Sharing fitness tracker data with your doctor shouldn’t be discouraged

Does your oncologist need to know how many steps you took yesterday? Maybe they should. MIT Technology Review recently covered the new trend of patients bringing data from fitness trackers and smart watches to their doctors’ visits. The two doctors quoted in the article are skeptical (to say the least) about the benefits to care that fitness trackers provide caregivers. With 91 million such devices expected to sell in 2016, it’s a trend that isn’t going away soon.

While caregivers can’t do much with the number of steps a patient has taken, the entire discussion highlights the issue that patients are ready and willing to be active partners in their health. Caregivers can find ways to work with the data that patients bring or work with technology companies to create better data but they can’t dismiss the move patients are making towards collecting their own health data.

One of the doctors cited in the Technology Review article concedes that devices targeted to measure one critical issue show promise:

Trister says that rather than tracking general activity, the most promising wearables target a specific thing. He cites startup Empatica’s Embrace wristband, which measures skin conductance — a signal that tends to rise as you get stressed — to detect an oncoming seizure.

But what the article ignores is that patients are collecting and presenting this data to their caregivers precisely because medicine has historically been opaque towards patients. Whether it’s been the “chart” that Seinfeld mocked to which patients never had access or the EMR-revolution which has left patients with a different login to each provider’s web portal, healthcare institutions have struggled to provide clear and easily-accessed information to the users of their systems.

Wearables that track health demonstrate unequivocally that patients want data about their own health. The question isn’t whether or not patients should track their health using wearables (they will). The questions are 1) how will caregivers work with patients to use that data and 2) how will caregivers work with technology companies to gather better data.

How Patients See It

Tim Bajarin wrote an excellent article about fitness trackers and his own triple-bypass surgery in PC Mag. In it, he describes his own highly-motivated reaction to his doctor’s prescription for health:

Right after I got home from the surgery, I was told I needed to walk and exercise more and eat better. The lack of attention to these things I am sure contributed to my serious health issues…The first thing I did was buy a fitness tracker that recorded steps, calories burned, and heart rate. I now try to push myself to get in my 10,000 steps per day and monitor calories and heart rate all throughout the day.

He identifies the key issue that patients face when collecting their own health data: what do you do with it?

…for those who have serious health issues, that data should also be shared with health providers. Today, doctors are reactive; I have to hand over that data, so they can tailor my health program to meet my needs. But in a digital world, where data can be sent instantly and is used for making decisions rapidly, the role of a health provider should become proactive.

And then, he gives a specific example from his experience that highlights how this could change his relationship to his caregiver. On a business trip to Hawaii, Tim noticed a spike in his blood sugar that his prescriptions did not address. Because he couldn’t reach his doctor and because he had an appointment scheduled for the next month, he continued to monitor but had no choice but to wait to see his caregiver. He did, however, recognize an opportunity for a technological solution to this:

If my blood testing kit was tied to a wireless device and sent directly to the doctor daily, my doctor could have taken a proactive role in my care instead of waiting for me to come in and react to the problem. I know that my doctor is very busy and does not want to be bombarded with data, but if the program was written correctly it could have included emergency parameters that said “if Tim’s blood sugar readings are above a certain range for five days in row, alert me and set up a time to me to call to deal with this.”

This is a conclusion with which a recent article in Quartz agrees:

As wearables are integrated into these health and fitness channels, health care professionals will look to the data collected on an everyday basis, rather than a yearly physical exam, ultimately shifting from an encounter-based health care to continuous care.

The Key Benefit — Connecting Care, Caregivers, and Patients

In an article on Huffington Post, cardiologist Dr. Richard Milani acknowledges that patient engagement is a key benefit to fitness trackers: “If we’re going to succeed in improving health, we have to get patients more engaged in their care.”

Another doctor quoted in that article connects the dots between patient and caregiver engagement using a wearable:

[Dr. Sarah] Timmapuri instructed [a patient] to monitor his pulse on his new Fitbit Surge. If it gets to about 155 beats per minute, he’s to end his workout.

“Even if I did not do a single thing with the information, just the patient knowing that I’m reviewing it will already have a positive effect,” Timmapuri said.

The Global Issue

Patient engagement is an issue to take seriously. Patient engagement can communicate priorities better than alarms. We see potential to engage patients and their families through apps and portals. So in reading articles dismissive of the benefits of fitness tracker data we have to remember that they take a myopic view of a global problem.

While it’s true that your oncologist might not want to read a spreadsheet showing your daily steps for the month, your cardiologist could use it. We shouldn’t dismiss the trend of wearables collecting health data. We should find ways to improve it and to engage patients further.

We should also recognize that actionable data benefits every person involved in healthcare. Patients want to see data they can use to take control of their health. Caregivers likewise need data that helps them respond to patients’ issues and concerns.

Big data can be scary for caregivers who know that steps on a pedometer app only tell one side of the story. But a lack of data is terrifying for patients. Caregivers need to recognize that the rise in health tracking apps represents the desire of patients to take an active role in their healthcare. We need to change the conversation to focus on how data can benefit everyone involved.

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