December 28, 2014
Some in Medical Profession Afraid of Technology
Well, maybe not all in the medical profession, but at least the author of this Joslin blog raises issues which are upsetting. I am upset by a statement by Howard Wolpert, M.D., Director of the Joslin Institute for Technology Translation (JITT) when he says, “While the iWatch has the potential to enhance diabetes care in the digital realm, it is still lacking crucial functionalities that prevent the iWatch, and similar devices, from serving as a sufficient replacement for current technologies, such as continuous glucose monitors.”
Now I have to wonder how he arrived at this. I don't think the Apple iWatch intended to replace continuous glucose monitors. If the iWatch can read the data from the current and future versions, then I don't see the problem. Too many of the diabetes tools are too proprietary and guard their data zealously. Dr. Wolpert does say, “I think this has tremendous potential. But for patients to effectively use this information, the information collected needs to be analyzed to identify patterns and this needs to be coupled to specific guidance and feedback to patients around their diabetes self-care.”
This sounds very typical of Joslin. They seem to assume that people with diabetes are too stupid to self manage their diabetes. Most doctors do not have the time to provide specific guidance and feedback to patients around their diabetes self care. And in many areas there is definitely a lack of certified diabetes educators to provide education about self-care.
“Apple collaborated with Mayo Clinic and Epic Systems to create Health and HealthKit and while these partnerships provide new and innovative ways to improve access to care, they also pose regulatory issues. Dr. Wolpert cautions that with diabetes, companies such as Apple do not, “always recognize the challenges associated with developing individualized tools for diabetes care.””
At least Apple collaborated with the Mayo Clinic and Epic Systems and this may be why Joslin is negative about the iWatch. The Joslin blog author goes out of the way criticize Apple at every turn as if the two organizations don't know about diabetes or even HIPAA. While it can be understood that it might take some time to make the best benefit out of the data, the author is doing a great job of decrying Apple and the iWatch.
“One of the drawbacks with all the data collected with multiple sensors using wearable technology is overloading the patient and caregiver with too much information,” said Dr. Wolpert. “It can be counterproductive if the information is not processed and analyzed, and if the treatment recommendations are realistic and manageable for the patient. The benefit derived from using the technology needs to outweigh any additional burden that might go along with the use of the technology.”
The second statement above is why I have to wonder why Dr. Wolpert thinks all patients' are stupid. Many of the tech savvy people are often capable of making better use of the data than many doctors make. To begin with, most primary care doctors do not even look at the data from the blood glucose meters or even the logs kept by the patients. All they are interested in is the HbA1c test and maybe ask a few questions and you are out the door.
“This is setting the stage for a transformation for the way healthcare is delivered, particularly for people with diabetes who often need around the clock guidance,” Dr. Wolpert concluded.
Apparently Dr. Wolpert has unlimited amount of time to spend with a limited number of patients. Most doctors spend about 15 minutes per quarter or about one hour per year, so we cannot count on around the clock guidance. It is obvious that someone lives in a dream world.