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    Digital ob/gyn: The big healthcare disappointment of 2016

    Dr Levine is Practice Director, CCRM New York, and Attending Physician, Lenox Hill Hopsital, New York. He has no conflicts of interest to report in respect to the content of this article.


    Typing the word “wearable” into Amazon returns information on more than 600,000 products, ranging from activity trackers, to fitness trackers, to smart clips, to arm- and wristbands, to smart watches. FitBit, Jawbone, Misfit, Garmin, and Apple Watch are just a few of the names associated with these devices. Regardless of the manufacturer or the form, all of these devices have the same general idea; they passively monitor daily activity and the data aggregated are streamed via a hardwire connection or Bluetooth and accessed through a mobile application or web-based portal. Since the advent of wearable devices, the products have gotten significantly smaller and lighter and are jam-packed with (sometimes) highly accurate sensors.

    The missing capability

    As these devices have increased in popularity, discussions about prescribing exercise have become much easier. But one capability is still missing: collection, compilation, and streaming of data in a meaningful way directly into a patient’s electronic health record (EHR). While I love seeing a device on my patient’s wrist, I am often at a loss when she is unable to tell me about her data. I have found that patients like knowing that they have walked 10,000 steps in a day, but they rarely can tell me (or show me) their daily step count or their daily weight. Did their weight go down when they increased their steps the preceding month? Some patients use dietary tracking apps such as MyFitnessPal, and I often ask patients about the effects of dietary modifications on their wellness (weight, sleep, energy level, etc). Few can answer. While patients can often show me that they are consuming only 1750 kcals a day, they often can’t show me how that affects their wellbeing. But is it the patient’s job to do that, or mine as her doctor?

    Apple took a huge step forward by creating the Health app, which is an easy-to-read dashboard of health and fitness data. It can integrate data from multiple sources (ie, wearables and nutrition tracking apps), and display the information concisely in one place. As a physician, though, I think there is something awkward about asking a patient to send me a screenshot of her data. In 2016, it’s realistic to expect that the data should not just flow into a patient’s Health app but also into her own EHR. Unfortunately, that is still not the case.


    NEXT: What's the holdup?

    Brian A. Levine, MD, MS, FACOG
    Dr. Levine is Practice Director at the Colorado Center for Reproductive Medicine, New York, New York.


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