Some examples:

I always wondered why I had a lot of trouble sleeping. Doctors laughed at me, until an orthodontist told me I should get checked for sleep apnea. Turns out I had very severe sleep apnea. I would have like this diagnosed much sooner in my life.

My Dad had afib, had it been diagnosed sooner, his surgery wouldn't have been a "get it done now" situation.

Once the true positives outweigh the false positives, everyone's going to consider these essential for health. That moment will probably be in 2-5 years.

I 100% agree. I think we are on the cusp of the "cyborg" era, like it or not. Humans will wear health tracking devices at all times. Already 10M+ do, from basically 0 a decade ago.

Personally the sleep tracking and heart rate data from wearing my bands since 2014 led me to a diagnosis and fix for a number of health issues.

But the real promise lies ahead, as new and better sensors are engineered. In addition to helping with traditional health issues, devices will increasingly allow the conscious part of your mind to have real-time self-awareness of the biological factors going on that influence your thoughts and decisions and answer questions like these:

- Did you say "no" to that thing because it was the right decision or because your blood glucose level was so low? - Was your high productivity level today a fluke or influenced by the high caffeine level in your system? - How "tired" are you really?

Some people might not like it, but I don't know if they'll have a choice. Not taking advantage of these technologies would put them at a disadvantage in school, work, sports, and perhaps all other areas in life.

I think that moment is more like 10-20 years out, but otherwise agree with you.

I think most doctors and patients would agree that getting information in a timely manner is more important than the mechanism by which it is transferred. While interoperability is something to strive for it's not the thing holding the system back.

This is what I'm talking about. We're so far away from actual interoperability it's not even funny.

> The time it takes to request and receive records on a patient is measured in days not minutes.

Yup.

> While interoperability is something to strive for it's not the thing holding the system back.

Not sure I follow you. The siloed data seems to be a pain point for most docs. Patient is admitted for evaluation of X, Y, Z concerning symptoms. Patient was admitted to a different hospital a week ago for the same symptoms. Different hospital is on a different system, so I can't get the patient's history from that visit. Guess I need to have the records faxed over tomorrow morning. In the meantime, let me go order a bunch of tests that are probably totally redundant to what was run last week, but I can't get that data right now, so gotta run them again. Huh, that's a interesting x-ray. Wish I had the prior.

Just because the systems can talk to each other, it doesn't mean that I can just automatically grab whatever patient data whenever I want. There are rules and procedures you need to follow when dealing with PII. If you are cavalier with these systems you will be fined or sued into oblivion. Time until transfer of data is the hard part, which is independent of interoperability.

There are bigger fish to be fried in this space, so if we are triaging healthcare technology I would put this low on my list of things to take care of.

Yes.

> Time until transfer of data is the hard part, which is independent of interoperability.

This depends if you consider dealing with the human and/or legal factors as part of interoperability or not. If the technology exists but the regulations or human factors don't allow for timely communication between systems, the systems are not interoperable. When we talk about "implementation" of a system in healthcare, we're not just talking about the setting up the technology, but changing hospital procedure, training, getting it approved by various committees, navigating legal issues, etc.

When we talk about 'disrupting' healthcare, most people don't realize that making a sexy piece of technology is the easiest part. FDA approval is effort-consuming and expensive, but plenty of health tech start ups and company initiatives have also done what Apple has done. And hence why I don't consider Apple's ability to get de novo 510k on a cool wearable 'disruptive' or a 'tipping point.' It could be influential on the consumer side of things, building a bridge between consumer health and healthcare. But how much does it touch the massive, unwieldy machine that is the healthcare system?

> There are bigger fish to be fried in this space, so if we are triaging healthcare technology I would put this low on my list of things to take care of.

No one is saying interoperability is the biggest fish. But it's a pretty damn big one. Perceived fish-size will likely vary from specialty to specialty, big urban hospital to rural clinic to private practice. What would you consider the bigger fish?

EHR vendors are actively working to enhance their applications to cope with new data streams coming in from consumer wearables as well as connected home healthcare devices such as smart scales and blood pressure monitors.

Is this actually the case? I haven't heard any talk of this at my institution, or on r/medicine.