Monday, February 11, 2008

Gadgets and Disease Management, Part 2

Just imagine for a minute a glucose meter "bluetoothed" to a cell phone with text communication linked to a disease management program:

DMNurse51 (12:25:14 PM): hey Auto response from

Kris101(12:25:14 PM): hold on...brb

DMNurse (12:25:25 PM): ok

DMNurse(12:25:35 PM): in cafeteria?

Kris101(12:31:51 PM): WU?

DMNurse51 (12:32:13 PM): did u check u’r noon glucose?

Kris101 (12:32:17 PM): lol no forgot

Kris101(12:32:26 PM): can check b4 1

DMNurse (12:33:39 PM): ‘k. I’ll call mom & let her kno.

I recognize there are HIPAA issues, getting informed consent from an adolescent to participate in something like this isn't easy and that there's malpractice risk. None are insurmountable.

I confess to not authoring a "I'll notify your doctor" in the scenario above, but a) I don't think most docs have the resources to respond to one missed blood glucose meter check and b) wouldn't mind "outsourcing" tasks like this and c) are very supportive of "systems of care" that handle inevitable minor mishaps.

Note that DM Nurse51 could be located the physician's office, out of state or across the globe in India. Note that the nurse was alerted by an ABSENCE of a blood glucose reading.

Idealistic yes. Unrealistic not at all, particularly because glucose meters enabled with bluetooth are already out there. Interactive data bases linked to decision support algorithms are already at hand. There are nurses armed with protocols that know what to do and how to do it.

In the opinion of the disease management blog, medical device manufacturers are perfectly positioned to tie it all together and it's just a matter of time until market forces make it happen so that it becomes a standard of care. What mom wouldn't pay to have this kind of support for their insulin requiring diabetic child?

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