tag:blogger.com,1999:blog-18943510.post9116790784798604597..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: When Patients Can Obtain Their Own EKGDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger39125tag:blogger.com,1999:blog-18943510.post-23561645393635983122013-08-06T17:33:18.965-05:002013-08-06T17:33:18.965-05:00I use a medical device every day that records data...I use a medical device every day that records data and has a modem that a Dr can dial into to get the data. It also stores the information to an SD card which gives me and others access to the information. This device is used not only by me, but by millions of others with the same medical problem... Sleep Apnea. To me, this EKG device is no different from my CPAP... it's just used for Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-45327614179499747902013-02-21T06:46:37.651-06:002013-02-21T06:46:37.651-06:00in my experience, the patients who would buy this ...in my experience, the patients who would buy this device are the same ones that could learn to palpate their pulse and determine whether they are in atrial fibrillation or NSR. If those are the only things on the differential list, this is an expensive tool.<br /><br />However, there seem to be potential uses for as yet unidentified rhythms that are extremely sporadic in nature. <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-50537683242719768872013-02-21T01:42:17.587-06:002013-02-21T01:42:17.587-06:00Is it going to help establish a diagnosis every no...Is it going to help establish a diagnosis every now and then? probably<br /><br />Is there a risk in the way the information will be used? maybe, maybe not... <br /><br />If a patient wants to know what their rhythm is by all means... but if they call me about it... I may set an appointment to go over the data set or require compensation for my time and liability when providing a diagnosis and Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-29461697275430350012013-02-16T19:28:37.632-06:002013-02-16T19:28:37.632-06:00I am in no way a heart patient or do I profess to ...I am in no way a heart patient or do I profess to have much knowledge of EKG's but as someone who has been in the healthcare field, I believe that this could be a highly beneficial product for alot of people who have abnormal rhythms. I personally think that if properly trained there are many people that would be able to tell when something is "out of whack." Of course every doctor Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-47103922062609123682013-02-16T17:03:58.692-06:002013-02-16T17:03:58.692-06:00I have several patients for whom this would be ver...I have several patients for whom this would be very useful. They have paroxysmal a fib but often can't tell if they are in fib and want confirmation. We sometimes try to figure it out using techniques like walking up and down stairs or other things, but mostly they come into the office. This little device will save them and me a lot of time and trouble. For select patients, it will be Ethan Weissnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-9031852234887107262013-02-16T16:13:04.751-06:002013-02-16T16:13:04.751-06:00As a patient, I appreciate this blog. Dr. Wes hig...As a patient, I appreciate this blog. Dr. Wes highlights many of the problems wrecking havoc in the current state of our healthcare system. To cover costs, doctors must be able to bill for time spent, however, I think this will be changed in the near future, whether doctors or patients like it.<br /><br />This article explains what is happening and some of the whys. http://www.medscape.com/Bob Fentonhttps://www.blogger.com/profile/12273528282720201489noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-1475314851122753502013-02-16T11:03:56.630-06:002013-02-16T11:03:56.630-06:00Dr. Dave Albert,
No prescription for your device....Dr. Dave Albert,<br /><br />No prescription for your device. No tie to any healthcare provider to allow you to secure automatic medicare or insurance cash-ola. <br /><br />Don't want to see your ads on TV about how "At little or no cost to you the patient, you too can monitor your heart at home, on vacation, anywhere! Our representatives will speak with your doctor and help insure that Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-25110099207352944712013-02-16T07:12:17.710-06:002013-02-16T07:12:17.710-06:00Dr. Wes,
The fact is, not all patients, far from ...Dr. Wes,<br /><br />The fact is, not all patients, far from it, have the ability to read & understand an EKG. But, so what? <br /><br />We had the same argument 17 years ago (!) when the NCI decided to make the PDQ statements for health professionals Open Access to all, including patients & caregivers. For years after that, I heard MDs complaining this was very dangerous or even that it Gilles Frydmannoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-4134048115481623572013-02-16T06:37:09.797-06:002013-02-16T06:37:09.797-06:00Anon is missing the point that a patient doesn'...Anon is missing the point that a patient doesn't have to be able to recognize ALL abnormal rhythms in order to help himself - only his OWN rhythm. In addition to his bad attitude already described by others. As a doc who has had episodes of abnormal heart rhythm since my 20's (like others, never captured on EKG), I can assure anon that those of us with the problem - NOT the entire patientbeverlyhttps://www.blogger.com/profile/13640602293864876951noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-60034654318021412502013-02-16T04:31:26.271-06:002013-02-16T04:31:26.271-06:00Wes
It sounds like Alivecor's disruptive EKG(...Wes<br /><br />It sounds like Alivecor's disruptive EKG(like much of technology in health care) real value might be to highlight flaws and opportunities in the existing medical system. <br /><br />For example<br /><br />1) PAYMENT MODELS FLAWED - A need to move to a medical home model (vs fee for service) so yes the team would be expected to respond to a patient's need for information in Anonymoushttps://www.blogger.com/profile/15643051324986386022noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-6108315064744375342013-02-16T04:11:41.824-06:002013-02-16T04:11:41.824-06:00The real world and how patients are already using ...The real world and how patients are already using tools like this. It is no different than a BP cuff, thermometer or diabetics who test at home. (I know please don't tell the FDA we aren't dogs and can figure out tools like this) <br /><br />I bought the Vet version of this last summer for a friends dog at the fire dept. Although it isn't approved for humans I of course tried it out Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-56479618349263833962013-02-15T12:29:36.923-06:002013-02-15T12:29:36.923-06:00Dr. Dave Albert:
First, thanks Wes for a great po...Dr. Dave Albert:<br /><br />First, thanks Wes for a great post that brought out real issues to consider. A prescribing physician will be responsible for the results so that is a real concern and being overwhelmed is also a concern.<br /><br />This is a first generation solution and I can assure everyone that it will evolve and improve but you have to start somewhere. We have conducted many David Albertnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-88802181735946691382013-02-15T07:48:57.319-06:002013-02-15T07:48:57.319-06:00Wes
You really got things stirred up, which is goo...Wes<br />You really got things stirred up, which is good<br />I could not agree more with and applaud the comments of Hugo Campos and Peggy Zuckerman aboveAnonymoushttps://www.blogger.com/profile/06567461441174228944noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-83494270930209221462013-02-15T07:40:54.946-06:002013-02-15T07:40:54.946-06:00If patients need permission from a doctor to recor...If patients need permission from a doctor to record data from their heart, it seems a small step to needing a prescription to record one's blood sugars, peak flows, daily calorie intake. Perhaps one should need a prescription to have a scale or thermometer at home? After all, the patient might not know how to interpret the results or might get upset.<br /><br />The idea that it is acceptablepheskihttps://www.blogger.com/profile/16102200723940843059noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-33553288799402818822013-02-15T01:34:28.478-06:002013-02-15T01:34:28.478-06:00A doctor has to write a prescription for many med...A doctor has to write a prescription for many medical items and certainly not in this country are they then responsible for say that of a PEG tube, the incorrect use, any obstruction etc etc.so I cant see why for an ECG/EKG monitor. same as the diabetics BGL meter!<br /> What I do know is that if a patient is able to see, doesnt have to understand, what electrical blips are occurring, and they Brendanoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-90199044666120834152013-02-14T23:04:03.291-06:002013-02-14T23:04:03.291-06:00I agree Dr. Wes's blog is neither absurd nor a...I agree Dr. Wes's blog is neither absurd nor a rant; it's simply reality that physicians have to face up to.<br /><br />At the same time, there are two contexts in which one might view a device like this (and others, like Scanadu). <br /><br />Firstly, it represents low cost care that has to be instituted into the mainstream of medicine. For too long have we been given this innovation Jayhttps://www.blogger.com/profile/01528282583935791466noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-47840646426042272132013-02-14T22:08:03.761-06:002013-02-14T22:08:03.761-06:00Dear paternalistic doctors and other medical perso...Dear paternalistic doctors and other medical personnel who believe that giving me access to my data is dangerous,<br /><br />You want all the control? Then be prepared to take every. single. ounce. of blame. <br /><br />Signed,<br /><br />A Heart Patient who learned to read ECGs after her cardiologist repeatedly and erroneously insisted her ECG was "normal."<br /><br /><br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-11381594106067207672013-02-14T21:13:59.247-06:002013-02-14T21:13:59.247-06:00@6:29 - all I can offer is an example in my own ca...@6:29 - all I can offer is an example in my own case. <br /><br />In my case, the arrhythmia was infrequent and short-lived. It wasn't possible to get a diagnosis via traditional channels. <br /><br />I tried - multiple times. $5,000 out of pocket later, I've had event monitors, holters, shown up at both the ER and an urgent clinic with an arrhythmia and had it convert while they triedAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-23705726402438940712013-02-14T20:06:16.413-06:002013-02-14T20:06:16.413-06:00Prescriptions should be reserved for some therapeu...Prescriptions should be reserved for some therapeutics. I can't think of any examples where restricting access to diagnostics has proved to be reasonable in the long-term. It took some years but home HIV testing is now available.<br /><br />When it comes to diagnostics, I would argue that the default is open access unless one can _prove_ that harm has occurred.<br /><br />The Internet will Adrian Gropperhttps://www.blogger.com/profile/14435645301228523460noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-10151426850095237292013-02-14T20:04:09.587-06:002013-02-14T20:04:09.587-06:00Wes,
I think the trickiest part of this is the br...Wes,<br /><br />I think the trickiest part of this is the broad scope of any patient population. No doubt there is a tremendous range of health literacy levels who you see in your practice - some of whom you might be perfectly comfortable prescribing the device for.<br /><br />The separation between the tele-reader and the person with no healthcare literacy is simply education.<br /><br />The HRCFShttps://www.blogger.com/profile/11622154166582114272noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-89426420991935926172013-02-14T19:54:40.523-06:002013-02-14T19:54:40.523-06:00The underlying issue here is not how difficult it ...The underlying issue here is not how difficult it might be correctly interpret an EKG, but that the information derived from the patient belongs to the patient. The patient can then decide how to utilize that information, requesting help from his cardiologist, or the neighbor lady. The reality is that the consumer/patient can truly access his radiology images, get those reports, which are peggyzuckermanhttp://www.peggyrcc.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-34735988757131846982013-02-14T18:29:42.883-06:002013-02-14T18:29:42.883-06:00Hugo,
The point I am making is 1. How is a untra...Hugo, <br /><br />The point I am making is 1. How is a untrained person who cannot make an informed decision based on lack of clinical training or experience going to benefit from looking at their own EKG?<br /><br />2. How are you going to treat a rhythm you know nothing about? For example. Most people who have a new onset of a-fib have a-fib with rvr. What is more concerning the decrease in Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-35863842170673508602013-02-14T18:04:38.089-06:002013-02-14T18:04:38.089-06:00How dare you not give away your services for free!...How dare you not give away your services for free! You are not a lawyer. Being a doctor is a calling. Physicians demanding payment is an outrage. Real physicians would not accept payment knowing that the gratification of caring for their patients is payment enough.<br /><br />Who cares that neutering a dog pays a veterinarian more than a cardiologist earns with a cardiac cath. <br /><br />AllAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-44984420253406181722013-02-14T16:57:53.804-06:002013-02-14T16:57:53.804-06:00Will,
Ah... the excuse that patients can't ha...Will,<br /><br />Ah... the excuse that patients can't handle information always creeps up sooner or later. <br /><br />I suppose you're making two points: (1) That sometimes it's best to know absolutely nothing about something rather than knowing a little about it; and (2) That it's pointless to be aware of a problem you can't fix. Neither are valid arguments, and I'll Hugo Camposhttps://twitter.com/hugoocnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-88859094226515953702013-02-14T15:36:05.452-06:002013-02-14T15:36:05.452-06:00Not sure how this would be any different than the ...Not sure how this would be any different than the advent of home blood pressure, SpO2, or EtCO2 availability.<br /><br />If anything companies could make some big money, have a bunch of MD's/CRT's on staff: "You send your tracings to our service, we'll read them, and send you back an interp and some key tracings to bring to your doctor for $X."Christopherhttps://www.blogger.com/profile/11415988855392944633noreply@blogger.com