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The Apple Watch is the first mass-market product with an ECG, which lets consumers get a reading of their heart’s rhythm and potentially pick up on a type of arrhythmia called atrial fibrillation. That’s a big deal, but it also raises some concerns.
While the device gives people more control over their health and better data on their conditions is laudable, many doctors are worried about false positives. That is, the Apple Watch may be wrong in some cases, resulting in healthy people rushing unnecessarily to the emergency room. Check out the Twitter hashtag #cardiotwitter to see how that’s playing out.
“I love the idea of patients participating in their own health, and I’m not anti-Apple,” said Dr. Brian Kolski, a cardiologist in Orange County, California. “But I also don’t want to be pulled away from those who are actually sick.”
Kolski said he recently started getting messages from patients who were using the ECG feature and just needed reassurance because they didn’t quite understand the reading. “U up?” one perfectly healthy patient emailed him at midnight one night, along with data from the watch.
“I’m in an area of Southern California where there are a lot of worried well,” Kolski said.
Critics are also concerned about misinformation, especially with the recent batch of unverified claims that the Apple Watch is saving lives.
The flip side is that numerous studies have found that patients are becoming more informed than ever, whether it’s through symptom searching on Google or accessing an ECG reading through their Apple Watch. And that’s changing the culture of medicine.
When patients are armed with their own health data, the relationship with their doctor becomes less paternalistic. They’re no longer rendered childlike to an authority figure, who provides instructions during an annual visit on the steps they should take to mange their health.
Instead, consumers are turning to discussion forums like PatientsLikeMe, where engaged patients with serious medical conditions discuss their treatments, doctors and other aspects of their care. Some doctors are embracing that trend, as it allows medical experts to be more proactive with patients, helping to keep them healthy rather than just treating them when they get sick.
“The Apple Watch could give doctors a new way to communicate with their patients,” said Dr. Oliver Aalami, a vascular surgeon and clinical associate professor at Stanford University.
Aalami said patients are more likely to notice if they have a skipped heartbeat or extra heartbeats, which could be problematic but might also be due to stress or too much caffeine. Doctors can help determine if the irregularity is due to possible signs of heart disease, requiring medical intervention, or something like anxiety, which can often be managed through alterations in lifestyle.
Similarly, Dr. Leslie Saxon, division chief for cardiovascular medicine at the University of Southern California, has publicly praised Apple for helping people take control of their health.
The early days of Apple’s ECG are forcing a balancing act between democratizing health data and turning too many patients into untrained MDs. Apple has stressed that its watch is not a diagnostic tool, and that patients should seek health advice from their doctor.
One fear among many physicians is that patients with data from sophisticated wearable devices will start to demand unnecessary tests and procedures, which can bring health risks and added costs to an already overburdened health-care system.
They also take doctors away from patients who really need their help. Dr. Eric Topol, a cardiologist, recently pointed out that there are even cases when an Apple Watch will accurately detect atrial fibrillation on someone who doesn’t have any troubling symptoms. Such patients may rush to get screened even though there’s no evidence to suggest that they should, Topol said.
Even more troubling are the false negatives, or instances of atrial fibrillation that aren’t picked up by the Apple Watch. With millions of people potentially using the ECG, very small errors can mean thousands of patients getting inaccurate information, prompting them to experience too much anxiety, or not enough.
Dr. David Albert, founder and chief medical officer of heart health technology company AliveCor, expects that artificial intelligence will eventually filter what ends up in the hands of doctors.
AliveCor sells its own ECG device for consumers and is among the emerging companies focused on ensuring that patients get direct access to important health information, but without overburdening their doctors.
The challenge is to avoid submitting an “avalanche of inconsequential data,” Albert said.