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Hello Health Guide, Goodbye Doctor's Waiting Rooms

The US Food and Drug Administration approved Intel's newest healthcare gadget: an in-home health monitoring system for patients with chronic conditions, called Health Guide.

While the clear advantages of this device's gathering health information and helping patients keep on schedule with their medications, such devices for these purposes already exist. It is the added technological features, including video conferencing and Internet relayed health data, that have dubious advantages when weighed against the privacy concerns and the real ability to integrate such a device into the healthcare system.

Goodbye Marcus Welby, MD--Hello Hal, Health Guide.

This "doctor in a box" is an 8 pound monitoring system connects to the Internet to send patient data to physician's offices, to remind patients to take their medications, to allow for video conferencing with patients' physicians, and to check and monitor vital signs (Gizmodo, July 12th).

While this new technology would seem to resolve a lot of issues for patients with chronic disease--allowing them to take medications on time (something crucial for many suffering from chronic diseases like HIV and diabetes) and reducing the need for in-person doctor's visits and endless waiting in waiting rooms--there are some obvious concerns with this technology.

First, there is the implementation of this technology and the integration of this device (and others like them) into the healthcare information infrastructure. For example, the use of video conferencing would be great to reduce the need for office visits and for doctors to be able to actually see patients, but how many physicians have webcams in their offices? The answer is not many, I would suspect. Or perhaps physicians would also have to buy the device in order to communicate with patients who own the Health Guide. Will enough physicians incur that cost to make the technology useful to a large population of patients?

Second, will there be adequate information security protections for healthcare data being sent via the Internet to physicians offices? This tried and true concern about health information security, privacy and confidentiality certainly exists with this product.

Lastly, would such a device in the home result in hyper-aware patients who become MORE concerned about their health? Constant vital sign monitoring and alerts may not be the best thing for patients already suffering for chronic disease. For those who do not manage their disease well, Health Guide could be a real help--but for others, it may result in more mental anguish than the added health benefits could offset.

Time will tell as to whether this in-home health monitoring system will improve patient care and outcomes, save costs and take care out of hospitals and doctors' offices, especially for those with chronic diseases--it certainly may. But I hope that healthcare providers and patients will think through the ethical issues about privacy and implementation before use of this new device is marketed for use to patients with chronic disease, a population who clearly could benefit from improved disease management, reduced doctor visits, and lower healthcare costs.

Summer Johnson PhD, guest blogger