Transforming healthcare with wearables
The idea that a wearable device may promote good health isn’t new, it was understood historically when Abraham-Louis Perrelet invented his mechanical pedometer in 1780. The difference is that today’s wearable sensors are connected, gather all kinds of data (heart rate, walking distance, location and more) and fit inside a Fitbit, Apple Watch or any of the other devices clamoring for attention behind those market leaders.
The analysts at Tractica say wearable health devices will be a $17.8 billion annual market with 97.6 million devices shipping each year by 2021. There are 39.5 million U.S. adults 18 and over using wearable devices, including smartwatches and fitness trackers, according to eMarketer.
So what can they do? Increasingly we see them used to help nurture and maintain healthy habits, for monitoring of chronic conditions, in research and in medical care provision.
There are high expectations. NHS England's medical director Professor Sir Bruce Keogh says, "These devices will put patients in the driving seat of their own care and allow us in the NHS to predict things, act early and keep people safe and healthy in their homes for as long as possible.”
An aging population and a scourge of preventable disease mean governments want the population to take more responsibility for its health. Chris van Hoof of Belgian research institute IMEC believes “Half of what determines our health is due to our behavior. Eighty per cent of heart disease, stroke and type-2 diabetes could be prevented if the behavior factors could be eliminated.”
We are also seeing increased usage of wearable devices in health treatment. In one instance, data gathered by a Fitbit activity tracker helped save the life of a 42-year old man suffering a heart seizure, the first known case of emergency room doctors using data captured by a wearable as part of the medical treatment decision making process.
In other examples, physicians at the UCSF Medical Center are developing a use for Google Glass for realtime virtual consultations with colleagues during medical procedures; while IBM is developing an essential clinical app for cataract surgeons for eye care company Bausch + Lomb
Another way in which wearables are making a difference is monitoring patients with serious conditions: 88% of physicians want patients to monitor their health parameters at home, according to Orange Healthcare.
This kind of care empowers patients with more independence while providing doctors with deep insights into habits, condition and adherence to medication. Beth Israel Deaconess has been developing BIDMC@Home, which monitors congestive heart failure and hypertension symptoms among home-based patients.
PriceWaterHouseCoopers claim 80 per cent of consumers believe wearable technology has the potential to make healthcare “more convenient”. IDC Insights says 70 per cent of healthcare organisations worldwide will invest in consumer-facing technology, including apps, wearables, remote monitoring and virtual care.
Perhaps the most starry-eyed prediction comes from CDW Healthcare, who claim, “Wearable technology could drop hospital costs by as much as 16% over the course of 5 years, and remote patient monitoring technologies could save our healthcare system $200 billion over the next 25 years.”
A boon to research
There’s a fourth impact: research. One challenge in the nascent mobile health industry is the lack of evidence, while another is the lack of oversight. For example, a study released in 2015 analyzing 243 depression apps available during 2013 noted that many lacked any evidence-based practices or clinical expertise in their design. Patients, medical professionals, device manufacturers and regulators have a vested interest in developing solutions that truly deliver on the promise of what they are meant to do.
With this in mind Apple last year introduced ResearchKit, which open source software scientists can use to harness iOS users into medical research projects. The impact of the release was immediate: Stanford University researchers signed-up over 11,000 people into a cardiovascular study using ResearchKit within just 24 hours after the iPhone tool was introduced.
“To get 10,000 people enrolled in a medical study normally, it would take a year and 50 medical centers around the country,” said Alan Yeung, medical director of Stanford Cardiovascular Health. “That’s the power of the phone.”
At the University of Rochester, over 10,000 participants are now enrolled in what has become the largest Parkinson’s study in history using the mPower app. The published study has given researchers greater insight into what makes symptoms better or worse, such as sleep, exercise and mood. There are trials taking place today in epilepsy, autism and skin cancer, among others.
There’s a useful guide to all ongoing ResearchKit projects here, but these tools have very quickly diversified and are already informing developments in heart, fever and diabetes problems and control.
Tractica research director Aditya Kaul explains some of the other ways in which wearables are impacting health, “Wearables are being seen as an extension of the digital transformation of healthcare, helping pharmaceutical companies to expand clinical trials, enabling insurance companies to engage with customers by incentivizing healthier living, helping healthcare providers to improve the delivery of healthcare, and empowering patients by providing them access to their own health data.”
Apple introduced a second open source research tool, CareKit, earlier this year. This is a toolkit for hospitals and health systems that is already being used for home monitoring of Parkinson patients by the University of Rochester Medical Center, UCSF, Parkinson's Disease Care New York, Stanford Medicine, Johns Hopkins Medicine, and Emory Healthcare.