An average-looking chap in a suit in hotel lobby takes out his phone and makes a call. “Hi. You ok?" he asks. “ I got a notification that you’re at 60."
Something that might sound vague or bizarre to many - what does "at 60" mean? - had a profound and immediate meaning to me. Many of my relatives are diabetic - it seems to be part of our heritage - and I knew immediately this person was talking to someone who was going into ‘insulin shock’ - their blood glucose level was dropping to dangerously low levels. Drop too low, and you go into coma while your brain, starved of food, dies.
“Yeah, I got notified your blood sugar is dropping - yeah I know you’re in Florida, but that device sent me a message. It’s great." A pause. “So you didn’t even know? You didn’t feel anything? Well, you would have." Another pause. “No, it’s ok. Just go have a Starburst or three." (Those tiny sugar bombs quickly raise blood glucose, and are a go-to pocket medicine for many diabetics.)
As I overheard this half of a conversation, everything I’d learned from my relatives about diabetes management became something entirely new. Diabetes requires a lot of management: constant finger pricks, blood glucose measurements, injections, and the eternal vigilance of a low GI diet. It never ends. That’s always been the responsibility of the person with diabetes, because it hasn’t been possible to share that burden.
Now, it appears, "connected" blood glucose monitors - possibly part of an implanted insulin pump - squirt their measurements into the cloud then send alerts to anyone who needs to know when a diabetic might potentially be having a problem managing their condition.
That’s a great thing. You hear occasional stories about diabetics who suddenly pass out in public, because their blood sugar dropped without any warning. A connected monitor is the kind of tool that could prevent this from happening much of the time. Beyond averting disasters, it likely helps the diabetic maintain a more consistent blood glucose level - the key to long-term management of diabetes.
It won’t end there. Some of those fitness monitors people sport these days can be used to detect irregular heartbeats - precursors to more serious cardiac issues. Blood pressure? Yeah we can do that, too, together with a growing range of other measurements of other symptoms for other illnesses and chronic conditions that require management. Blood-oxygen metres are becoming mainstream mainstream.
We’re draping ourselves with devices. The next logical step is to share that data as broadly as is reasonable.
While we can and should worry about the security and integrity of such connected health systems, we should also adopt them as rapidly as possible, because they offer us a chance to offer our help to those we care for, wherever we are.
We’re only at the beginning of understanding how to do that, but it’s interesting that Estonia is experimenting with the use of public-key cryptography - giving each Estonian a public/private key pair - to allow an individual’s medical data to be freely shared - in encrypted form. Until the patient grants a cryptographic release to a medical provider, the data remains locked up - but it’s already at the hospital, emergency room, and doctor’s office.
It’s quite reasonable to assume that the last seven days of someone’s cardiac data, or blood glucose levels, or blood pressure, would be similarly encrypted, uploaded, and made available on a continuing or emergency basis to anyone with the right credentials.
We’re seeing a lot of proposals to create centralised medical data systems - honeypots for hackers who know that you can change your credit card, but you can’t change your biology. We need to start to avoid centralised anything when it comes to IT: bigger targets suffer bigger attacks.
When your Apple Watch tells your cardiologist that they really should make some time for you in today’s schedule, and your autonomous vehicle drops you at the door just in time to be ushered inside the examination room for a check-up, we’ll have a medical system that has moved to real-time - and we’ll nip many problems in the bud, before they become life threatening.
Over a decade ago, a study in the Australian state of Tasmania showed that one quick daily phone call with a nurse could keep sufferers of COPD (end-stage emphysema) out of the hospital much of the time - saving huge amounts of money, and improving quality of life. That simple bit of connectivity - a phone call! - yielded amazing results.
Now that we’ve got all sorts of sensors and systems and everyone’s walking around with a supercomputer in their pocket, we can completely rewrite how we deal with illness, even develop new ways to help us ‘lean into’ wellness. It’s early days, but that father in that lobby of that hotel proved we’re already well on the way.
Back to that conversation I overheard, which ended like this.
“We’re all in this together," said the businessman to his son. “You, me, your mom. We’re all here for you. Go team." ®