A recent news release from the Rochester Institute of Technology describes a revolutionary product to monitor patients with congestive heart failure in the comfort of their home. Researchers developed toilet seat–based technology to measures biometric data during, well, what we do while sitting on a toilet. The heart rate, blood pressure, blood oxygen levels, stroke volume, and related data that are gathered are forwarded to heart failure teams for early intervention even before problems become symptomatic.
Monitoring patients with heart failure who live at home is an important aspect in the management of this condition. Some estimates suggest that within 30 days of hospital discharge 25% of patients are readmitted, and 45% are back in hospital 3 months after discharge.
Heart failure patients may be divided into three categories: simple, complex, and highly symptomatic. The (often younger) patients with fewer complications do not necessarily need complex care plans or complicated electronic monitoring. The older, highly symptomatic patients may benefit more from palliative care services. It is the middle group that requires a patient centred, multidisciplinary heart-failure management program.
On one hand, I admire the imaginative work of exploring robotic data collection, as long as it proves to be accurate, easily interpreted, and economically feasible. On the other hand, there is solid evidence for the overall value of heart-failure specialist, nurse-led, multidisciplinary team management, incorporating home visits and some telemetry, for the middle group of patients with complex morbidities. And I deplore diminishing the art and humanity of medicine provided by experienced health care professionals.
Reading about this toilet-seat technology reminded me of “The man who mistook his wife for a hat” in one of Dr Oliver Sacks’ short stories. Like the shifting reality for the man in that story, there is, to me, a growing and alarming shift away from our concept of the art and humanity of medicine. Let us not displace the visiting nurse with a toilet seat.
—George Szasz, CM, MD
I gratefully acknowledge comments from Dr Mark Szasz during my preparation of this post.
Chan YK, David AM, Mainland C, Chen L, Stewart S. Applying heart failure management to improve health outcomes: But which one? Card Fail Rev 2017;3:113-115.
Rochester Institute of Technology. Toilet seat that detects congestive heart failure getting ready to begin commercialization. 5 March 2019. www.rit.edu/news/toilet-seat-detects-congestive-heart-failure-getting-re....
This post has not been peer reviewed by the BCMJ Editorial Board.