Broadcast Retirement Network’s Jeffrey Snyder discusses how doctors can use the data gathered in wearables with CU-Anschutz’s Michael Rosenberg, MD.
Jeffrey Snyder, Broadcast Retirement Network
I’m joining me now with Dr. Michael Rosenberg. He is a cardiologist with CU-Anschutz. Dr. Rosenberg, it’s so great to see you this morning.
Michael Rosenberg, MD, University of Colorado Anschutz
Great to see you, thanks for having me.
Jeffrey Snyder, Broadcast Retirement Network
And we just passed, we were kind of jokingly saying, I was jokingly saying at least, that we just passed Heart Health Month. But really, doctor, it’s March. Every month of the calendar is Heart Health Month.
Michael Rosenberg, MD, University of Colorado Anschutz
Yeah, at least in my world, we tend to spend a lot of time thinking about that.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, heart disease, cardiovascular disease, high cholesterol, that is still the silent killer. It is still the number one disease when you look at the Center for Disease Control, right, doctor?
Michael Rosenberg, MD, University of Colorado Anschutz
Yes, and it’s also, a lot of it is preventable, which is, I think, where most of the motivation comes to try to find ways to improve health and reduce the risk of cardiac disease, for sure.
Jeffrey Snyder, Broadcast Retirement Network
Are there certain populations that, at least in your practice and CU-Hermann Schultz, that you’ve seen maybe that are unexpected in terms of having cardiovascular disease, having challenges with the heart?
Michael Rosenberg, MD, University of Colorado Anschutz
Not so much in my world. I’m a subspecialty of cardiology, so I manage rhythm disorders. So like atrial fibrillation is probably the most common one and relevant to what we’ll talk about is probably the number one reason people come in with wearables or information from outside.
So the majority of them, it’s not surprising because most of them are older and age is the biggest risk factor, but we do see it in younger people and often actually have a diagnostic challenge of whether we believe that what a device told them they had is actually what they have, so.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, and we’re talking this morning about, I guess, not I guess, we’re talking about how some of those devices can be analogous and help you as a practitioner. I’m not wearing a device this morning, but I do have one. I wear it on my wrist fairly regularly.
It tracks my sleep, it tracks my pulse, some of my, I guess, my heart rhythms. How helpful is that to someone like yourself when you’re trying to diagnose atrial fibrillation or some type of heart ailment?
Michael Rosenberg, MD, University of Colorado Anschutz
Sure, I think there’s two parts to it. I think that what I tell a lot of patients, the monitor telling you that you have a rhythm, which is based on kind of a pulse measure, it’s called a PPG monitor, it’s not very accurate. And the companies don’t claim it to be diagnostic in nature.
It could be suggestive, but I tell a lot of people, if your watch is telling you something, you should be skeptical, especially if you feel normal. Where we use them very effectively, I think, is the flip side where someone’s having symptoms and it’s tough to capture. Certainly in the electrical world, we need to get an EKG or some kind of electrical signal of what’s happening with the heart electrically to see if what they’re feeling is actually an arrhythmia.
And that’s where watches that can actually produce the signal. And in fact, there’s wearables and there’s also just at-home kind of EKG devices. And those can be extremely useful, and in particular for people that don’t have symptoms that often.
And so, there’s patches and there’s even implanted devices you can use to detect these, but it’s been kind of a game changer in terms of being able to make these diagnoses without a huge invasive burden. And there, I have been surprised. In fact, we’ve had people where we thought they had some condition and then they finally got a signal from their watch and it’s something totally different.
But there, it’s not the watch telling us, it’s them getting the signal from that and then we can look at it in the clinic and make a diagnosis.
Jeffrey Snyder, Broadcast Retirement Network
Do they bring like a trunk load of data or do you access to it? I’m just curious. I mean, how do you, that’s a lot to parse through, even if you have some type of artificial intelligence tool.
Obviously, you’re trained as a physician to look at these things, but I would imagine that some patients can be kind of overboard and be like, I have 50 spreadsheets filled with data over the last 365 days.
Michael Rosenberg, MD, University of Colorado Anschutz
There are those patients, yes, who want to share. Those patients didn’t need wearables for that. They often would come in before with their home blood pressure measurements and everything and want you to look at their charts and things.
But yeah, most of the new devices now are pretty user-friendly in that sense. They can get a report that’s a PDF that they, there’s a lot of, even people I wouldn’t have necessarily thought of as incredibly tech savvy can come in with something on their phone that showed what their heart was doing when they had the symptoms. We actually have a system in our healthcare system where we can actually, they can transmit through the electronic health record to us and then we can view them.
So if they’re home, they send us a message with a picture of what the heart was doing as recorded by the device and then we can see. So yeah, it can be extremely helpful, but yeah, that’s not the reams of information or, and certainly a lot of the, I would call it entertainment-based commercial sort of stress monitors and all the, a lot of that type of data is not super useful, even though people do sometimes bring it in.
Jeffrey Snyder, Broadcast Retirement Network
But I think what it’s done is it creates a lot of awareness. And so maybe someone who is younger, I always think about, yes, older people like myself probably start to get a breakdown in some of their cardiovascular system over time, but the younger folks that are wearing the watches, the wearables, they’re in tune with it. And it actually could help with future cases or preventing future cases of cardiovascular disease, I would imagine.
Michael Rosenberg, MD, University of Colorado Anschutz
Yeah, I think so. I think it’s the way I would kind of equate for a lot of those patients, it’s sort of like if you have a diet log where you have to start writing down what you eat and once someone’s doing that, they’re just more likely to eat more healthy because they have to write down and see what they’re eating. And so in the same way, if you have a activity monitor that’s showing you how active you were during the week, you’re more likely to wanna have higher steps.
And so I do think it can be motivational, not for everyone. I mean, in some people it can add stress in particular if it’s telling them things that we don’t think they actually have. But certainly, yeah, as a way to just raise general health awareness, I do think it could be very valuable in that regard.
Jeffrey Snyder, Broadcast Retirement Network
And these devices, I guess, are about, the Apple Watch in particular is probably about 10 years old-ish. We’ve made great technology progress. I would imagine, you know, you’ve probably talked to a lot of technology folks.
I mean, there’s an infusion between technology and medicine. We’re gonna see even better smart wearables over time. I mean, we’re probably just at the very cusp of where this will eventually go.
Michael Rosenberg, MD, University of Colorado Anschutz
I think so. There’s some interesting dynamics there that I think are challenging. The main one being what’s considered medical grade versus sort of just commercial, you know, entertainment we think of.
So the Apple Watch, you know, in a way it’s not medical grade. You can’t prescribe an Apple Watch to make a diagnosis the way there are monitors where you actually can do that. That space is being narrowed.
I do think, I mean, I’ve done 10 plus years of research on wearables, and I will say that the motivation for me has always been, you know, if you think about how do we find out that blood pressure was important for heart disease, it’s because people could come into the clinic and you could measure their blood pressure. But I always said that you’re getting a sample of like one day out of a year of this measure, whereas if you had a way to collect information about what they’re doing, you know, on day-to-day basis, you probably could find a lot more factors that can predict heart disease, and that can be modifiable as well.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, well, certainly I think it’s great. Obviously it’s not physician grade or medical grade, but, you know, I think hopefully we’ll get there. Maybe there’ll be at some point implants where, you know, you just stick it into your body or the doctor sticks it into your body and, you know, you’re reading data 24 hours a day, seven days a week.
I guess we’ll have to, that’s maybe a little, maybe some privacy issues there.
Michael Rosenberg, MD, University of Colorado Anschutz
But then- We have those already. It’s just, it turns out, and again, I actually thought that people might want that because, you know, there’s a monitor you can plant under your skin that records your heart continuously. In my mind, it would have been nice because then you don’t have to charge it the way you do your watch every night and stuff like that.
It turns out people are super excited about implanting things in their body if they don’t need to. So, but potentially for sure, yeah.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, well, it’s certainly exciting and it helps people like you make the best clinical medical decisions on behalf of patients. Doctor, we really appreciate you joining us. Thanks for all the great research you’re doing.
Thanks for joining us. And we look forward to having you back on the program again very soon, sir.
Michael Rosenberg, MD, University of Colorado Anschutz
Yeah, absolutely. Thanks for talking.