha, I’d be so lost with the technology I’d just need a blown-up version of that printed paper. Get me my AARP card. 🙂 I think technology can be really helpful but if you can’t work anymore like me, then how do you keep up with it? I can use a computer still and that’s about it (and still running a copy of Office 2003/lost my career at the very end of ’02). It’s sort of like how I needed you to help me adapt my laptop further (thanks!) because I had no clue I could do that and who’s going to help in these parts? I’m having a major issue with technology this week due to something breaking and needing to be replaced that is now extinct (should write a post on that, as well). Ugh. But, I hear you as most people do have smartphones, etc. and know how to use apps and all that and therefore more options should be given, but keep the blown-up paper for the old people and me. Lol.

    • You know, I wouldn’t have had such an issue with bigger font/spaced paper. But I think they can make medical tablet devices for patients in a way that takes into account that not all patients are super-techy. They should be using and giving out these tablets. In terms of lost money from repeated tests under crappy reimbursement, I can’t imagine that investing a bit in improved patient compliance wouldn’t be cost effective if not actually beneficial (btw, I am aware that the previous sentence has a triple negative but I’m too under-caffeinated to rewrite it properly just now).

  2. Medical tablets sound doable and I’m used to way more than triple negatives around here. Lol. You got me to actually write a post tonight about my technology issues and horrid ordeal this week (last week?), but my posts take a couple days at least, so stay tuned…

    I seriously think you have such great ideas on how to make the world easier for many of us or just more logical and it sucks that you have nowhere to go with them. I think you need some schematics/prototypes and a business plan and then go on that Shark Tank show and see if they’ll invest, while taking 90% of your net. :/ I wonder if there’s a company that only makes things like you dream about and you could work there and not have to schlep all over the city doing silly things like eating in some food court! It’s such a niche market, or is it? Hmmm. It reminds me of the Seinfeld episode when George needs a new job and has all these crazy ideas (yours aren’t crazy) like being a talk show host and Jerry tells him that he thinks you need to know someone to get that job. Quite the conundrum there, but I’m rooting for you…


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