Push-Button Medicine

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eta Young, 81, a retiree from Lodi, Calif., suffers from congestive heart failure and requires almost constant monitoring. But she doesn't have to drive anywhere to get it. Twice a day she steps onto a special electronic scale, answers a few yes or no questions via push buttons on a small attached monitor and presses a button that sends the information to a nurse's station in San Antonio, Texas. "It's almost a direct link to my doctor," says Young, who describes herself as computer illiterate but says she has no problems using the equipment.

Young is not the only patient who is dealing with her doctor from a distance. Remote monitoring is a rapidly growing field in medical technology, with more than 25 firms competing to measure remotely — and transmit by phone, Internet or through the airwaves — everything from patients' heart rates to how often they cough.

Prompted both by the rise in health-care costs and the increasing computerization of health-care equipment, doctors are using remote monitoring to track a widening variety of chronic diseases. In March, St. Francis University in Pittsburgh, Pa., partnered with a company called BodyMedia on a study in which rural diabetes patients use wireless glucose meters and armband sensors to monitor their disease. And last fall, Yahoo began offering subscribers the ability to chart their asthma conditions online, using a PDA-size respiratory monitor that measures lung functions in real time and e-mails the data directly to doctors.

Such home monitoring, says Dr. George Dailey, a physician at the Scripps Clinic in San Diego, "could someday replace less productive ways that patients track changes in their heart rate, blood sugar, lipid levels, kidney functions and even vision."

Dr. Timothy Moore, executive vice president of Alere Medical, which produces the smart scales that Young and more than 10,000 other patients are using, says that almost any vital sign could, in theory, be monitored from home. But, he warns, that might not always make good medical sense. He advises against performing electrocardiograms remotely, for example, and although he acknowledges that remote monitoring of blood-sugar levels and diabetic ulcers on the skin may have real value, he points out that there are no truly independent studies that establish the value of home testing for diabetes or asthma.

Such studies are needed because the technology is still in its infancy and medical experts are divided about its value. But on one thing they all agree: you should never rely on any remote testing system without clearing it with your doctor. s