MindBullets 20 Years

CHRONOCONDRIA OVERWHELMS HEALTH SERVICES

Apple Watch sales fill doctors' surgeries with the worried-well

There’s a new disease plaguing the technoscenti, and it’s overloading the doctors. It’s called “smart-watch sickness” or even “Chronocondria.”

Over 200 million people now wear smart-watches packed with sensors measuring everything from pulse-rate, to blood-pressure, to body-temperature. Never in the course of human events have so many people had so much information about themselves.

And they’re responding as people do. In a blind panic.

“It’s madness out there,” says one MD who prefers to remain anonymous. “Most of the people who see me come in complaining of heart murmurs or too-low blood-pressure, or diabetes. And not a single one of them is physically ill.”

Doctors’ patient load is now filled with the worried-well, over-reacting to the unreliable telemetry collected from their devices.

“The danger,” says Professor Joy Lamez of Mount Sinai Hospital, “is that these devices are worn in uncontrolled circumstances. So, even if they are capable of taking accurate readings – which most aren’t – they are not used correctly.”

And the real impact is on the seriously ill, who battle to get appointments.

“We need regulatory help to control these watches,” says one exhausted physician. “One of my elderly patients died at home last week. They found her still clinging to the phone, trying to get an appointment.”


ANALYSIS >> SYNTHESIS: How this scenario came to be

Background
Wearable digital devices have a long and uninspiring history. It isn’t until 2012 that Nike’s Fuelband and Fitbit’s One find a niche in activity tracking for health enthusiasts. These are not real smart-watches but they provide an entry to the market.

In 2013, Pebble becomes the most successful crowd-funded business startup ever when they raise US$ 10.2 million on Kickstarter. Launched in July 2013, the Pebble is the first popular smart-watch.

The big producers are watching and Google is first to respond. In 2014 the US search and media company announces Android Wear, an operating system designed for smart-watches. By the end of the year, a wide range of devices for all price-points from companies like Samsung, Motorola and HTC have hit the market.

The tech world is holding its breath, though. What will Apple do?

In September 2014, Apple makes its move. Announcing their new Apple Watch and a new medical software toolkit called ResearchKit designed to improve healthcare data collection from wearable devices. The Apple Watch will go on sale on 24 April 2015.

April 2015: iWatch therefore iAm
The queue outside Apple’s flagship store in Fifth Avenue, New York, extends all the way down to West 44th Street. Some people have been waiting in line for days.

Rodney Cornwallace is first in line. “I can’t wait,” he grins.

Down the road an altogether different gathering is taking place. An informal conference of America’s leading health insurers is listening to a talk by public health researchers into the opportunities from wearable health-monitoring devices.

“We’re interested,” says Dr Connie Fernandez of Blue Cross, a large insurer. “Wearables mean that we can supplement our actuarial models with real-time health activity data from our members. The interesting thing is that users self-identify, meaning we don’t need to buy this for members or demand that they wear it. We can offer discounts to those who share their tracking data with us.”

Unspoken is the risk to those who won’t track their data, or who are immediately identified as having health concerns.

November 2015: Health wearables have their Hollywood moment
With one full quarter of sales behind them, Apple has sold an astonishing 32 million Apple Watches. The sector as a whole means that almost 87 million people are wearing some form of activity tracker.

In November, James Bond is seen wearing a custom platinum smart-watch in Spectre, the most successful movie in the franchise and actor Daniel Craig’s last outing in the iconic role. Apple paid a record US$ 72 million to be Bond’s wristwatch of choice for the next five movies.

It is worth every cent. “We’ve sold 12 million Watches in China since the movie launch,” says Kim Chen, an Apple China spokesperson.

Google announces a partnership with Nike and Fitbit, while Microsoft leverages their investment in their Health Vault service to provide apps for both platforms. Doctors start receiving patients armed with telemetry data. “I’m not too sure how comfortable I am with this,” says this correspondent’s GP.

June 2016: Doctors experience chronocondria
The first doctors to experience the trend of obsessive worried-well patients sporting wearables are in San Francisco where almost 20% of the population owns such devices.

“My surgery is overwhelmed,” says one doctor in a frantic letter to the public health department. “People who have no business in my surgery are preventing us from getting anywhere near people who need us desperately.”

At an emergency session at the California Association of Public Hospitals and Health Systems, Dwight Engelbert declares: “Our obsession with tracking our health with wearable devices has created a new condition, chronocondria. We’ve given the worried-well an endless stream of telemetry of dubious quality with which to completely block up our health service.”

‘Chronocondria’, ironically, becomes a popular Twitter meme and leads to even more people turning up in emergency rooms.

April 2017: Food and Drug Administration considers regulation
“The danger,” says Professor Joy Lamez of Mount Sinai Hospital, “is that these devices are worn in uncontrolled circumstances. So, even if they are capable of taking accurate readings – which most aren’t – they are not used correctly.”

Professor Lamez is speaking at a special summit arranged by the FDA in Washington to consider a response to healthcare services being overwhelmed. Numerous government agencies are meeting, and observers are attending from the NHS in the UK, Gesetzliche Krankenversicherung in Germany, and France’s Haute Autorité de santé.

“Our problem is that regulating the devices themselves will not solve the problem,” says Dr Hans Gruber, of BSI Medical Devices, a notified body. “The real problem is finding a way that patients can have their telemetry assessed without clogging up care services.”

Microsoft chooses that moment to announce a new product related to their Health Vault. Users can upload their telemetry and receive instant diagnostic results.

It is unclear whether new services like Microsoft’s will help ease the congestion but, in the interim, patients who need care continue to die, as those suffering under the anguish of chronocondria swamp health services.

Warning: Hazardous thinking at work

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