I originally shared this as an update on Linkedin and it generated some interesting discussion but as discovery and retention of content on Linkedin is a bit hit and miss since Microsoft acquired the company in June, I thought it might be worth cutting and pasting the comments thread in a blog post for posterity and to share with those who don’t use Linkedin:
Joel Selanikio: And this is just getting started.
David Doherty: oh yes but the fear of becoming little more than an iPhone accessory brand is real even in the boards of the biggest global Medical Imaging firms:
Johan Goris: think again https://theskepticalcardiologist.com/2017/02/15/sustained-atrial-fibrillation-or-not-the-vagaries-and-inaccuracies-of-alivecorkardia-and-computer-interpretation-of-ecg-rhythm/ also
David Doherty: Think again? There’s nothing stopping Kaiser Permanente San Diego having their own Cardiologists reading the ECGs that their own Patients record/share. You know you don’t have to use Alivecors read services?
Johan Goris:It was a generalistic reply on a generalistic statement.
Johan Goris: not to mention the many “put your finger on the camera” Afib detection apps. PPG based Afib actualy only sustainable for follow-up of AFib diagnosed patients, not for screening and only when clinically validated …
David Doherty: I think you know it’s unfair to compare either the medicomp or alivecor to these unreliable apps that lack evidence of their effectiveness despite the claims. Perhaps you’re inventing a problem that doesn’t exist in the hope that we’ll stay distracted and keep the life support going for the broken medical device sales model in which the Patient never knows the price and never has a choice. The real threat isn’t cookie cutter me too apps that promise a lot and offer very little but it is that medical device companies need to turn around their business model if they’re going to survive being redesigned by mHealth. The question we should be trying to answer is how would the Born Mobile Generation sell that medical device? https://mhealthinsight.com/2015/09/22/bornmobile/
Johan Goris: Just like it’s unfair to compare validated ECG machines offering extended arrithmia detection with Kardia from Alivecor… The link you included refers a.o. to the Aura Activity Monitoring Ring ( I guess they mean the OURA ring) … clearly an unvalidated device for sleep monitoring, as they themselves conclude in their pre-compliance study : https://support.ouraring.com/helpdesk/attachments/6027900621 … “the variability in individual accuracy in some parameters informed the ŌURA team of clear opportunities for improvements” There is no technological chicken & egg situation with mobile biomonitoring, it’s the just the chicken often reluctant to deliver the real egg (not just empty shell). Some mHealth devices manufacturers (± 15% in my +3000 # database) do perform and will probably make it, if only they keep their claims realistic. Its a funding/adoption chicken & egg situation suffering from hyperbolic inflation/distrust from people with skin in the game.
Johan Goris: But I disagree … the system is not broken … it was built this way … and needs a restore (but not without a clever backup)
Denis Khitrov: Surely it’s still a sign of changes. RPM and personal health tracking solutions bringing a lot of disruption and gives more freedom to the end users. A lot of shifts will happen in direction to simplier consumer devices, because regular dynamic changes monitoring may be more valuable than precision of measurement. But that would hardly replace “what doctor is prescribing”
Emmanuele Angione: “90% of strokes can be prevented” is a big – BIG statement. Where will clinical liability fall if things go wrong for the patient? On the patient using that device? On the clinician interpreting the data from that device? On the developer of the algorithm? On the ISP?
Alivecor is also doing great work to support researchers (including colleagues of mine using their tech in leading European Medical Institutions) and publish evidence on their technology:
Also check out this brilliant interview with Alivecor’s CEO Vic Gundotra to get a feel for how the tech is enable machine learning that is transforming how we practice medicine:
Seamus Flood: Promotes owning your health not leaving to the medical professionals to wave magic wands