Editor's Corner | The New World of Personal Health Monitoring
For more than a year, we have heard much about the government monitoring our telephone calls. However, the monitoring of our behavior goes well beyond any government program. There are a number of internet companies whose main function is to monitor our online use, compile data on our interests and behaviors, and then sell the information to companies who place highly targeted advertising on our web browser.
If you search the internet to find details on a specific product or service, you are likely to see advertising that displays similar products or services on your browser for weeks after the search.
In a similar fashion, your smartphone contains abundant information regarding your movements and behaviors. If you allow location tracking, available software will tell you when you are near a restaurant of interest, alert you to a friend or colleague who is nearby, or notify your family when you are near your home. (You can even follow your child if he or she has a smartphone with tracking enabled.)
Certain map applications can tell you about traffic flow by tracking the motion of smartphones moving along a specific highway. There is even an application that can secure your smartphone by tracking your particular arm and hand movements. Once your characteristic pattern is established, if someone else uses the phone, it will lock when it detects a different gesture pattern when the phone is used.
We are in a new world where personal information can be distributed to people or systems that might use the information for commercial purposes. But, more importantly for health-related monitoring, new technology gives us new ways to improve care. At the ACC's 2nd Annual Sports Cardiology Symposium held in October of last year, there was considerable discussion about methods for monitoring heart rate and rhythm in athletes and other exercising adults who complain of palpitations or performance impairment during exercise activity. We agreed that a typical exercise treadmill protocol used for cardiac diagnosis is often not stressful enough to detect arrhythmias during high-intensity exercise, and continuous monitoring during the athletic activity is more likely to provide insight into the diagnosis.
We are in an interesting period, where the engineering application of sensor technology is advancing so that skin surface sensor patches that contain sophisticated monitoring circuits in a Band-aid®-type patch applied to the skin for a week or more can be used to detect abnormal heart rhythms during extremes of exercise. These patches can store information for several weeks and, when removed, be placed in a reader that will send the entire recorded episode to a monitoring station for analysis. Some patches can send continuous signals to a smartphone, which in turn will send the information to a central monitoring system.
Today, personal behavior, location, preferences, and interests can be easily discerned from our online behavior and smartphone use. The availability of health information for chronic disease management or for wellness monitoring for prevention can provide a new dimension of health care and has the potential to improve health and reduce the cost of care. While we may feel some discomfort with the widespreadalmost universalavailability of personal data because of modern information systems, each one of us can learn how to optimize these new tools and systems to improve health care.
Alfred A. Bove, MD, PhD, is professor emeritus of medicine at Temple University School of Medicine in Philadelphia, and former president of the ACC.
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