How wearable technology could lead us into the future of healthcare.
By Jim Poggi
If you perform an internet search on wearables, you will find references going back to the 13th century with the first eyeglasses. In the timeline there are classics including calculator watches and Bluetooth earpieces, and less notable items including the sneaker phone and airconditioned top hats. Trying to separate the innovations from fashion fads and out-of-control technology has fascinated me since I put on my first “fitness tracker” 10 years ago.
This month I will take you on a journey to think about wearables and how they fit into the world of healthcare today and tomorrow. There will not be an update on where to buy the latest sneaker phone. I plan to use my insights on how healthcare and wearable technology have evolved and intertwined so far and consider what I believe to be some useful possible applications of wearables for the future. I encourage you to put your imagination to work and think along with me: what about wearables?
Wearable fitness trackers have evolved from simple devices that measure your steps to devices that now track your steps and daily activities and can also perform a one lead ECG, recommend exercises and fitness routines, track and trend pulse rate, cheer for you when you show progress against fitness goals, provide meditation and breathing routines and more. Though I have used a fitness tracker for over 10 years, I’ve frequently described wearables as technology designed for the worried well(thy). They seemed cater to a pretty specific sub-set of Americans: those who cared about their fitness level and wanted to actively participate in improving it with wearable technology.
With type 2 diabetes, obesity, and uncontrolled hypertension all increasing and negatively impacting the health of Americans overall, I’ve felt that most Americans who wore them had a fashion statement in mind rather than health and fitness improvement. Granted, there is a committed group who use their wearable device to improve their overall health, fitness and even train for athletic events. But, even with smartphone applications providing a remarkable range of data element tracking options and sophisticated interpretations of the data, wearables have not yet found their larger mission in healthcare. They were technically interesting, provide a definite coolness factor, and have proven to influence behavior for committed individuals, but I did not see them influencing improvements in overall health for the general population. I have changed my mind.
Imagining the possibilities
However, everything changed when I saw the first continuous glucose monitoring systems coupled with smartphone and wearable technology. The benefits were impressive: instant and continuous feedback on glucose levels, no fingersticks, a wearable sensor that lasts for days and sends data to the manufacturer’s monitor or a smartphone, and greatly improved comfort and convenience for the users. Just getting rid of the pain and inconvenience of fingersticks is a big leap forward. And these devices have been shown to provide information and feedback that results in better control of both glucose levels and A1C.
Overall, this is an impressive step forward for patients with diabetes. It has the potential to reduce morbidity and mortality associated with diabetes and improve patient lives, the patient experience and improve overall health – all because of the continuous data stream, ease of use and integration with smartphones that have become part of our daily life and greater convenience and less pain through replacement of fingerstick technology with a wearable sensor.
As I reflected on the innovation provided by the wearable sensor technology coupled with smartphones, I began to wonder where the path of wearable technology could lead us in the future of healthcare. Could it be harnessed to target morbidity and mortality associated with chronic disease states, help with anxiety and depression, or alert us to the earliest stages of an infection? What unmet needs could this technology fulfill?
I’ve put some thought into how wearable technology could provide tangible benefits to the healthcare system by providing actionable data that influences diagnosis, monitors data related to a chronic condition (such as our diabetes example), speeds the path to care or even uncovers an underlying condition before it becomes obvious. Here are a few possibilities that intrigue me. I encourage you to harness your imagination and come up with your own list of possibilities.
Improving hypertension control
According to NIH/NCBI data, hypertension effects 32% of adults in western society, accounting for over 8.5% of all physician office visits. Over 50% of all hypertensive patients are considered poorly controlled. Finally, hypertension is linked to heart disease, stroke, and kidney disease, all of which are among the 10 leading causes of death in the United States. What if a wearable could monitor blood pressure in real time and provide feedback? What if it could also administer medication as insulin pumps do? What could the future of hypertension look like?
Infection
COVID-19 has led to widespread use of non-contact infrared thermometers, but they don’t provide continuous monitoring of body temperature for the individual patient. What if there was a sensor in the ear or elsewhere connected to real-time temperature monitoring and reporting? Could respiratory infections be caught earlier? Could we reduce the incidence of sepsis? Could ER diagnosis of patients take place before widespread infections took place?
Neurological disorders
Narcolepsy, seizure disorders and other neurological disorders involve changes in the patterns and transmission of brain waves. Some animals, including dogs, can become alert to seizures in their earliest stages. So, there is something here that can be measured. What if wearables could track these changes and provide an alert before the neurological disorder results in a seizure or the patient sleeping inappropriately?
I find the potential of wearable technology coupled with knowledge of which clinical conditions are subject to assessment by real-time monitoring to be an area of technology and healthcare on the verge of fundamental changes. I have my shortlist of conditions where I see opportunity for improvement. What is on yours?