Accidental immersion reporting: my heart monitor experience
I don't normally have a lot of personal experience with the things I write about for work. I don't have nearly enough money to invest with a hedge fund, I'm probably never going to have a pension, and I may one day be wealthy enough to need a registered investment adviser, but not quite yet. I love the stories that allow me to write about interesting financial concepts that also have some relevance to my life, and the lives of my peers. That was one of the reasons I loved reporting and writing my recent health care feature. It was about how asset managers are investing in the future of health care, but it also included a lot of science about how our bodies work and discussion of new technologies that anyone can use. I assumed that would be the extent of my personal connection to the story, and I was OK with that.
Then, after the piece was finished and published, I had a follow up appointment with my cardiologist. I've been seeing her for about a year and a half, since I started having heart palpitations while training for the New York City Marathon (which I did not end up running, for obvious reasons!) My heart is fine structurally, but when I told my doctor I was still bothered by the palpitations, she suggested I wear a heart monitor for two weeks so she could get a better sense of what (if anything) was going on. I had worn a monitor once before, for 24 hours, and it was not a pleasant experience. I was left with extremely irritated skin where the monitor had stuck to my chest and the wires had gotten tangled up in my clothes. I was excited, then, when I realized that my doctor had quickly upgraded to the newest technology: the Body Guardian Remote Monitoring System from Preventice. How it worked: I stuck an adhesive strip with sensors on my chest over my heart, snapped on a small square monitor and pushed a button, which allowed the monitor to communicate with a smart phone made just for this purpose. The monitor tracks the wearer's heart rate constantly, sending a full report at the end of the designated period. But if the wearer feels something irregular, he or she can push the button, select any symptoms they may be feeling on the smart phone screen, and a report is sent directly to the doctor. If anything truly dangerous happens, the monitor is supposed to pick it up and send an emergency alert.
I think my experience with this thing gave me a much more practical idea of the true impact of the health care revolution. Because once the awe at the fact that my doctor could essentially watch my heart beating from her office if she wanted to wears off, the reality that technology and the people who have to operate it are flawed settles in.
I have really sensitive skin, so I was told to change the sensor strip as infrequently as possible. The problem with that? After a day or two, its stickiness started to wear off, and if I moved around too much the monitor disconnected. This was mostly just annoying, until the end of the first week when I was standing in my kitchen doing dishes and had an intense run of (what I think were) premature ventricular contractions. I'm pretty used to them, but when I haven't felt any for a while and am not feeling particularly anxious, they can be scary when they decide to pop up, especially when there seem to be several in a row. I immediately reached for the smart phone to log my symptoms, but I was met with an error message about connectivity. I sent my doctor a non-urgent message through her hospital's web portal - another much lauded technological innovation - to see if she could check the log for a reading. There was nothing. When she showed me the print outs at my follow up appointment today, I saw where the disconnection happened - a flat line. "You weren't dead," she said, "so we know it disconnected." I was frustrated and disappointed. How useful is an exciting new piece of technology if all it can tell you is that you're not dead?
To be fair, the monitor worked properly for most of the two weeks, and it showed me and my doctor that my heart works normally most of the time, too. But that one five second period when I really needed to see what was going on, the technology let me down. Or did I let down the technology? Maybe I should have known to change the sensor strip earlier. Maybe the person who taught me how to use it didn't emphasize that enough. Maybe the disconnection was caused by something else entirely.
Whatever the reason for my frustrating experience, it's a reminder that however exciting new technology-based health innovations seem, however effective they would be for patient outcomes if they worked perfectly, they often don't. Humans still have to operate the technology, for the most part, and that introduces room for error. Maybe that margin will grow smaller and smaller as investment and research into new health technology continues. For now, I'm dialing back my enthusiasm just a little bit, though I won't hesitate to try something like this again. And perhaps more importantly, I'll be adding a little more healthy skepticism to my reporting on health care technology.