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October 22, 2016
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Logged Down With Loggers

Two of the requirements of the Patient Protection and Affordable Care Act are "accountable care" and "meaningful use". It looks like this is supposed to spread from healthcare providers to health records to individual patients, in some sort of patchwork round-robin mishmosh that makes War and Peace look like a Sesame Street comic book.

The way I read it, I can only be accountable for my health and my physical development if I can get meaningful information from my health logs — meaning, that they display the data I need in a manner that my providers and I can make use of, without requiring me to sacrifice my entire day to the process of manually logging, analyzing, and displaying the relevant data.

So far, what I'm finding falls woefully short.

My computer has two logging programs1, plus my Excel workbook, and if I go the glucometer route my insurance suggests, I might be adding a couple of more2. My mobile devices have separate "diabetes" folders that hold logging apps almost literally from A to Z. On my browsers, I've returned to Livestrong -- at least for now -- and I've found Walgreens rewards my logging with bonus points to use at their pharmacies. (Walgreen's is getting a lot more attention from me since I've signed up with Isis, but that's another story.) I also have an inactive Microsoft Health Vault account (which logged, but did not properly integrate, the information from my inaccurate Homedics blood pressure monitor and one of my One Touch meters). I've had to give up using Polar Personal Trainer because Map My Ride thinks the info uploaded from my watch and the info uploaded from my smartphone are two separate rides taken at the same time...

In short, I'm logged down with loggers.

I wish I could reduce this all to one or two programs, with my data backed up online to something like my Box, Drop Box, or Google Drive account. But all of these logging sites and programs capture different things, approach them differently, and not for the life of them display the information I need, in the ways I need it.

I need all my measurement graphs on the same page. That includes blood glucose, blood pressure, multiple food parameters (calories, carbs, sodium), exercise, hydration, and weight all graphed by time, day, and/or date. Without that "all in one" view, I've no idea if I'm really sodium sensitive (as are a number of people with hypertension), or it's just something restricted for good measure; I've no idea if it's calories, carbs, or trigger foods causing that glucocoaster; I've no idea if I really burn as many (or as few) calories as that exercise tracker (or Livestrong) estimates.

I need my non-exercise measurements displayed by time of day, not by some artificial sense of "meal times" and "sleep times". I need a log that doesn't limit how many times a day I test my blood glucose (or when, if coming up from a low or down from a high), or how frequently I log my blood pressure (does it change with activity? fasting?), and I'd like it to integrate real-time logs of my heart rate, speed, and elevation if I add the correct pedometer or cyclocomputer. My schedule changes with work and other things; I sometimes graze rather than meal; I sometimes have to refuel a workout or treat a low. My loggers should be able to adapt to that.

I really don't care if putting all of this data into one view (or two, if I look at both graphical and tabular) requires FDA approval (it shouldn't, but we all know how that goes). I do care that the system that will do all of that will synchronize readings between all of my devices (like Evernote does with my notes and lists and such), I do want it available for less than $25 per year (or even free, if covered by ads or my health insurance), and I do want unlimited personal access to my data.

And needless to say, I need it to work with any and every brand of glucometer, heart rate monitor, sphygmomanometer (blood pressure cuff), pedometer, cycling computer, and other body measurement device out there. Automagically.

I know some of that is a tall order, but it is what my healthcare team and I need to make "meaningful use" of increasingly-detailed (and loggable) health data.

Co-Pilot (Abbott Diabetes Care) and Zero-Click (Agamatrix/Wavesense)

One Touch (J&J/Lifescan) and/or AccuChek 360° (Roche)

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