From 3M Health Information Systems
TMI: How Much Is Too Much Information?
We are in the midst of an information explosion in healthcare, which brings more responsibility to healthcare payers, providers, and patients themselves. Providers must be able to help patients distinguish between information that is useful for achieving important healthcare objectives, such as those espoused by the Triple Aim, and what is just noise.
Google recently announced they are developing a wearable device to remotely monitor a person’s heart with a continuous electrocardiogram. Even though the statement from Google is that it will not be marketed as a consumer device and is intended to be prescribed to patients or used for clinical trials, the head of the life sciences team at Google, Andy Conrad went on to say “I envision a day, in 20 or 30 years, where physicians give it to all patients. Prevention means all the time.”
There are two problems with this statement.
First, simply having more information does not necessarily help prevent or treat disease. There are anomalies in our bodies which can be detected through imaging, monitoring, and probing that neither currently nor in the future are destined to have a negative impact on our health. Furthermore, if these anomalies eventually produce symptoms, then treatment at this point can be equally or more beneficial than it would have been if rendered earlier. Treating symptoms, rather than identifying anomalies that may never lead to a problem, reduces the anxiety, potential harm, life disruptions, and disease labeling that comes with too much information.
Second, a distinction must be made between disease prevention and health promotion. The information collected from wearable devices should not simply “raise awareness,” but should also lead to positive actions that improve our well-being. Information that leads to exercise, healthy food choices, stress reduction and quitting smoking will have more value to the general public than the continuous monitoring of a person’s pulse, respiration, blood sugar, or heart activity.
While there may be a place for wearable devices for patients with specific diseases or chronic conditions, there is a tendency for medicine to extend beyond its limitations of benefit. For example, tight glycemic control achieved through monitoring blood glucose and HbA1c had been widely accepted for years as the standard for treating persons with diabetes. However, many studies, including a large study published in the New England Journal of Medicine in 2008 question whether excessively low blood sugar resulting from tight glycemic control may actually harm more patients.
Wearable devices have not yet made it into the mainstream of healthcare. Before accepting the technology of wearable devices into the collection of screening and diagnostic tools, its value to the general population, as well as to specific patient groups should be considered. Even if the cost and inconvenience posed to the patient wearing the device remains low, the potential harm of collecting too much information may incur unnecessary costs, result in unnecessary care, and ultimately, produce unintended harm to the patient.
Steve Delaronde is director of consulting for populations and payment solutions at 3M Health Information Systems.