Latest Apple Watch to Cure Heart Disease (Yes, That’s the Sarcasm Font)

By this point, I think that most people have seen the big announcement coming out of the Apple event that the Apple Watch 4 now has ECG and other heart monitoring capabilities built in. The watch will notify you if your heart rate is too low and instances of atrial fibrillation that it detects. Plus, all of this is done as an FDA cleared device (some are reporting that Apple got their FDA clearance in 30 days which is crazy fast for a medical device).

The response to this announcement has been quite interesting. Most aren’t surprised that Apple has been moving more and more into healthcare. Plus, there have been a lot of reports that have mistakenly called this the first consumer ECG which it’s not. AliveCor deserves that credit and I recently wrote about another consumer ECG which is just one of many that are coming. However, many are suggesting that the Apple Watch will be the first time that many younger, healthier people will be regularly using an ECG like this. That’s an interesting idea.

As you might have assumed by the title of this post, I think the Apple Watch announcement isn’t much ado about nothing, but it’s also not the announcement of “sliced bread” being invented either. Let’s dive into what this announcement really means for healthcare.

As I mentioned when I wrote about the other consumer ECG, there’s currently somewhat limited value in what can be done with a single lead ECG. So, it’s important to keep this Apple Watch announcement in the right perspective even though I’m sure most consumers won’t understand these details. One person even commented on how Apple created messaging that calls it an “intelligent health guardian” to confuse people while still avoiding liability:

Perception sells and Apple is as good at creating perception as anyone. Will many more people buy an Apple Watch if they perceive it as something that will help them monitor their health better? Definitely. However, there are some other consequences that many doctors are warning about when it comes to this type of tracking hitting the masses.

First up is Dr. Nick van Terheyden who provides a comparative example of why all this “testing” could lead to a lot of incidentloma’s (Nice word I assume he made up to describe false positives in health tests):

A nephrologist at Cricket Health, Carmen A. Peralta, chimed in with this perspective:

The problem with these devices is that it’s not in Apple’s best interest to truly educate a patient on what the device can and can’t do. If a single lead ECG like this was a reliable arbitrator of when to go to the ED or when to not go, then it would be extremely valuable. However, many doctors I’ve talked to are suggesting that a single lead ECG isn’t sufficient for this type of information. So, a false negative or a false positive from the Apple Watch can provide incorrect reassurance or unfortunate anxiety that is dangerous. Who’s going to communicate this information to the unsuspecting Apple Watch buyer? My guess is relatively no one.

Another doctor made this ironic observation when it comes to the false positives the Apple Watch will produce:

You can just imagine the Apple Watch template in an EHR system. I wonder if it will include an Apple Watch education sheet. Maybe the EHR could send that education sheet to their watch instead of the portal. Wishful thinking…I know.

Another doctor made this poignant observation about the announcement:

We could go on for a while about prevention versus diagnosis. However, I don’t think it’s really an either or proposition. Prevention is great, but detection and diagnosis are as well since we can’t prevent everything.

This MD/PhD student summed up where we’re at with these consumer health devices really well:

I agree completely. The Apple Watch is directionally good, but still far away from really making a significant impact on health and/or our healthcare sysetm.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

4 Comments

  • The positive predictive value is actually 45% that means over half the warnings are false positives, so Dr Nick’s statements of 20% is shy by about 30%, and will likely be higher in the young population that will predominantly use the tech. I see the tech aa valuable but how do you use this to the benefit of the patient and the healthcare system is another question. The flaw in the plan IMO is the fact that Apple did not cntract with a third party service to do a manual read and virtual consult via text message, vs pushing the data to the primary care provider and incur a lot of extra cost and waste in the system.

  • Thanks for sharing the added stats Tom. Just illustrates the point even more. You’re right that having it tied to a third party service would have been a much better offering. AliveCor has done this. I don’t think Apple is even going to tie the result back to the primary care provider. I think it will mostly be to the patient. Then, it will be up to the patient to show the PCP.

  • It is much ado about nothing.

    If they happen to detect A-fib in someone under age 50, they should do a blood alcohol test next!

    BTW: the term “incidentaloma” has been around a long time. It refers to unexpected findings on any test done for reasons unrelated to those findings. It is used mainly with regard to unexpected findings on imaging tests such as CT, MRI and ultrasound scans. Nearly all incidentalomas are clinically insignificant. On the other hand, sometimes we find occult tumors that can be cured because they’re found very early.

    Nice job on this commentary!

  • Hank,
    Yes. That is the challenge we face. We’ll have a lot of incidentalomas, but we’ll also have some great stories of early discovery. It’s a challenging thing, but will work itself out over time. That said, I think the clinically relevant findings from the Apple Watch in its current state will be few and far between.

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