William Wijns MD PhD FESC

Abstract

He leads a research project to develop wearable sensors that can monitor high-risk patients, alert them to potential danger signs and help prevent heart attacks.The Irish project will ultimately lead to the production of devices to monitor an individual's vital signs which will put the patient at the centre of his or her own diagnosis and treatment.Such devices, along with the emergence of specially enabled smartphones and the patientgenerated data they provide will move away from what innovator and author Eric Topol MD refers to as 'medical paternalism' towards a more democratic patient-centred form of medicine.The connected health/technology enabled care (TEC) revolution is coming to a wristwatch or smartphone near you-if it isn't already there.Wijns says: 'That is where the future is heading and it's not just wearables and the data they collect but also access to genetic information that patients will make available to doctors.A patient will come with their genetic profile and some identified abnormalities and will ask the doctor what should be done about the problem.It's not so different to what happens now, but it will be patient driven'.Some clinicians fear this will result in the physician being relegated to the role of technician, but Wijns sees it at as an opportunity to reset the patient-doctor relationship.For interventional cardiology, it offers unprecedented opportunities to evaluate, to anticipate, and to plan interventions as opposed to waiting until patients arrive at the more advanced stages of disease when there is structural damage to vessels or valves.Wijns says there is a precedent in the way interventional cardiology changed the physician's role.'When I started medicine, cardiology was a contemplative discipline involving measuring, documenting, and analysing diseases, which was interesting but irrelevant from the patient perspective.Intervention changed our discipline and many others to become therapeutic by giving us a combination of drugs and devices to use.Treatment had previously been the role of the surgeon and the cardiologist existed to make diagnoses'.The rise of monitoring devices and the shift in emphasis towards the patient as an arbiter of data in the journey to diagnosis, is Wijns suggests, a cause for celebration rather than a development to be resisted.'We will have more time to talk to the patient and discuss things.Smart computers will learn how to make a probability diagnosis from

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