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There are, perhaps regrettably, some merits to our rapidly emerging Net-enabled Big Brother surveillance state. After all, as long as our doctor doesn’t know how much we really drink, smoke or eat, or doesn’t see that we daily skip our high blood pressure pills, isn’t it easy to lapse from the straight and narrow path?
That’s clearly true, according to the World Health Organization.
The WHO estimates only about half of patients actually adhere to their prescribed medication regimens, noted Joseph Kvedar, a doctor and the director of the Center for Connected Health. “That’s probably generous,” said Kvedar. “People fall off the wagon.”
The center is part of Boston-based Partners HealthCare Inc., and its purpose is to use technology to supplement traditional health care processes and create superior outcomes, he explained.
However, Kvedar found that by using an online diabetic monitoring system, patients were more likely to stick to their prescribed routines — and in turn, this led to better glucose management. Last fall, the center sponsored a six-month pilot study with seven patients diagnosed with type 2 diabetes. Each patient was equipped with a glucometer attached to a modem, and three times a day, they did their glucose readings and uploaded the data via the web to a central computer. The system was simple. The modem was commercially available, the website was customized with a few rules programmed in, and a patient could interact with it easily and see relevant information trends. They could also enter information about their exercise habits or other data, which the site arranged into a usable context.
To keep everyone honest, the information was uploaded directly from the glucometer, without manual data input. A nurse practitioner overseeing the patients immediately saw if any of them hadn’t taken the glucose reading, or if they showed any problems. That reduced the time and expenses for the nurse and ensured that the patients who actually needed immediate attention get it. “It’s ‘just-in-time’ intervention,” Kvedar said. “Not, ‘Come and see me in a month when I have space on my calendar.’”
It also turned out that if the patient was aware there is a system — a Big Brother — that is monitoring them, they were more likely to actually stick to their glucose management program than otherwise. Now Partners is doing other trials, this time using 200 patients from six primary care practices affiliated with either Massachusetts General Hospital or Brigham and Women’s Hospital.
The center is also conducting studies on patients with other chronic conditions, such as hypertension, in which the participants use a blood pressure cuff attached to the modem instead of a glucometer. Another of the center’s important areas for research is with patients with congestive heart failure.
For those more afraid of their doctor’s scowl than of death itself, a consenting loss of a little privacy might be a lifesaver.
The Union Soldiers On
Populist outrage isn’t confined to national grumbling over the bloated bonuses at dead-in-the-water insurer AIG. Here in Massachusetts, there is at least the seed of it as well. We reported last fall that members of the International Brotherhood of Electrical Workers (IBEW) 103, based in Dorchester, picketed outside Framingham town hall. They were protesting the Massachusetts Life Sciences Center board’s vote to award the town $5.2 million as part of an infrastructure grant for planned expansion of Genzyme Corp.’s manufacturing operations.
As promised, the IBEW has continued this trend. On March 16, its members protested at the town hall in Billerica, where the planning board was to vote for an approval of an expansion for biopharmaceutical company EMD Serono Inc., based in Rockland. The company intends to construct a 120,000-square-foot addition to its existing office and research and development facility located at 45 Middlesex Turnpike.
About 50 protestors showed up, said Lou Antonellis, IBEW 103’s business agent, expressing frustration with EMD Serono. “It’s receiving a $7 million tax break to expand and won’t commit to using local workers,” he said in an interview. He’s not worried these biotech companies may up and leave due to the protests. “They say they’ll move to North Carolina. I’m not buying that.”
The planning board granted the permit — “with conditions,” according to the Billerica town website.
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