Each morning, 37-year-old Mark Ricktor steps out of the shower and onto a scale next to his dresser. "Good morning," says a cheery female voice. "Your weight is 308 pounds. You are four pounds over your target weight."
Lots of people have talking scales, but Ricktor's may be keeping him alive. A father of two living in Menlo Park, Calif., Ricktor has cardiomyopathy, or enlargement of the heart - a rare condition in someone so young. Symptoms include an abnormal heartbeat and fatigue so extreme Ricktor used to drift off to sleep in midconversation. The disease is treated with a laundry list of medications - Coreg, Digoxin, Lasix, Zestril - and careful monitoring. Doctors must keep track of small changes in weight and fluid retention - changes that can lead to congestion in the lungs, low oxygen levels in the tissues and even cardiac arrest.
Which is where the talking scale helps. After weighing Ricktor, the DayLink monitor - a product of Reno, Nev.-based Alere Medical - quizzes him: Are you short of breath? Are your ankles swollen? Did you sleep with an extra pillow last night? Ricktor answers by pushing Yes or No buttons on a box the size of an answering machine that sits on his desk; the scale plugs into the box, which in turn plugs into a nearby phone jack. The DayLink transmits his weight and responses to a nurse's station at the Palo Alto Medical Clinic. If anything seems amiss, a nurse alerts his doctor.
Alere's interactive scale is just the latest manifestation of "telemedicine." At its simplest, telemedicine means a doctor conferring with a patient via video conferencing (a technology that's been in use for four decades). There's also teleradiology, in which X-ray and MRI images are wired to a specialist for analysis.
But the big story in telehealth lately is home monitoring. The plummeting cost of hardware and the availability of high-speed telecom services have made it feasible for doctors to keep closer track of patients likely to require costly hospitalization. Alere and a handful of other medical equipment companies - peddling devices that can keep an eye on all sorts of chronic conditions, such as heart disease, diabetes, asthma and depression - see remote monitoring as a potentially huge business opportunity.
According to the federal Health Care Financing Administration, annual health care spending in the United States is expected to hit $1.4 trillion this year and $2 trillion by 2005. About a third of that will go to caring for the sickest 1 percent of the population. If remote monitoring can keep even a small percentage of those patients out of the hospital, vendors figure it'll save insurers billions - and earn the vendors a handsome return.
