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Yeah, it's good at spotting issues... but man, health monitoring creeps me out. I don't want to live in a world where insurance companies and employers force us to hand over this data. Just feels really creepy to me. Like way over the line.
You just invented this situation in your head. No one is handing over health data to insurance companies or employers.
If you're an engineer or payer relations expert and you'd like to help build the future of healthcare, definitely drop us a line! hello@cardiogr.am. We're especially looking for Javascript engineers, Android engineers, and salespeople with payer experience.
When ECG in Canada?
Seems Apple is having problems getting the ECG feature approved outside the US. I've heard nothing for a few months from the EU about this passing over this side of the pond.
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It's entirely possible that a test which was net positive when applied "with probable cause", can even become a net negative if applied without. Because testing the whole population will produce many more false positives. I doubt the tests they are running here will actually go that far. But pervasive testing does need different trade-offs to targeted testing. At least we may have more complete data from which to und…
> Because testing the whole population will produce many more false positives. That is the issue that should get resolved with time. The watch will receive a lot of feedback from medical professionals to adjust its reporting because now we'll know so much more about what symptoms are really worth paying attention. But of course, there will be an adjustment period like what we are seeing now. This has always been true…
So, for a heart monitor, you'd only have the test run if you had another symptom, such as shortness of breath, an irregular heart beat, etc... Otherwise, you will end up with many more false positives, which can be dangerous in and of itself. What if someone who legitimately has a heart condition had an Apple watch and ran the test. But what if that person then ignored the watch because all of their friends tried the same thing, and went to the doctor only to find out it wasn't anything to worry about. Their false positives could have a real impact on someone who had a true positive result.
The more you test, the more you'll find. Now, it's perfectly possible that many of the subjects in this study bought the watch specifically because they suspected that they had a heart condition. In which case, the study pool could be skewed away from the general population.
There is no way to adjust for this. The more people you screen, the more you'll find. Whether or not it's a true positive or false positive is another question. And I'd argue that Apple would need to skew their reporting towards removing false negatives instead of removing false positives, just from a liability point of view. You're much more likely to see Apple sued over this than a typical medical device manufacturer.
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Given the choice between A) Everyone is told nothing. B) 5% of people are told “Here’s something. It’s serious.” And, 45% of people are told “Here’s something. But, it’s not serious.” Option B sounds greatly preferable.
Depends... does "Here’s something. But, it’s not serious" take expensive, risky, and invasive medical tests to get to the "not serious" part?
And then, if you knew that 45% of people got a false positive, how likely is the 5% (the true positives who really need it) going to believe their initial result and even get the followup?
Yeah, it's good at spotting issues... but man, health monitoring creeps me out. I don't want to live in a world where insurance companies and employers force us to hand over this data. Just feels really creepy to me. Like way over the line.
I don't want to live in a world where insurance companies or employers have any need or incentive to have this data. Like most developed nations outside the U.S. for example.
You want a specific medication, or a non-generic medication in Australia? Too bad. It's not that it costs more, you just can't get it. Things like Wellbutrin are as illegal as crack. And if you do something like tell your doctor that you tried a bunch of medications and Vyvanse is what works best... they'll literally treat you like someone trying to score opiates. They don't like it when you have an opinion on medications, and you get all sorts of lectures about how bad drug advertising is. It's a very dated, "I'm the doctor, you have to do what I say..." mentality.
And the wait times... "Oh, did you need back surgery? Because you're under 65 and you are over weight, that means you're now bottom on the list... and you'll have to wait for 1-2 years to have this done." A co-worker of mine here is a larger woman, but she just paid out of pocket rather than go on a 2-year wait list. Oh, and the recovery room... there were like 4 people crammed in one room sharing one bathroom. Doctors came in and were talking about care and medical details, in front of total strangers and her visiting guests. No privacy at all. The government would absolutely use health / fitness data to prioritize care... it's not that everyone gets unlimited treatment, they still have budgets.
What else? Remember those classes in college where you couldn't understand the professor because he had such a thick accent? Yeah, that's pretty much every doctor here now. You go to the ER and you need stitches, you end up waiting for a few hours and when you're finally seen the doctor is like, "Why weren't you escalated faster?" "I couldn't understand what your triage nurse was saying, she doesn't speak English... and I haven't got a clue if she understood me... she just told me to sit and wait..." My friend needed 14 stitches and waited over 3 hours in the ER holding a bloody towel on her hand. Only got someone to do something when she started dripping blood on the floor after it had soaked through the towel.
Anyway I know health care sucks in the US, and I do want to get to a point where governments pick up the bill... but holy hell, if the choices at present are what we have in the US or what they have in Australia... man, they both really suck. If you're someone with a job, and with any money, the US model works slightly better.
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Nothing specific to this article, but this comes up often in medicine. Sure, you can pay to run more tests, find some things earlier (along with some false positives), but the outcomes and treatment aren't any different than if you waited for more obvious symptoms and could take a more accurate test.
What? An ounce of prevention and a pound of cure and all that. Early detection is key in a lot of situations, so how could earlier not be better? Why wait unnecessarily?
By all means, don't ignore symptoms! Just don't go looking for them.
Like with any medical test: if you do more tests you will find more incidence. The same thing happened with various forms of cancer screening. If we were to test everybody for everything very few people would be found to be 100% and a lot of unnecessary procedures would be the result. Given the obesity problem this result should not be a surprising finding anyway.
My Apple Watch was a few hundred bucks. My latest ER visit for tachycardia (idle heart rate over 100) came to over $3000, with health insurance. And all they did was tests.
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I don’t think so. HIPAA defines the “covered entities” — e.g. hospitals, health plans — that must follow its regulations. Being a company that handles health data does not automatically make you a covered entity. https://www.hhs.gov/hipaa/for-professionals/faq/190/who-must...
This isn't 100% accurate. While I can't say much about the case of the apple watch, I can say that there are a ton of tech companies which are not covered entities but which do fall under HIPAA guidelines. For example, the company I work at is not a covered entity because we do have access to PHI we have certain regulations we have to follow. Further, we have to sign BAAs with any covered entity we work with defining…
For example, what is Apple's exposure here? I doubt any... they keep your data private because it's good for business (and they can then advertise how privacy conscience they are and get people to buy more watches). They aren't doing it because they have to follow HIPAA regulations.
A more interesting question is -- if the Apple watch was purchased as a medical device (maybe even with insurance or a prescription), does Apple's data processing need to change at all? What about if people got a watch as part of a medical study (not people that already had the watch). Would that be different?
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I'm more concerned with the data being sold/ leaked and it impacting insurance premiums.
When has Apple ever sold or leaked data to third parties ?
I'm not stating that this has happened, but yeah, I worry.