Author Robin Cook: When Your Smartphone Becomes Your Doctor

Author Robin Cook in 2008 (Patryk Korzeniecki via Wikimedia Commons)

Author Robin Cook in 2008 (Patryk Korzeniecki via Wikimedia Commons)

Some doctors might tell you that their electronic medical record systems have already plunged them into a horror story along the lines of a “Coma”-like Robin Cook thriller. Dr. Cook himself sounds the alarm about the possible dangers of high-tech health tools in his latest bestseller, “Cell.” (As in cell phone. As in an app that functions as your dream doctor. Except when things go wrong in that sinister Robin-Cook-ish way.)

But there’s not a trace of the Luddite about him; he co-wrote a piece in the Wall Street Journal recently that began:

A sweeping transformation of medicine has begun that will rival in importance the introduction of anesthesia or the discovery of the germ basis of infectious disease. It will change how patients and physicians interact. It will change medical research and therapy. “Sick care”—the current model of waiting for you to get sick and then trying to alleviate symptoms and make you well—will become true “health care,” where prevention is the mantra and driving force. Welcome to the world of digital medicine.

We chatted at a lunch last week for the Friends of the Newton Free Library, where Dr. Cook taught a rapt audience the rudiments of thriller-writing. Our conversation, lightly edited:

In your latest book, “Cell,” a virtual-doctor app goes horribly wrong. But in your recent op-ed piece in The Wall Street Journal, you sound very bullish about digital medicine. So are you feeling some ambivalence here about digital medicine?

The point is that it’s coming and nobody’s going to stop it. And none of the stakeholders are all that excited.

I was thinking that you’ve written a kind of an electronic health record nightmare — but then, some doctors say they’re already living that in real life. Continue reading

Love That Fitbit ‘Force’ Tracker, Don’t Love The Wretched Wrist Rash

The author's Fitbit Force rash (Courtesy)

The author’s Fitbit Force rash, even after weeks without the tracker. (Courtesy)

There has been a flurry — dare we say a rash? — of reports in recent weeks from new owners of the Fitbit “Force” activity tracker who developed nasty skin irritations under the device that lasted for weeks even after they stopped wearing it.

The Today Show has covered the phenomenon — “Get serious about fitness, get rewarded with a weird skin rash,” they write — as has The Consumerist: “Fitbit Force Is An Amazing Device, Except For My Contact Dermatitis.”

The complaints crescendoed to the point that Fitbit issued an apology “on behalf of the entire company” and posted a Web help page and FAQ for rash-afflicted customers. Here, a Boston health care executive and CommonHealth regular reader describes her own “roller coaster ride” with the Fitbit Force — including the “second life” interactions around Force rash issues she has observed online. 

By Alexandra Lucas
Guest contributor

I pre-ordered the Fitbit Force, an activity tracker you wear on your wrist, the minute I heard about it last fall.

I’ve worn half a dozen activity trackers over the years, and they were fine but the Force promised to have it all: a display with a watch, a step counter, a running total of how many flights of stairs I’ve climbed, and gratifying vibrations and flashing lights when I met my step goal. I could set silent reminder alarms. It would sync with my iPhone wirelessly and the app had a decent dashboard so I could track my progress over time. It looked sleek. And because it was a wristband, it would make it easy to see how I was doing in real time. So I was as excited as a kid on Christmas morning when it arrived, and I put it on immediately.

Bekathwia/Flickr Creative Commons

(Bekathwia/Flickr Creative Commons)

Why do all these features matter to me? I’m an average, middle-aged, overweight executive who’s training for her first half-marathon (walking), trying to offset the poisonous temptations of sitting in front of a computer screen all day, and working on building better habits like going to bed when I’m tired. The Force fit my personality beautifully. I’m motivated by data and instant rewards. I don’t have the patience to check a phone app all the time to see how I’m doing. I don’t want to worry about losing a clip-on tracker or sending it through the wash (though I did once, and it registered a couple of thousand steps and came out fine).

The Force met my expectations and more. It really motivated me to get up from my desk and move, take the stairs at work, and go to the gym to get those steps in.

So what happened? After wearing it for five or six weeks, I noticed a rash on my wrist, right under where the Force’s metal battery is. I took the Force off but the rash continued to get worse. On a whim, I googled “Force rash” and found out that others had the same problem. Then I went on to the Fitbit user forum and found a thread of comments – up to 1386 at last count, and growing 80 a day – from people who have the exact same rash in the exact same place that I do.

Reading the comments was both illuminating and horrifying. Everyone had the same symptoms, most occurring a few weeks after they started wearing it. The rashes have lasted for weeks and in some cases spread and got infected. Continue reading

Coming Soon To Your Smartphone: Where The Cheaper MRIs Are

Picture it: Your doctor tells you that you need an MRI. Okeydoke, you say, pulling out your smartphone and typing in your zipcode. Up pop the 20 closest high-quality imaging centers, and you choose the most convenient.

That’s my visualization based on a casual mention that Blue Cross Blue Shield chief Andrew Dreyfus made last week of a new app now in development. “We’re pretty close to delivering this,” he told a health reform forum at Suffolk.

He pointed out that MRI prices can range from $500 in a community imaging center to $1500 at an academic medical center. That’s certainly an incentive to help members find cheaper, free-standing centers. And we all have an incentive to seek lower cost care as we shoulder more of our own medical bills.

I asked Blue Cross for more details, and spokesperson Jenna McPhee responded that the “PILOT” app is indeed well along and should be ready for a small group of Blue Cross members to try out in the next couple of months.

The tool is designed to identify the closest free-standing imaging facilities (for MRIs, CT scans, and lab work) sorted by zip code proximity. While it does not provide specific cost information, it locates high-quality free standing imaging facilities that are lower cost than getting an MRI, etc. in a hospital setting.

Here are the key features:
Member starts search by entering a zip code
MRI Locator lists the closest free standing imaging facilities sorted by zip code proximity
Other features include:
Uses Google Maps
Member can map facilities and get driving directions
Ability to dial the facility with a click

My blue-sky dream: The app not only gives you locations, but tells you what the overall price would be at each center, and how big your co-pay would be. They can do it for gas station prices already. Maybe someday…