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Medical Monitoring Goes Mobile

Scott Mace, for HealthLeaders Media, August 13, 2013
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"As the price comes down and the data science grows, it's going to become more and more routine," Mattison says. "The problem is, we don't have a lot of data to know where the thresholds are.

"Until we calibrate all of these devices and all those streaming data for different contexts, we're going to have a lot of false alarms."

There was even a Mayo Clinic study a few years ago that found that monitored patients had higher mortality than unmonitored patients, Mattison says. "What happens when you put a monitoring device on someone who's ill and you don't give them any encouragement that this is going to help them?" asks Mattison. "They are constantly aware that they're sick. What it does is it raises anxiety levels and fear, and fear raises your cortisone or it raises your adrenaline, and both of those are known to be acute phase stress reactants. That increases your mortality. That's been known for 50 years."

The solution, Mattison says, is to convert mobile monitors from "worry devices" to "reassuring and supportive and healthy devices for that category of people."

Kaiser is about to begin testing the AliveCor, an FDA-approved case for the iPhone that lets the phone collect ECG data by resting the case's electronics on the fingers of each hand. "There's a very high percentage of people with atrial fibrillation who go for quite a period of time before it's diagnosed simply because if it's intermittent, it might not be detected at those rare moments when they're actually in a clinician's office," Mattison says. "[If] we can detect atrial fibrillation earlier, we can prevent a significant number of catastrophic events by diagnosing and anticoagulating those folks as appropriate."

The clinical need exists and efforts to develop and deliver the technology continue.

"Real-time data delivered to patients and physicians is going to be an essential component to providing 21st century care and achieving the goals of the triple aim," says Rich Roth, vice president of strategic innovation at Dignity Health, one of the nation's five largest health systems, an 18-state network of nearly 10,000 physicians and 56,000 employees with more than 300 care centers. "While it may take a few routes, and we need to make sure to address the digital divide effectively, it's hard to imagine it not being a standard of care in the next three to five years."

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