Should Everyone Be Monitoring Their Health?

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My sense is that there will always be a few people who are intensely interested in those things, my sense is it's not a huge portion of the population and not likely to get a lot bigger. I maybe completely wrong about this, but my sense actually is that a lot of people in healthcare and particularly healthcare IT, overestimate the extent to which patients want to constantly monitor their health.

My patients all have HIV. I don't want them checking their CD4 count everyday or even every week, it's not relevant, it's not helpful, they have lives to get on with. So the notion that even people with chronic disease would be obsessed with their sugar levels or it doesn't strike me as particularly feasible or even desirable.

So for a healthy 26 year old triathlete marathoner to want to monitor their heart rate 10 hours a day, that's your hobby? That's fine. My sense is we now have all this new tools and we haven't yet figured out how to use them in ways that are useful and practical, so this strikes me as an interesting thing for some people, we're still struggling to try to figure out just how much how accurately do we need to know your blood pressure, how many times a day do we need to know it.

There's an interesting object lesson here in so called tight control of diabetes and several years ago researchers thought, boy, if we could measure your sugar levels not once a week or once a day, but constantly and give you insulin constantly to keep it in this narrow range so called tight control, boy, you'd do a lot better.

So we did the experiment and it didn't do better in fact they died sooner. So it's an interesting reminder that just because we can do something doesn't necessarily mean that we should do something, and we now have all this wonderful new tools and technology and in health care as frankly in so many other areas, we sometimes have to rattle around for a while to figure out not just what you can do but what you should do or what you want to do that can be useful, and it strikes me that our increasing capacity do real time constant physiological monitoring, is in that category of [UNKNOWN] thing to do now.

Where would it really be useful to go that far.