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.
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