#6 Wearables: A Revolution in Health Monitoring

A few decades ago, the idea of 24/7 health monitoring would have seemed more like a fantasy from Star Trek. Nowadays, there are ample fitness trackers and smartwatches available for your average Joe. The question to be explored is whether wearable technology can go beyond fitness trackers and become a strategy to revolutionize the healthcare space.

A wearable device is one that is worn on the body to track vital signs or health and fitness related data. Wearable technology is a relatively new term. However, pacemakers have been around for years that are considered a wearable device. Pacemakers can now be equipped with wireless sensors that enable them to send real-time data to smart devices.

A recent survey found that 1 in 5 Americans own a wearable device and 1 in 10 wear it daily.[1] As this industry continues to grow at a rapid pace, it is anticipated that the healthcare industry will gain large benefits from the devices and the data they collect.

Fitness Wearables

Smart watches have heightened the information that we know about our own wellbeing. Providing a snapshot of our health in real time. We can now improve our healthcare strategy as we are empowered to take control and monitor our own health. Biological factors such as heart rate, sleep cycles, steps, calories burned and stress level can all be captured by wearing any of the latest Fitbit, Garmin or Apple Watch devices.

Being a fitness freak myself, I love to keep track of my fitness and health data. I am fascinated with the copious amount of data that you have access to with a wearable device. For those of you unaware of the analytical possibilities of wearables, I will go through some of my data, accessible with ease via the Garmin Connect app.

The chart below shows my heart rate vs movement throughout the day. The heart rate fluctuations coincide with the level of activity. My heart rate remained at resting while I was asleep, increased when I began moving, peaked while I went for a run and then diminished when I went to sleep. Over time, you begin to notice distinct patterns and recognise any unusual observations. I’m not saying you can self-diagnose but you can make a reasonable assumption when something is wrong. Therefore, this a first step in the right direction to be able to understand our own health without the need for a visit to the GP.

Figure 1

A nifty aspect of the wearable device is the ability to detect sleep cycles (Figure 2). It observes what time you began sleeping, what stage you reached deep sleep and at what points you woke up during the night.

By measuring your heart rate, it can calculate how stressed you are each day (Figure 3). It encourages you to take some “down-time” to relax and reduce your stress levels. As you can see, I’m at level 19 and clearly stressed to the moon. Perhaps, I deserve a vacation from college!

Figure 2

Figure 3

I swear this is the final graph for all you stats haters, it’s our bread and butter. The wearable device encourages you to set targets for your health performance. This graph shows my total steps, with green signifying that I exceeded my target and blue showing I was below. It is very satisfying when you meet targets and set PBs. It rewards you with badges for meeting certain targets which help to promote exercise. This was only a small sample of the endless analytics available.

Figure 4

Good news, it’s new years resolution time, wearables can help you achieve those ambitious targets!

FDA Medical Grade Approval

Most wearables to date have been restricted as a consumer good in the fitness market, failing to provide a plausible solution for healthcare professionals. This is because the adoption of wearables to a clinical setting requires passing rigorous regulations to be FDA approved.[2]

Although wearables have collected large amounts of useful information, they lack the required accuracy and consistency to be used from a clinical perspective. A physician will not risk the possibility of mistreating a patient on non-medical grade data.

However, the gap is not far and the FDA is changing their approval process to fast-track smartwatches. For example, Fitbit is teaming up with Google to improve the security of their data and the shareability with medical professionals by adopting Cloud infrastructures and APIs.[3] Showing that wearables are becoming a strategic device to provide accurate data that medical professionals can use the diagnosis of patients.

Benefits

Wearables can enhance the healthcare system by enabling Doctors to remotely monitor their patient’s health. Allowing them to make better and more informed decisions as they have access to real-time health records. This will lead to quicker diagnosis and treatment of conditions.[4]

It is predicted that the adoption of wearables will greatly reduce hospital spending. Typically, patients are checked every 4–8 hours in hospitals. [5] This may not be enough attention depending on the needs of the patient. To solve this problem, a wearable device called BioPatch has been deployed to alert nurses with smart notifications when patients need urgent attention. This will enable nurses to prioritize patients more efficiently. It can also be used to monitor patients at home, notifying the hospital with any bad signs.[5] This can reduce unnecessary hospital visits, lowering the cost strain for hospitals and freeing up time for more urgent cases.

Furthermore, it is anticipated that wearables will lead to an increased life expectancy, a reduction in sick days in work and a range of advantages to both healthcare professionals and patients.

Innovations

The adoption of wearables in healthcare is still in its growth phase. Nonetheless, there are many innovations that are applying wearable technology in this space to digitally transform it.

1. TempTraq is a start-up that is creating 24/7 temperature monitoring devices. About the size of a bandage, it tracks a patient’s temperature and transmits the data to a smartphone. If it exceeds a specified range, a notification will be sent to the app. It is important that a child’s sleep is uninterrupted especially if they are ill, TempTraq is making this possible.[6]
2. A seizure detection device called NightHawk alerts epilepsy sufferers of seizures during the night. There have been cases where a mid-night seizure has resulted in death. This wearable aims to save the lives of epilepsy sufferers. It uses heart rate and movement sensors to check if they exceed certain thresholds, waking them before it happens.
3. Wearables are being applied to aid mobility. An Irish start-up, ActionSense, have created a glove to rehabilitate and monitor stiffness for patients suffering from reduced hand mobility such as Arthritis.[7]
4. Glucose monitors are becoming more and more popular with diabetic patients. They can wear the device day and night to keep track of their blood sugar levels. With the press of a button, a microneedle is inserted and collects information about blood sugar levels. The wearable device displays the information which can be uploaded to a companion app. It is rumoured that the next Apple Watch will have this functionality, but who knows with Apple.
5. To manage pain, wearables have begun monitoring a patient’s electroencephalogram (EEG). When a high pain level is sensed, it can distract the user via a connected tablet. An interesting technology is Quell by Neurometrix, comprising of a band on the upper calf that blocks pain signals by delivering nerve impulses that travel to the brain. The level of therapy can be altered in the app according to the user’s preference.[8]
6. The FDA recently approved a pill that tracks if a patient swallowed it. Wait, surely, we’re now in the category of Edibles?!? Medication adherence is a problem with treating mental health disorders. It can assist caregivers by informing them via a smart device if patients are actually taking the medicine.[9]
7. Wearables can even improve your sleep! Philips has created a headband that uses sound technology to complement the slow waves of the brain to prolong one’s deep sleep.
8. Google Glass is a wearable pair of glasses that brings information into your line of sight. Still, in early days, it could be used by surgeons to get guidance for difficult procedures from other medical professionals. It could be used as a learning tool for new physicians or by a dentist to detect unnoticed cavities. A successful application called Augmedix has a remote scribe which removes the need for Doctors to type during consultations, giving more eye contact to patients and speeding up the process.
9. Socks. Yes, even socks are becoming a wearable technology too! Sensoria Fitness has developed a sock that records daily exercise, distress and detects if a person is taking their medication. So, you can now track if your elderly father is actually taking the medicine, he says he is!

Data Ownership

In the future, wearables should reduce the need for bulky patient files as they will be made available on wearable platforms. Although, with this abundance of medical data generated, problems arise with security, privacy and access to data. There is a concern that this information will end up in the wrong hands. An important question is who should have access to your data and who owns it?

Would you let your boss have access to your data?

Well, some companies have established schemes that already use fitness trackers to monitor staff wellbeing.[4] For example, companies use their employee data to monitor stress levels in the organisation. Perhaps it could work out beneficial with additional vacation days as a result of overwork. Or on the flip side, say goodbye to pulling a “hangover sicky”, your boss will see you were up at 3 am boogying in Diceys!

Would you let your insurance company have access to your data?

Insurance companies are giving discounts to customers who let them track their health data through wearables devices. They claim that having access to your health data will enable them to create more personalised policies, more accurately representing the right insurance price. John Hancock Insurance is no longer issuing traditional policies, solely interactive policies. Ireland’s biggest insurance company, Irish Life are also edging towards the introduction of wearable technology. People who are already healthy will be attracted to this option for discounted policies. Although, policyholders can score premium discounts for hitting exercise targets tracked on wearable devices.[10] This will incentivise all to adopt healthy habits and could possibly serve as a strategy for a healthier population.

The application of wearables in healthcare is a strategy to improve our understanding of our own health data and promote a healthier lifestyle. However, we are still witnessing its development stages and it won’t be long before every item of clothing in your wardrobe will be recording your data.

Happy new year to all. Team Checkmate believes 2019 will be a momentous year for technology breakthroughs in the healthcare industry. See you next week for blog #7.

Slán,

Gavin,

Team Checkmate

References

1. Advancedmp.com. (2018). Wearable Devices in the Healthcare Industry. [online] Available at: http://www.advancedmp.com/wearable-devices-in-healthcare/
2. Waqaas Al-Siddiq, F. (2018). Medical Wearables: How Next Generation Devices Will Change Healthcare. [online] Hitconsultant.net. Available at: https://hitconsultant.net/2018/01/24/medical-wearables-devices/#
3. UK, P., Analysis, N., Moscaritolo, A. and Moscaritolo, A. (2018). Fitbit and Google Team Up to Link User Data With Medical Records. [online] PCMag UK. Available at: https://uk.pcmag.com/news-analysis/94649/fitbit-and-google-team-up-to-link-user-data-with-medical-rec
4. Wearable Technologies. (2018). The State of Wearable Technology in Healthcare: Current and Future. [online] Available at: https://www.wearable-technologies.com/2018/10/the-state-of-wearable-technology-in-healthcare-current-and-future/
5. Vinches, A. (2018). How Wearable Tech Is Taking Over the Healthcare Industry | SightCall. [online] SightCall. Available at: https://sightcall.com/wearable-tech-taking-healthcare-industry/
6. Medgadget. (2018). TempTraq Stick-On Wireless Temperature Monitor Cleared |. [online] Available at: https://www.medgadget.com/2018/11/temptraq-stick-on-wireless-temperature-monitor-cleared.html
7. Condell, D. (2018). What’s next in the world of wearable healthcare?. [online] RTE.ie. Available at: https://www.rte.ie/eile/brainstorm/2017/1130/923961-whats-next-in-the-world-of-wearable-healthcare/
8. MIMS News. (2018). Health you can wear: Top 10 medical wearables. [online] Available at: https://today.mims.com/health-you-can-wear--top-10-medical-wearables
9. Ajmc.com. (2018). FDA Approves First Pill That Tracks If You’ve Swallowed It. [online] Available at: https://www.ajmc.com/focus-of-the-week/fda-approves-first-pill-that-tracks-if-youve-swallowed-it
10. Irishexaminer.com. (2018). Fitness wearables could form part of Irish life insurance. [online] Available at: https://www.irishexaminer.com/breakingnews/business/fitness-wearables-could-form-part-of-irish-life-insurance-870428.html