“Time is what we want most, but what we use worst.”
–William Penn
April is almost over and I still have not completed my review of the latest health app I have been using. The Health App of the Month will be back and better than ever in May. Hopefully, with time, I will have more posts this summer on many Digital Health topics. As always, if you have any comments, suggestions or ideas for the site, please let me know.
It has been one year and one month since I started this website that focuses on real world applications of digital health. I have had a lot of fun creating a this site and creating an online conversation about digital health.
The most exciting aspect of the website has been to see all the different areas of the world I have visitors to my website. This March has been my 3rd best month in terms of total views. While the majority of the views come from the USA, I have also had visitors this month from Brazil, Serbia, India, Venezuala, Belgium, Jordan and Spain.
I would love to hear from anyone outside the US about what digital and mobile health looks like in your country. Add a comment to this article, or email me at dranderson@drmatthewanderson.com or reach out on twitter @DrAnderson19.
This is an article that was originally published on KevinMD.
Much of the discussion surrounding the presidential election this year focused on “fake news.” There were countless stories in newspapers and on television news shows about these obviously biased and fictitious posts that might have affected the outcome of the election. I could not help thinking during this campaign season that if you think fake news is bad for politics, you should try being a physician.
As physicians, we are on the front line in the fight against fake news and deal with the fall out on a regular basis. This is nothing new, especially for Primary doctors like Family Physicians, Internists and Pediatricians who have to deal with volumes of fake news within the limited amount of time they actually have with a patient.
Physicians are always trying disprove fake news with patients. We talk about the limited benefits of numerous vitamin supplements in the face of countless publications and marketing efforts that do not have to be evaluated by the FDA. Red yeast rice is not equivalent to statins for preventing heart disease. Gingko biloba will not treat dementia, no matter how organic or pure it is, no matter how many people write about its effectiveness.
A website recently touted the 25 beneficial uses of Apple Cider Vinegar. This list included treatments for acne, bad breath, under arm and foot odor, to kill bacteria causing a sore throat, prevent diabetes, lower cholesterol, improve digestion and remove warts. But wait there’s more! Apple Cider Vinegar can give you healthier hair, whiter teeth and even better tasting barbecue sauce. This is in addition to its ability to be a nontoxic cleaner for your kitchen and a weed killer for your garden. This is a list of pure conjecture passed off as facts, and people believe it. Even the comments section of the article has readers saying “good to know.”
I have had several patients tell me about all the health benefits of vanadyl sulfate. Specifically, they have stopped their medications for diabetes because of everything they have read about vanadyl. Each patient’s course plays out the same way: these patients research for information, completely buy in to this natural supplement, stop their medications and then their A1c goes up dramatically. But “Americas most trusted wellness doctor” says it works and is willing to sell the supplements to you as well.
The most egregious and widespread item of fake medical news involves vaccines. From causing autism to inciting sexual behavior, decades of fake medical news about vaccines exist. Many times doctors are seen as complicit in pushing this harm on people. A quick look at twitter for #vaccines, and the news of vaccination harms is overwhelming.
The whole fake news complex plays on the vulnerabilities of those searching for the information in the first place, looking for what mainstream media or money-loving, golf-playing doctors won’t really tell you. You are being held down or missing out on critical information – information someone else doesn’t want you to know. If you can get this information, everything will be better — your life, your health, your economy, your country.
As a physician, I try to be a steward of medical information. I want my patients to seek out good quality medical information on their own. I steer them to websites such as Mayoclinic.org or Webmd.com and gently dismiss information from sources I do not trust.
So fake news may have negatively affected the campaigns of Hillary Clinton and Donald Trump, but fake news affects every clinic and hospital in America every day. This is not to say that political news is more or less important than medical information or that either is more susceptible to the “fake news” problem. Inaccurate statements presented as facts should always be challenged, and the medical community has a unique and difficult responsibility to engage it.
Title: CDC Vaccine Schedules
2016 was a very exciting year for me. I completed my MBA, took on a new role at my institution as Associate Chief Medical Officer and in February I launched this website, Digital Health and You. This website has been an important outlet for me and I hope has helped improve the landscape of medicine and digital health.
During residency, one of my patients brought a tape recorder to his appointment. It was a bulky old tape recorder, which was already antique technology 10 years ago. He was older and wanted to record his appointment so he could remember every detail. His children often called him and wanted an in-depth report of all of his medical visits. He decided he would audio-record his appointments and send the tape to them instead.
His intent was good, but I could only imagine terrible outcomes. Somehow, my voice would be used against me. Maybe my documentation would not match my words. Maybe it would be obvious on the tape that I forgot to ask a crucial question. When he told me he wanted to tape our encounter, my mind almost immediately jumped to it being Exhibit A in a lawsuit.
Before he could plug in his tape recorder, I told him he could not tape his appointment. (Looking back, I am not sure what made me think I had the power to say no.) We compromised, and I wrote a letter to his children summarizing our visit and any tests or medications ordered. He was satisfied with that, and this system worked for us throughout my residency.
My memory of this was brought to the fore today as I learned about the new SnapChat 
Spectacles, wearable glasses that go on sale soon. Created by SnapChat itself, these trendy sunglasses are equipped with a small video camera. After pushing a button on the frame, the glasses will take up to 30 seconds of video of whatever the wearer happens to be looking at. Of course, Spectacles connects wirelessly with the wearer’s phone and can instantly post videos to the social media site.
There are other products on the market right now that can do similar things. The iOn Snapcam weighs less than an ounce and is a 1.5 inch-wide square camera with the ability to take pictures or video. It can clip to clothes and, at just a tap, start recording. It can even live-stream for up to an hour!
What does this have to do with healthcare? Recent advances in technology have propelled many new ways to access healthcare, but these two products have the potential to be detrimental.
How long will it be until someone’s Spectacles video becomes admissible in court? A simple tap of someone’s glasses, and 30 seconds of a full patient encounter could be taken out of context. Plus, it could be posted to multiple social media sites as well. What about the privacy rights of other patients around someone with these video recording devices? If someone posts a video to their social media profile from a physician’s office lobby, other patients will likely be in those videos. How will we protect privacy of the other patients in those situations? 
If you are a physician, would you recognize any of these social media video tools? What about your staff? Would you feel comfortable telling your patients to make sure they were not collecting video or live-streaming their appointment? Do you have a written policy to provide patients about limiting video capture in the office?
There are many rules and regulations that require healthcare providers to obtain very specific consents before using any type of image or video recording of our patients. Protecting the privacy of our patients is both the law and our responsibility. Being aware of the new video technologies and preparing for their use by our patients are increasingly more important parts of that responsibility.
