Wearable Technology Will Move Patients to More Continuous Care-The HSB Blog 4/26/21
Wearable technologies will transform patient care from episodic to longitudinal by bringing empowering innovative solutions that provide more continuous care insights as well as more convenient and frequent transfer of information between patients and providers. As a result, patients will receive higher quality, lower cost care. For example, given advances in technology, wearable sensors paired with advanced algorithms can now be used to predict a range of conditions including the onset of infections, inflammation, and even insulin resistance by monitoring vital signs such as heart rate, physical activity and skin temperature. Wearables provide an easy to use and convenient way for consumers to monitor their own health and eliminate the need for preplanned actions by patients such as finger-pricking or manually entering data in records. As a result, users can seamlessly monitor their health data via an app connected to the wearable and tailor the use to themselves and their lifestyle. Wearables have an expected annual growth of 30% globally and are forecasted to generate roughly $67 billion by 2030. Nevertheless, there are still issues surrounding access to wearables, such as broadband access, education, cost, safety, and data privacy/security.
Wearable technologies will:
Work to improve health outcomes and provide cost-effective solutions
Increase patient self-awareness and engagement allowing people to monitor their health more conveniently
Allow health information to be shared more fluidly with providers, enabling early detection and prevention of diseases while maintaining health
Potentially lower hospital costs by as much as 16% in the next 5 years
As noted in Nanoelectronics Materials, Devices, Applications, “originally designed for acute, episodic care rather than ongoing treatment of chronic conditions, the current health systems are not good at providing the ongoing, coordinated care required by the latter.” They add that since “the large majority of diseases are linked to chronic disease” integrating coordinated care with health systems will be key particularly as the number of patients in the 65 or older category increases as a percent of the population.
Wearable consumer healthcare devices have been around for over a decade. Fitibit invented its first step counter in 2010. Since that time the market for wearable technology and smartwatches has exploded. For example, according to a Pew Research Center study conducted in June 2019, roughly one in five adults regularly wear a smartwatch or wearable fitness tracker. The global market for healthcare wearable devices is expected to grow at an annual growth rate of 30%. The growth is expected up to $27 billion powered by smartwatches. These technologies are designed to both empower and engage patients by allowing them to capture data about their behaviors that lets them monitor their daily health and share their health information with providers. Moreover by providing timely and accurate feedback these devices can educate patients as well as empower them to take corrective action when misperceptions exist (ex: amount of daily exercise) thereby facilitating disease prevention and maintenance of health. Health data collected by wearables can be categorized into either ‘quantified self’ (QS) or wearable technologies. Wearable technologies typically automates data collection and uses an algorithm to analyze the data it collects and then presents recommendations based on the data. Quantified selfers apply the unanalyzed personal numeric data collected from the wearables to activities such as eating, sleeping, and exercising which the user can then use as motivation to potentially drive behavior change. Wearables are embraced by users because they are an automated way to track certain data as long as the user is wearing or carrying the device. Wearable technology ranges from smart-watches to smart fabrics. The most commonly measured data include vital signs (heart rate, blood pressure, body temperature, blood oxygen saturation), posture and heart health via an electrocardiogram. From those first step trackers, wearables have now evolved to include: 1) smart glasses for monitoring electrical impulses in the wearer’s brain while tracking eye movements, 2) necklaces for heart monitoring, 3) contact lenses to track glucose levels or eye pressure, 4) headbands to capture electroencephalograms, and 5) apparel embedded with technology that allows cardiac measurements. These wearable technologies can directly impact clinical decision-making as they allow real-time measurement and diagnosis of issues that can facilitate timely interventions. In addition, since the measurements are continuous and longitudinal instead of episodic, patients can get better, more precise care while reducing the cost of care (ex: patient monitoring and rehabilitation outside of hospitals). According to “Wearable Technology Applications in Healthcare: A Literature Review” wearables are currently being used in: 1) prevention and maintenance of health including fall detection, physical activity monitoring, stress detection and weight control; 2) patient management using point-of-care diagnostic devices; and 3) disease management including cardiac monitoring, blood pressure monitoring and, diabetes care management, just to name a few. While the technology is still in its early stages and there is debate about the usefulness of consumer vs. medical grade wearable technology for clinicians, as the quality of the technology improves this gap should narrow considerably. Nanoelectronics Materials, Devices, Applications notes “by combining the convenience and frictionless use of consumer wearables, the signal quality of medical-grade physiological sensors and the personalized algorithms to adhere to coaching, powerful solutions will emerge that would assist our health at any age.” In addition, a number of studies have demonstrated that while consumer wearables may not be as accurate as medical-grade technology there is a correlation between their measurements and those taken with medical-grade technology.
The integration of wearable technologies provides innovative solutions for combating healthcare issues since they are designed to maintain health by continuously monitoring conditions and enabling disease prevention. Not only can they provide real-time, early indications of adverse health situations, wearable technologies can reduce costs by helping diagnose and treat conditions before they become acute and often can receive care without the expense of visiting a hospital or other facility. According to Forbes, wearables are projected to lower hospital costs by as much as 16% over the next five years. These technologies provide convenient and cost-effective access to those seeking care. In addition, wearables can allow at-risk patient populations to be monitored more closely and become more actively engaged with their health, thus accelerating and improving health outcomes. Although there are many positive aspects to utilizing wearables technologies, we must recognize that they are still in the early stages of achieving their potential. Issues such as user acceptance, data privacy and security, and ethical applications may impact accessibility and acceptance. Ensuring patient confidentiality and data security while complying with HIPAA regulations through devices such as encryption and authentication will be vital to ensure that data is trusted, and secure. Patient compliance and adherence will also weigh heavily in the success of wearables with patients being the key ingredient in the application. Therefore, user interface and user experience must be tantamount in the design of the wearable products and their accompanying applications. Well designed wearables should encourage patients to actively address the role their behavior plays in their health and take responsibility for their lifestyle choices. For example, according to a study by HIMSS entitled, Wearable Technology Applications in Healthcare: A Literature Review”, user preferences need to be considered in the design of devices in order to gain clinical acceptance and be useful within typical user settings for patients. Wearable devices should be compact, simple to operate and maintain and not affect a user’s daily behavior. Similarly, healthcare providers must ensure that patients are comfortable enough in their clinical relationships that they will be compliant in their use of the technology and well-versed in operating it to achieve successful use. Moreover, the more individual patients use wearable devices, the better artificial intelligence and machine learning algorithms will be at collecting and discerning patterns collected from their behavior and recommending personalized interventions to improve their care and health. Importantly, when used to their fullest potential, wearables will not be replacing healthcare professionals, but rather will act as an adjunct to clinicians to make it easier to manage health outcomes and provide insights, particularly for those who may lack access to clinicians or need more continuous monitoring.