Tech vs. Touch: Finding Balance in Modern Healthcare

Hello, welcome to the Ask Dr. V Show. I'm your host, Dr. Val DeCrowder, and you can just call me Dr. V. I have over 30 years of experience as an award-winning emergency medicine physician, and I have witnessed countless health crises that change lives in an instant. But one thing I've noticed time and time again is how many families struggle to actually really navigate our complex healthcare system. It is really, really not easy. And what happens is you kind of have to navigate this healthcare system when you're probably the most stressed or have the lowest energy and really distracting you from healing and getting through whatever health crisis you're dealing with. So this is where our show comes in. Our goal is to empower you with knowledge and the tools to take control of your health. And today we're diving into the pros and cons of technology in medicine. So I wanted to really talk about this because I get a lot of questions about, you know, all of the new technology in medicine and should we really trust it and what is really happening. I specifically get the question a lot when people are asked whether or not they want to use robotics or laser. So technology is really, really revolutionizing medicine very, very quickly. And it's making an impact on diagnosis, treatment, patient care. Examples of some of the technology that's making a difference are obviously robotics, artificial intelligence, advanced diagnostic tools, and it's really allowing us to go into places and avenues that we have not been able to go in before. But it also is kind of presenting some ethical dilemmas, creating some distance between the patient and the physician. So I thought this would really be a great discussion to have today. What I wanted to actually first talk about is sort of like the balance of human interaction versus technological advancement. So, you know, the relationship between human touch, your personal interaction with your doctor, and technology, sometimes they can really conflict. And as we begin to integrate more technology for medical care, sometimes it actually makes you a little bit more distant from your physician, and it sort of decreases the amount of personal touch or contact or even verbal communication sometimes that you have with your healthcare provider. But there are several advantages, and so I kind of wanted to go through some of them, right? So technology really helps us to actually improve efficiency and also improve precision. So when you look at things like MRIs, CAT scans, automated lab processing, these all help us detect diseases earlier and also with a higher degree of accuracy. Now, if you take something like CAT scans and MRIs, and then you add an AI component to it or an AI algorithm to it, then you can process. We can process vast amounts of data and it really helps us get diagnoses faster and it also minimizes human error. It makes things much more dependable as far as outcome. The other area where we're seeing technology really help us in medicine, and this really occurred as a result of COVID. So this was one of the benefits of COVID is telemedicine. So many physician offices had to actually really convert over to telemedicine as a result of COVID. Prior to COVID, telemedicine existed, but Medicare and Medicaid, and some of the insurance companies, would not actually reimburse for those visits. So one of the things that happened as a result of COVID is the insurance companies got used to reimbursing for telemedicine platforms. And you can integrate with telemedicine wearable devices so the patient can really access healthcare from the comfort of their home. And with the wearable devices, patients can also transmit information. So we can see sort of what someone's heart rate is or what their heart rhythm is. This is really, really important when you have areas in our country that may be remote, maybe there's no physician locally, or you have a patient or family member that is that has difficulty getting out of the house for whatever reasons. So when you talk about the downside of technology, one of the main complaints that I hear from patients is sort of the loss of human touch and that it sort of depersonalizes things. I think there's um physicians may have the tendency to focus less on their bedside manner. Um and that's a really bedside manner is a really, really essential element of patient care. And so sometimes when you know the physicians begin to actually spend more time interfacing with the computer or interfacing with whatever technology it is, it can be a little bit off-putting for patients and their families. One of the other downsides of it is that, you know, some patients really want to rely on the physician and not rely on technology. So when they see a physician primarily use technology to diagnose or treat, they it it makes everything feel a little impersonal. In some cases, the patients even are dissatisfied and actually mistrust what is actually occurring. Uh the third thing that we see is um we can see nurses and providers over-rely on technology. And we've all done this ourselves, right? Where you know we rely too heavily on something that we've seen online or uh or Chat GPT or whatever it may happen to be. But you know, what happens is if a healthcare provider becomes over-reliant on technology and does not engage with the patient, then they may miss something. Um there's a lot that occurs in the back and forth uh communication, um, nonverbal cues, um, emotional and psychological aspects of patient care. So it's really, really important that we keep that human component and pick up on the subtle symptoms and that technology is an adjunct that actually helps us. Okay, so one of the first technologies that I get asked a lot about is AI or artificial intelligence. And people want to know, you know, are we using AI in medicine? Um, you know, is there artificial intelligence that's impacting their healthcare? And the answer to that is resoundingly yes. So let me let me let me uh share with you guys a little bit about how we actually use AI. And you you may or may not see it during your particular patient visit, right? So one of the first ways that we use AI and that we're starting to see it used is increasing diagnostic accuracy of tests that are performed. So specifically, and I'll give a really good example of this, if someone comes into the emergency department with a stroke in my emergency department, their non-contrast head CT is actually read by AI. And the non-contrast head CT may be read by AI before the radiologist reads it. Now, there's still a radiologist that overreads it and takes a look at it, but I may get a result from AI before I get a result from the radiologist. So that's really helpful when there are a lot of CAT scans to be read and maybe not as many radiologists reading them. The other place where we actually see AI being used is in predictive analytics, right? So there's all sorts of algorithms that we use for deciding, you know, how well is this person going to do in surgery? What is the likelihood of maybe someone who's critically ill in the ICU? What is the likelihood of them surviving? So this can sort of be helpful in deciding uh what procedures to perform, whether or not someone should go to surgery, whether or not someone should stay on life support if they have a lot of comorbidities. So, you know, in the past, some of these decisions were sort of based upon the physician's experience. Now there's actually AI algorithms where we can actually put the patient information in and they can actually give us actual predictive analytics. The other way AI is very helpful is in diagnosing. I recently got a really interesting AI app for diagnosing in the emergency department. We often have patients come to the emergency department with really odd rashes. It can be very difficult to know why a patient has a rash when we don't really understand maybe what's going on in their home or work environment or all the things that they've gone through over the last couple of weeks. So there is an app now where we as emergency physicians can take a picture of the rash. We can put in a couple of signs and symptoms, you know, whether or not the patient has a fever or not, or whether the rash blanches or not. And it will give us the top three diagnoses or four diagnoses, and it'll also tell us how likely a particular diagnosis is. So um, and it will actually go on and actually provide us treatment plans uh for each of the diagnoses if we have some concern or some unfamiliarity with whatever the particular diagnosis is. So that's actually extremely helpful, and other professions are seeing the use of AI in that area as well. The last area where AI is really helpful is really decreasing uh physician workload. You know, we're always um, it seems like we're always, whenever we're working, it seems like we're always behind. Uh so we're always trying to see more patients and decrease the wait time for patients in our waiting rooms, etc. So one of the things that I've also used recently for AI is a scribe service. I can use my personal cell phone, I can put it on speaker phone, the patient, I ask the patient their normal questions around, you know, what happened to them, what are their allergies, what are their medications, their past medical history. And the patient and I can have a normal conversation, and AI will then generate a history and physical for me based upon my interaction with the patient. So that decreases the amount of time for me actually typing in everything that the patient told me. It helps me actually be more efficient. So those are the things that are really helpful. So when we talk about AI and its role in medicine, there are some downsides to it. And I wanted to kind of go over that as well. So one thing is AI does not have human clinical judgment, right? AI really is great at processing data, recognizing patterns, right? But it doesn't have the human intuition or the emotional intelligence. So when there are cases where there are multiple factors involved, um, AI may miss the subtle clues that a human physician might pick up on. So it's really, really important not to rely too heavily on AI without human judgment, without a clinical physician judgment, because it can lead to flawed decision making. The other thing that there's been a lot of work on with AI, because AI is collecting all of this information, it really relies on a lot of data and a lot of personal health information. So there's been a lot of work to help protect against data breaches and misuse of patient information and ethical things like that. And I have to say, I think that in general, the world of technology has done a really great job in making sure that people's individual data is private and addressing potential security concerns and decreasing uh data breaches. The other thing is that AI, because it works on a lot of data, right? Let's say you have data and it's primarily women, then it can be biased when you actually put the same data in and it's a man. Or similarly with minority groups, if you have a lot of data and it's based upon a non-minority group, then there may be some bias in that actual in those actual algorithms. And when you then go to apply AI to a minority group, you may see some health discrepancies. So we've specifically seen this in the arena of diagnosing skin cancer because skin cancer is often diagnosed in non-minority populations, the AI sometimes is not as good at picking it up when skin cancer involves a minority patient. So there is or there can be some built-in bias in AI depending upon how diverse the data set was that actually built the actual algorithms. Alright, so the next technology that I think is important, and this is the one that I probably get asked about the most, is uh robotics. So robotics in healthcare is very, very interesting. We've gotten to the point where robotics can help with surgery. They help the surgeon during surgery. Um they also are, you're seeing the use of robotics in uh rehabilitation tools and also in prosthetics. Um it's increasingly robotics are increasingly integrated into surgery, uh, diagnosis and rehab, and it's really opening up a brand new world. So I wanted to kind of go over a couple of things that we're seeing with robotics. So when you look at minimally invasive surgery, then you're seeing robotic systems like the Da Vinci surgical robot system, and that basically allows surgeons to perform very, very, very precise operations with much, much smaller incisions. And this leads to faster recovery times, reduced risk of infection, less pain for the patient. So it really, really works out well. It is particularly beneficial for complex surgeries like prostate removal, heart surgeries, spine operations, etc. When a surgeon uses robotics, uh the surgeon is still controlling the robot. So it is not a system that operates by itself. Um, so there is still the concern. It's just the robotic systems can tell the difference between different types of tissue better than uh a surgeon's eye. And so that's how come often we see really good results with robotics. Okay, so the other the other thing that robotics can help with is uh robotics can help actually provide surgical specialties in remote areas where maybe that specialty is not available. So, you know, sometimes some rural areas don't have certain specialists, or sometimes it can be an emergency where the patient is too unstable to be transferred. We're beginning to see now that some specialists can perform procedures remotely, particularly in rural or underserved areas where that specialty may not be present. So in in this sort of situation, robotics sometimes can be really, really life-saving. The other area where we're really seeing robotics is in the area of rehabilitation and prosthetics. This is very, very interesting because you know you have folks sometimes that are paralyzed or can't move their limbs as normal. And in the use of robotics provides exoskeletons to help people regain mobility that maybe they lost as a result of a stroke or a spinal cord injury. We're also seeing prosthetics that are powered by robotics really helping improve the mobility and functionality of amputees. This is really an exciting area because it actually brings a level of life and activity to people who suffered injuries or medical diseases that really took that away from them. So this is an area that's really, really promising. Now, with everything, there's always pros and there's always cons. So let's talk about some of the cons and what are some of the downsides of robotics. The main downside, which we've talked about this a lot on the Dr. V show, is the robotic systems are very, very expensive. They're expensive to purchase, they're expensive to maintain, and they're expensive to operate. So when we talk about, you know, how much is the cost of healthcare? Um, robotics and some of these technologies really are responsible for a lot of clinical advanced advances, but it is at a very high cost. Um, the other thing is that, you know, robotics are not always their machines. They're prone to technical failures. Uh, they can have software glitches, they can have hardware malfunctions. Um, so these sorts of things can kind of lead to complications. Um, they certainly don't occur at the same rate that human error occurs, but it does occur. The other thing that is a downside with robotics is the surgeon has to be extensively trained on how to operate a robotic system effectively. So I often tell people that if you're going to have surgery and you're gonna have it done robotically, you do want to find out how long has your surgeon been doing robotics. And you that'll give you an idea of you know how extensively is he trained, how often is he doing these? These are reasonable questions to really um to really ask. The learning curve associated with mastering robotics is significant. But a lot of physicians and a lot of surgeons have really come up to speed, and also now it's a part of residency. So residents are being trained on this during their residency program. So one of the other downsides of robotics is that you know there can be sort of an over-reliance on it. Um, it's really important that, you know, the surgeon himself still has the technical skills to perform the surgery, right? So if something happens during the surgery, that you know, you want to make sure that your surgeon hasn't been doing so many robotics that he doesn't know how to do the surgery itself, right? And and most of the um uh physics, most of us as physicians, we have regular continuing medical education that actually keeps our skills up and abreast. Um, but that is uh always a concern that there's an over-reliance of robotics and certain uh technical surgical or clinical skills will be lost over time. All right, so so the next technology that has really transformed medicine, which I am really excited about, is telemedicine. And telemedicine is really helping us transform and overcome many, many, many different barriers. And um it has led to video calls, online consultation, patients uh with wearable devices, sending in uh actual data for us to look at, um, and it has just been an absolute game changer, particularly for rural areas, underserved areas, and people with mobility challenges who really struggle to get out of the house. So there's a lot of pros of telemedicine, and one of the first pros I'm gonna tell you about telemedicine is it's cheaper. It's one of the few technologies that is really helping us decrease or control health care costs. It is much more efficient and it's much cheaper to have a telemedicine visit than it is to, let's say, for instance, transport a patient to the to the doctor's office and the amount of time and resources that go into going through the doctor's office, registration, the nurse, etc. So it is cheaper and also much, much more cost efficient. Also, it's been particularly beneficial in areas like providing mental health services. For some people, it helps to decrease the stigma. They're not seen as going into the mental health provider's office. They can do it from the privacy of their home, either on their iPad or laptop or on their phone. So it's been particularly helpful when it comes to mental health, behavioral health, and also addiction services. Telemedicine has also allowed us to sort of bridge geographic barriers, you know, where you know there might be a need for long-distance travel or specialized services. It really helps to get all types of services in all types of uh areas. The other thing is you can actually do telemedicine more frequently. So sometimes you have patients that are really fairly sick but not sick enough to be admitted to the hospital. And so the physician really needs to monitor them a little bit more closely, like maybe see them once a week or even twice a week. Well, telemedicine sort of allows you to really do that. And so telemedicine is really, really an exciting area. But just like everything, it also has its downfalls. So, one of the things about telemedicine is you've got to have a stable internet service. And there's so many areas in rural America that do not have stable internet services. And I know that there's been a push during the last administration to actually get internet service all over the country in very uh rural areas and Very remote areas. But that is a barrier if a patient does not have access to a reliable internet. The other thing with telemedicine is obviously we can't perform a physical exam to the same extent that we could if a patient was actually right in front of us. Now, for some situations that's important, and for other situations, like let's say, for instance, you're monitoring someone's glucose, maybe it's not as important. So the physicians will really actually determine that, and a lot of the primary care doctors will say, you know, to actually see the patient related to this reason or that reason, I need to see them in person, and they will segment their patients and they'll say, you know, these patients I can actually see by telemedicine because of what they're actually coming in for. So it's really important to ask your doctor, like, could I actually follow up with a telemedicine visit? And they'll actually be able to tell you. You have the same issue you have with AI around privacy and security. Um, again, there's been a lot of uh a lot of advancements to make sure that sensitive health information is really protected. And lastly, you you again have some of the concerns about, you know, I don't really have the human touch, um, I don't really feel like I'm getting to know my doctor. And and those are also some of the uh cons. Previously, uh, we had insurance companies that weren't uh reimbursing for telemedicine, but as I said, since COVID, we've had less and less problems with that. The other thing that's important is that telemedicine all also requires the patient and the physician to be in the same state. So because of regulatory laws related to our licensing, we as physicians and even nurses, we are licensed in a particular state. Some physicians are licensed in multiple states, but you have to be seeing a patient that is in a location that you are licensed in. So if I'm seeing a patient in Rhode Island on telemedicine, I need to, on the other end, have a Rhode Island medical license. And lastly, you know, there is some concern about, you know, people giving informed consent over telemedicine. You know, is the provider really able to gauge whether or not the patient understands what they're what they're being instructed to do, or does the patient really have a comfort level with the treatment plan? And this again is some of the human interaction that is important. So, you know, if those things are important, you can kind of weigh those pros and cons in your decision making around whether or not to use telemedicine as part of your care. All right, well, now it's time to answer your questions. You can email me at info atasdrv.us. That's INFO ataskdrv.us. Just include your name, location, and question, and you never know, you might hear your question on the show. All right, we really have an interesting topic today, which is technology and medicine, and I will be answering some of the most important questions surrounding it. So let's get right into it. I've got a couple of questions and we'll kind of go through them and get the answers to them. My first question is from Paul, and Paul wants to know do doctors trust AI to help them figure out medical issues and should they? Oh, great question. So we we do trust AI, but you still have to realize that AI is giving us a couple of potential possibilities. So AI is not saying with absolute certainty this is the answer as far as diagnosis. But AI may give us maybe three to five top diagnoses to consider. And maybe on our own we would have maybe come up with two or three, and it gives us an extra one or two to consider. So it's not like we're totally relying on it for our diagnostic help, but it's more of kind of like a guide. That would sort of be um, that would be the best way. It's a guide and it's also a supplement, but it's not a replacement for our our professional clinical judgment. So great question. Patricia wants to know while I appreciate all the technology advances as well as telemedicine, I also feel that seeing a doctor has become transactional. It seems like they don't touch you as much, their bedside manner is quick and on the clock. Where is the balance? Great question, Patricia. This is uh to do with not only technology, but also some of the financial pressures of physicians. So because of uh many times reimbursements are decreasing, physicians are being pressed to actually see more and more patients per hour. In addition, you have hospitals that are purchasing other hospitals, and in that acquisition, they're looking for increased efficiency. So part of it is technology, and part of it is actually what's happening financially on the landscape of medicine. I would say in general, I do believe that uh AI is helping physicians to become more efficient and to be more productive, but we do have to sort of make sure that we don't we don't lose our human touch. At the end of the day, everybody, you know, it's not you're you're not going through an assembly line, right? This is a human-to-human interaction that's occurring to kind of get you healthy and back on your feet again. So I understand your concern. I just think that it's not just technology, it's technology plus also some of the financial pressures that are currently exist in the industry. Mark has a question. He says, Doc, I can't help but feel like many docs are just phoning it in these days. I'm not sure why the costs are getting higher when the patients are expected to do things like use wearable devices, prick themselves, bring their own urine to the lab. What gives? So, yeah, this is I you know, I kind of feel the same way when I go to the grocery store and I'm supposed to do my own checkout. I'm like, wait a second, what I'm not getting my groceries any cheaper. What's going on here? So, so I understand. I totally understand your your uh concern. You know, I think in the situation of wearable devices, I think, you know, it's really important to understand that that really allows us to see moment by moment what is going on with the patients. And oftentimes what happened, what would happen would be that the patient would come into the office, we would get a spot check, but we wouldn't know what would happen the next day or the next evening. So, you know, more data is often helpful when we're trying to manage chronic diseases. I I do understand the frustration when it feels like you as a patient are doing more and then um the bills are increasing. And and that's really due to a lot of factors that is, you know, related to the cost of these technologies. There's also a shift, you know, there's a big, big shift to more outpatient and more preventative care so that uh patients actually don't experience some of the adverse outcomes that they do. So, you know, I I would say that, you know, Mark, when you're interfacing with your physician, just kind of, you know, communicate your frustration and have a conversation and kind of kind of get to uh what works for you. I think it's really important. Not all types of care work for everybody. Some people want to use more technology, some people want to use less technology. Have a conversation with your physician about what actually works for you. Here's a question that we have that was emailed in. I'm a tech enthusiast, and I am wondering if doctors are concerned about being replaced by robots at some point in the future. So, you know, interesting, um myself and my other colleagues uh that are physicians, we really don't have uh a lot of conversation or concern about being replaced. I think that there's a couple of things. One is that, you know, medical physicians, we are licensed by the state. And, you know, ultimately the insurance companies, the hospitals, the lawyers all want to have a person that is responsible for the outcome of someone's health. I don't see them transferring that responsibility to a robot, for instance. So I think ultimately I I do see physicians um staying a part of of healthcare and and treating patients. I do think that over time our role may change and that we may be managing or monitoring or interfacing with more technology and more robotics to get the outcome. But I personally don't see a future where we'll actually be replaced. Now, there was a a study where um they brought in patients to completely interface with a robotic physician. And I have to say, patients didn't like it, and they really, really didn't like it. So I think at the end of the day, um the human-human interaction is really, really important. And it it's a it's it plays a very, very big role in um your health care and uh and and also in getting well. So great question. Giovanna, hey Dr. V, you know what? My doctor and I communicate through the medical portal more than anything. While I appreciate the convenience, I'm not a doctor. So a lot of times he talks with medical jargon and without my ability to really ask questions in real time, and it's just it's just not cool. Is this the new normal? So, great question. So, you know, often in healthcare, we talk with each other and we talk by email and we talk by text with other nurses and providers, and we use a lot of medical jargon. And I think it's really important for us as providers to be reminded that, you know, when we're talking with patients, it's really, really important to not use that jargon. So if your provider is actually responding with a lot of medical jargon, you might want to just let them know, like, I don't really know what you mean by these initials or these acronyms or what you mean by that. Could you tell it to me in plain English? And if you ask him, I suspect that he will then change. What you don't want to do is pretend like you understand what he's saying when you really don't understand what he's saying. So if you don't understand what he's saying, certainly um ask him to sort of explain it in plain jargon. And then the other thing too is, you know, if you have a lot of questions and you've got a lot of concerns, make an appointment, go in to see him personally, and really get to the bottom of it. And I really advise people to create a list of questions before you go into your doctor's appointment. So when you get there, you can literally just read them off a piece of paper and really get the answers to what it is you need. Great question. Okay, Anthony asks a question. Hey, Dr. V, I watch a lot of sci-fi and medical shows. I see how docs are using robotics and surgery. This may sound crazy, but I gotta ask this question. Is there ever a time where the robot takes over and the surgeon loses control? Or what if the machine malfunctions in the middle of surgery? Has that ever happened? So, a couple of things is that one is the robotic instrument during surgery is always under the control of the surgeon. So again, I think that it's really important that ultimately the surgeon is the one that is actually controlling things at that uh throughout the surgery. Now, malfunctions do occur, and when they're very rare, but usually when they do occur, um they're set up in a way where the physician is notified, the machine will often stop so that no damage is done to the patient. In a lot of hospitals, you'll find that uh there are backup robotic surgery machines, or in some situations, then the surgeon manually takes over the surgery and completes the surgery uh manually. So there is really a lot of control and safeguards in place. It's not a situation where the robotics can just run wild on their own. But great question. Next question. My issue with technology in medicine is that there's no nuance. You can't read a person's nonverbal cues or connect with them emotionally or hear their tone of voice or sense their fear or sense their stress. I'm worried about the human connection and the quality of great question, because this is actually where where the rubber hits the road. And a lot of patients want to look into the wider their eyes of their doctor, talk with him face to face, get reassurances, and really know what sort of things the physician is thinking about, what sort of things could possibly cause a problem, what do they need to actually be concerned about moving forward? And again, I think that if you are in a situation where you feel that your physician is over-relying on technology and you're losing that human contact, you really want to ask the question and just say to them, I really need to talk to you. Can I can I talk to you and ask you a couple of questions for a minute? And, you know, really request what it is you need around interactions with your physician because we don't necessarily know. Some patients are in a rush, they want to get out, some patients are like, yeah, yeah, yeah, I got it. And if you have additional questions, just let us know. Oftentimes we will stop and take the time to answer whatever questions we want you to have a good outcome, just like you want to have a good outcome. So, Dr. V, I want to know: will robots ever deliver babies? Really good question. So, when you look at the field of OBGYN uh and specifically childbirth, you'll find that we use a lot of technology in um, for instance, the ultrasound and actually seeing whether or not there's a problem with the baby's development uh while in the abdomen. You'll also see robotics used for sometimes repairing those defects while the child is in utero. You also see a technology used for monitoring, monitoring of the fetus and monitoring of the mother during a delivery. Um you don't actually see that uh, you know, the delivery of an actual child is still a manual, a manual procedure, but we will see sometimes C-sections will use or have the assistance of uh robotics, but in general, the actual delivery of a child during a vaginal delivery is still a manual procedure and requires a lot of uh real-time adjustment to what's actually happening and what's actually going on in the clinical scenario. So, great question. All right, Savannah has a question. She says, uh, I wear a Fitbit and my husband also tracks his steps using Apple Watch. Um, how accurate do you think these wearable fitness trackers are for monitoring heart rate? And can our information be sold or accessed by hackers? So, great question. So the wearable uh trackers, fitness trackers, um, are providing sort of like a rough estimate of your heart rate, um, which is really all you need for exercising. They can be within 10 or 15 percent of what's actually accurate. Um they may not be necessarily as accurate as a medical grade device that you would actually see in a hospital setting, but those devices are much more expensive, and you really don't need that degree of precision when you're really just trying to manage how well are you doing as far as working out and and exercising. Um as far as privacy, it's it's really interesting. A lot of the fitness trackers use um encrypted data, so they take your data and then encrypt it so that if uh they are hacked, uh the data is less valuable. Um, however, I always tell people, you know, every single device that you use, whether or not it's a Fitbit or Apple Watch or whatever, they all have different privacy policies. And you want to make sure that you're familiar with the privacy policy for the particular device that you're using and that you're using really strong passwords and understanding what is happening when you're sharing your data. So it's really, really different across different devices, but great question. All right, we've got another question by email, and it says when we go to the doctor, we sign paperwork that promises that our electronic medical records will remain private. With all of these political changes on the horizon, should we be concerned about our personal data being shared? So, you know, this is a really, really good question, and um, I see a lot of younger women really have concern about this when they use sort of devices that monitor their periods or pregnancies and things along that line. Now, I I can tell you that there we have a federal law in place currently. It's called HIPAA, and it is the Health Insurance Portability and Accountability Act. And basically, it regulates the privacy of all of your medical records. And it basically says that your medical records are only accessible to you and whoever you say they should be accessed by. But your question is a different question is could there be changes to that in the future? And for that, I have to say, I wish I knew, and I'm I'm not certain. I do know that it would take a lot to actually change this particular law, which is the HIPAA law, because it's been in place for so long. Um, but I I'm not certain whether or not there'll be enough political shifts to actually change our right to our personal private privacy of our healthcare information. The other thing that you want to really make sure to ask is hospitals do get hackers and breachers just like everything else, and you want to actually ask your physician or ask your healthcare system uh that you use um what sort of protections do they have in place. Um but there have been situations that although they're rare, where data has been uh hacked. So stay tuned and stay up to date to see what happens with privacy laws. It is a really important issue for a lot of patients. Thanks for the question. All right. Marjorie says her question is this my watch tracks my length of sleep each night. Something about this is a little spooky. Additionally, if blue light is bad for sleep, what about the electronic waves on our body all night? Is that something that's harmful in us in a particular way? So, so great question. Um, so all of these devices have electromagnetic fields or EMFs. Um, and it's really an area of ongoing research to sort of see what is the impact of EMFs. So right now, I haven't really seen that the research actually is particularly in one direction or the other direction. I would say right now that's still an area of ongoing, ongoing research. However, what I would say is that it is really important to sort of limit your exposure at night and also to limit your exposure uh to blue light from devices. And one of the things you can do is you can uh put anything that has a screen, you can put it on night mode. Um you can also, you know, you don't have to monitor your sleep every single night. Like once you actually kind of get an idea of your patterns and what you need to do to improve it, then you don't necessarily have to have these devices on at night. And so um I think you know, until until we get real answers to some of these questions, I would limit limit my use of it at night and limit the exposure that it had to my body until science can really catch up and find out what impact do these devices have. Great question. All right, I got another question, which is a great question. Uh, and uh the question reads, My mother lives 2,000 miles away and her health is failing. How can modern technology help with us as a family taking care of an elderly family member that lives so far away? So this is really great. So a couple of things is that a lot of doctors' offices and hospitals have patient portals. So you can actually get permission, assuming your family member allows you to have permission, so that you can actually get on their patient portal. So then you can kind of see what's happening with their care as they get CAT scans and MRIs or EKGs, what are the results of it, and then you can also engage and ask whatever particular questions. Um, the other thing that's important is a lot of the health trackers now, um, they'll they'll track, you know, heart rate, blood pressure, sleep patterns, but they also track whether or not you fall or not. So sometimes these devices can really help notify family members that there is a problem or that something is going on. Um, I would say though, you know, if you live 2,000 miles away from a family member, you want to make sure that there is a neighbor or somebody locally near your family member that you can call to go check on your family member should you actually see something that is alarming on one of their devices. But a lot of these devices are really, really helping us actually care for family members that are far away. Great question. All right, we've got another question, and it's who actually regulates digital health products? How are they actually regulated? So this is really this is really a great question. So in the United States, digital health products are regulated by the FDA, the Food and Drug Administration, and specifically they oversee medical devices, what are the complication rates related to them, what are the hypersensitivity reactions, or any cons or pros associated with health related tools. The FDA makes sure that the products are safe and effective for whatever their intended use is. But you do have other federal agencies that are also in. Involved in the whole data informatics system, and that is the uh FTC, which is the Federal Trade Commission. So the Federal Trade Commission actually regulates issues like data privacy. Um the advertising claims that the company is making actually accurate? So the regulatory oversight really sort of involves these two agencies, the FDA and also the FTC. Thanks for the question. All right, Barbara asks, Dr. V, are there any specific digital health products that you would recommend for diabetes? Oh man, this is really this is another area where technology has really, really made a difference. You know, it used to be that your only option was really to either go into the doctor's office and get your blood drawn or to prick your finger, which is really kind of painful. And so now there are um mobile devices like the DEXCOM and the Freestyle Libre, and they sort of attach to your uh shoulder and they provide real-time glucose monitoring. And I, you know, patients love them because you know they can see the results of what happens to their blood sugar when they eat particular foods, and it also can help them eliminate foods or add foods to their diet that uh provide them with uh level glucose support. So there's also a lot of diabetes management apps, like there's MySugar, spelled S-U-G-R, and also Glucose Buddy, which also helps uh patients track blood sugar and food intake and exercise. Lastly, you have things like insulin pumps. A company by the name of Medtronica actually does insulin pump, and that actually provides continuous insulin delivery and sometimes it integrates, you can get it to integrate with your smartphone. And so it's really important. This has really, really made a difference for people in managing their blood sugar and it's taken a lot of the guesswork out of the whole, out of the whole situation. So if you have diabetes and you want to get a little bit more help from technology, ask your doctor what sort of things would be right for you given your clinical situation. Well, that's a wrap today. We had a great time chatting to you about the pros and cons of new technology and medicine. If you've got a question or a topic that you want to hear covered, please don't hesitate to reach out. You can email me at info atasdrv.us. That's info ataskdrv.us. You can also catch me on social media or follow me on Twitter at askdr underscore v. We'll be back next week with more insights and information. Until then, stay informed, stay empowered, and remember your health matters.