George’s Corner: July/August 2014

by George Pennebaker, Pharm.D.

I am a gadget nut — but are there limits?

My dad was a gadget nut. When he was about 12 he built his own spark-gap, dots-and-dashes transmitter and listened on a crystal radio headset. All before voice and music were being broadcast. I remember all of the wire and tape recorders that he bought and fussed with. Sadly, he did not live long enough to see and enjoy the emergence of the computer age. However, he passed his love of gadgets on to his sons.

I used to take apart mechanical watches and clocks just to see how they worked. I still take things apart, but I have no idea what is going on inside. The technology is growing sooooo fast.

It seems that every day I see an announcement of a new gadget (sometimes several). The big change in the last few months is the prevalence of new health-related gadgets. Apple, Google, Motorola, and a lot of smaller names are talking about gadgets and software that have the potential to totally upset (or revolutionize) healthcare.

It will not be long before the gadget measuring heart rate activates the ECG gadget, which will automatically dial 911 if it thinks there is a problem. And tells 911 about the problem and where you are. Maybe that should relieve my worries. 

For instance, I have a gadget that clips onto my iPhone and records my ECG (electrocardiogram) by measuring the electricity in the tips of my fingers. It shows me my ECG and automatically sends it to a study that I volunteered to join. It even reminds me if I miss too many days of recordings. The gadget can be bought over the counter by anybody, or on Amazon. So do I need to study cardiology so I can read the ECG?

There are products that are under development or already available that can measure glucose blood levels using technology embedded in a contact lens. Gadgets can monitor your adrenal gland function, various circulatory parameters, and more. Other options include heart rate, temperature, oxygen levels, and number of steps taken (and how fast and how far). Tomorrow when I open the paper, probably there will be more announcements.


This is much more than just getting information faster and more easily. The revolution comes from who is now getting it and what they do with it. Is the ECG reading that I get whenever I want it going to change my worry levels? Should it change my worry levels? There is a mood reader under development so that I can see what my mood is after I look at the reading, which only adds a layer of complications.

It will not be long before the gadget measuring heart rate activates the ECG gadget, which will automatically dial 911 if it thinks there is a problem. And tells 911 about the problem and where you are. Maybe that should relieve my worries.

All of this will be done by your new wristwatch. Or by electronics embedded in your clothing. The only way to avoid it is to not wear your watch, or to be naked. Or to not get these scary gadgets.

What about all of the medical-care systems that have to deal with the emergence of these new gadgets? Where and when should the information be sent? Who should see it? What do they do with it? How much of it should be believed? Who checks the reliability? Who licenses it?

The FDA is fussing about it but seems to be taking a “let’s see what happens” attitude. Government agencies write rules to solve problems. So far, no problems to solve, so no rules.

There are several types of people who come to mind when trying to think about the impact.

Hypochondriacs. They are likely to get as many gadgets as they can afford and take multiple measurements every day. They will read everything on the Internet (true or false) and follow their own logic system in deciding what to do.

They will ignore the data just like they don’t go to the doctor when they have significant symptoms. The doctor might find out that they are sick — so no more denial.

They will analyze every little blip with the tenacity of a Ph.D. student. Not that these people will do anything. Some of them just analyze.

The “Aw s__t” people.
They see something, say “Aw s__t,” and that’s as far as it goes.

The confusable.
They see more information than they can assimilate, get confused, and walk away.

We see all of these people in our pharmacies every day. They all need help — someone to talk to, someone to share information confidentially and offer counsel. All of this additional data is just going to increase their need.

Marketing and Distribution

Should these things be sold in Apple stores? Those techies are great, but they have no medical-judgment training. I think that most of these gadgets should be OTC, but only if provided by a pharmacist. The buyer needs to know what is being bought, what it can and cannot do, when to ignore it, when to take action, where the information is going, etc. And most importantly, where to go with questions. Of course, we pharmacists are going to have to take more CE courses to get us ready.

Healthcare Practitioners

I have shown my ECG gadget to some physicians, nurses, and pharmacists. Universally, they do not want to try it, even though I assure them they are the only ones who will see the results. (It has a “try it” mode.) But I can see their minds spinning, trying to sort out all of the implications. A year ago the only time an ECG was taken was in the ER or a cardiologist’s office. Wow, what a change! Remember, this is just one example. There are and will be many more.

Thought for Today

The future is accelerating and will overtake us if we don’t run faster. CT

George Pennebaker, Pharm.D., is a consultant and past president of the California Pharmacists Association. The author can be reached at; 916/501-6541; and PO Box 25, Esparto, CA 95627.