A year after being diagnosed with atrial fibrillation (a condition in which irregular heartbeats can cause atrial fibrillation), a 70-year old woman returned for another diagnosis: new-onset anxiety due to her smartwatch. The patient began to worry about her smartwatch notifications, even though she didn't have any obvious symptoms. She took 916 ECG recordings via her watch over the course of the year.
Lindsey Rosman is an assistant professor of medicine at the University of North Carolina School of Medicine. She wrote about this case in a paper. This was only one example of the many patterns seen in cardiology clinics. She says that patients with irregular heartbeats, arrhythmias or heart palpitations were bringing in stacks of paper and data from smartwatches.
Smartwatches can be a powerful tool in cardiology. They help doctors to educate patients and provide researchers with big-picture information on health trends. Some patients may find them more harmful than beneficial. Rosman believes wearables can be amazing. Rosman says that wearables can be amazing, but they could also have unintended effects for patients. They may cause and perpetuate anxiety.
They may cause anxiety in some patients, which can be unintended.
Access to health information on-demand is likely to be a major problem. She says it can lead to a pattern of monitoring for pathologic symptoms.
Rosman and her colleagues noticed that patients became upset by seemingly innocuous readings, such as elevated heart rate notifications due to exercise or readings that were inconsistent or inconclusive. These results were misinterpreted and encouraged patients to use the device more often. The 70-year old patient experienced the same thing: her ECG usage increased every time she received a notification.
Doctors may struggle to handle the sheer amount of information patients provide when they are continuously checking their heart rhythm. There is only so much time available for a patient visit and it is not enough to go through many heart rhythm readings. This can cause problems between doctors and patients. Patients may feel they are having a problem but their doctor might not be able to see the need for a change in their treatment. Rosman states that there would be a disconnect between the experiences of patients and their families and what healthcare providers are doing.
This anxiety could be caused by other types of data collected on smartwatches. Rosman suggests that people might become fixated on their breathing rate or blood oxygen levels as a result of the COVID-19 pandemic.
It is not yet clear how many patients may experience this kind of anxiety or what risk factors could make it more common. Rosman is trying to answer these questions. She wants to know how anxiety affects patients' health and quality-of-life, and whether those patterns lead to people seeking unnecessary medical care. This 70-year-old patient is just one example. However, Rosman found that she visited a healthcare provider 12 times in the past year, even though she did not have any symptoms that would warrant a visit.
However, the potential for someone to develop anxiety or have other health issues while wearing a wearable does not diminish their potential benefits. Rosman states that this is an issue doctors, tech companies and other stakeholders need to consider. These groups should collaborate to create better patient education information about how patients should use the device, and how they should interpret it. Information about health data provided by tech companies is often confusing.
Rosman states that we need something more than a fifth-grade reading level. This is typically the target audience for patient education materials. You should have it in many formats, such as an audio form.
She says it is a difficult task but not impossible. If we are going to develop the technology, then we must create the patient information in order for them to understand it and be able to use it effectively.
