Curr Treat Options Cardiovasc Med 2019 Apr 15;21(5):21. Epub 2019 Apr 15.
Department of Medicine, Divisions of General Internal Medicine and Biomedical Informatics, Chief Medical Information Officer of Population Health, University of California San Diego, 9560 Towne Centre Drive, San Diego, CA, 92121, USA.
A busy community cardiologist finished reading eight echocardiograms over lunch and started clinic at 1 pm. As three patients waited, "Jane," a 45-year-old graphic designer was seen for "skipped heart beat." She works about 50 h a week, exercises at the local gym, and enjoys eating a healthy diet. About 4 months ago Jane began experiencing her heart "skipping beats." She initially attributed the symptoms to long hours in the office and caffeine. But, over the holiday, her brother purchased a smart watch and she began digitally recording her cardiac rhythm. About a month ago, the device detected possible atrial fibrillation, so she called and scheduled this visit for a cardiology consultation. Upon that visitation, she and her physician reviewed the device readings. While it appeared to be an irregular rhythm, before either considered a treatment plan, they began to ask questions ranging from the following: "Is this an accurate diagnosis?" "What other data are available to better understand the risk of a cardiac arrhythmia?" "How is this data analyzed so that the best treatment plan can be made?" "And, what type of clinical decision support system is required to 'virtually' monitor people like me using digital health devices to improve the efficiency and quality of care delivered in population health?"