Application of HIT

Class,

This week, I have created a fictitious case study to help you critically think about the content in this weeks threaded discussion. This case study focuses on smart watches, since this health technology has improved significantly over the past few years, enabling many watches to detect ventricular tachycardia, atrial fibrillation, atrial flutter, and second- or third-degree atrioventricular block (Pay, 2023). Please read through the scenario below and then answer the questions that follow.

Maria, a 45-year-old woman with no known cardiac history, arrives at your urgent care clinic worried about an irregular heart rate reading on her Apple Watch. Earlier in the day, after completing a vigorous workout, the device alerted her to a possible arrhythmia. She reports no chest pain, shortness of breath, dizziness, or other symptoms.

Maria shows you screenshots of her heart rate trends, since she cannot link the data to the clinics electronic health record (EHR). She says she Googled irregular heart rhythm and became anxious after reading about sudden cardiac arrest or even death. On your physical exam, you note her vitals and ECG are within normal limits. Maria admits she has been wearing the watch constantly and checks her heart rate multiple times a day. She has a family history of cardiac arrest, so she is extra vigilant and anxious about her heart health. She asks whether she should buy a medical-grade heart monitor.

As a nurse practitioner, you must decide how to address Marias concerns, interpret the wearable data responsibly, and educate her without dismissing her fears.

Clinical judgement questions (answer as many as you would like):

1. What steps would you take to critically evaluate the reliability and clinical relevance of Marias wearable heart rate data?

2. How would you communicate the limitations of consumer-grade wearables while maintaining patient trust and encouraging healthy self-monitoring behaviors?

3. What strategies could prevent unnecessary ED visits triggered by consumer health alerts while ensuring serious conditions are not overlooked?

4. How might improved interoperability or decision-support tools enhance safe and efficient use of wearable data in similar scenarios?

5. What ethical or privacy considerations arise when patient-generated health data is stored outside the healthcare system?

Looking forward to your responses,

Reference

Pay, L. (2023). Arrhythmias beyond atrial fibrillation detection using smartwatches: A systematic review. Anatolian Journal of Cardiology, 27(3), 126131. https://doi.org/10.14744/AnatolJCardiol.2023.2799Links to an external site.