Keep Your Friends Close and Your Doctor Closer: Wearable Technology in Healthcare

My wife gave me an Apple Watch for Christmas. I immediately became addicted to it, constantly fiddling with it, and seeing what aspects of my life I could control from my wrist. While researching if a 12-year-old Toyota Tacoma could be started using the watch (spoiler alert: it cannot), she apologized for it not being the series 4 which has the ECG feature.

The ECG, or electrocardiogram, is a test that records the timing and strength of the electrical signals that make the heartbeat. By looking at an ECG, a doctor can gain insights about your heart rhythm and look for irregularities. The ECG feature of the new Apple Watch is their first meaningful venture into the exploding wearable technology market.

Changing Forms of Wearable Technology in Healthcare

Growing up in the 1980s, the concept of a wearable medical device conjured images of bulky equipment protruding from someone’s body. Smaller technology is usually the goal, so over time the definition of a wearable medical device became a device that is autonomous, that is noninvasive, and that performs a specific medical function such as monitoring or support over a prolonged period of time. The term ‘‘wearable’’ implies that the support environment is either the human body or a piece of clothing. Wearable medical devices have transitioned to wearable technology. Fitness trackers such as Fitbit and smartwatches have revolutionized the methods for tracking and monitoring healthcare information. It does not stop there though as skin patches, implantable devices, and an FDA-approved pill are all on the market now. These devices are used for monitoring a patient and potentially administer medications based on data that is received.

Smartwatches Leading the Charge

Smartwatches are leading the charge in the wearable technology explosion given the multiple functions outside of healthcare that they provide. A report from the NPD Group states that 1 in 6 US adults own a smartwatch, with those number forecast to continue rising. The age of those in the research was mostly 34 or younger. These results are a good sign for healthcare as the adoption by older generations would be presumably for medical monitoring benefits. Smartwatches by Garmin and Google are also making strides in the market, though still far behind Apple and Samsung.

Accuracy of the Apple ECG

Growth of the wearable technology market within healthcare would not be possible without continuous improvement in data quality. Given the buzz around the Apple ECG feature, the accuracy of the device needed examination. Dr. Sanjay Gupta, CNN Chief Medical Correspondent, reviewed the Apple ECG for CNN. In it, he described that Apple’s commitment to accuracy and improvement of the ECG seemed to be real, while also describing that there was still a ways to go.

For a close to home example, I interviewed Dr. Kelly Gajewski, Pediatric Cardiologist at Children’s Hospital in New Orleans, about the quality and potential of the Apple ECG.

Sample ECG from Apple Watch Series 4
Sample ECG from Apple Watch Series 4

 

I discovered the excellent quality of the Apple 4 ECG when my patient emailed me a pdf of his rhythm while having palpitations.  I was able to accurately diagnose his dysrhythmia from a single strip and discuss treatment options right away.

Dr. Kelly Gajewski

 

With continued advances and connectivity to other devices, is it possible that a person experiencing a life-threatening heart event is saved thanks to their wearable technology? I believe that we are not that far away from that day. The global implications for this capability are significant.

Wearable Technology Worldwide

Wearable technology is seeing an increase globally.  CCS Insight forecasts that smart wearable devices will double by 2022 and have 233 million units sold worldwide.   The wearable technology market is expected to reach $68.6 billion in market size by 2026 based on a report from ResearchAndMarkets.com. Given the availability of devices, North America is expected to own a significant portion of that growth. The reasons behind this are opposed.  On one side, poor dietary habits and a sedentary lifestyle have led to the need to monitor diseases such as diabetes, hypertension, and obesity. On the other, awareness of tracking fitness for the more active lifestyle allows for the growth of the market due to the desire for health-level feedback. The Asia Pacific region will show the fastest levels of growth due to market penetration of devices, income available, and chronic diseases in the population.

Disrupting the Insurance Industry

Wearable technology in healthcare has the potential to disrupt the way the insurance industry operates. John Hancock announced in 2018 that it would offer only “interactive” policies where a consumer can earn discounts as an incentive to maintain fitness.  The method for interaction is through fitness tracking on a smartwatch or other wearable technology. Similarly, Humana insurance will use Fitbit Care to assess insurance premiums for the consumer.

The promotion and incentivizing of healthy living are necessary to improve the population’s overall health. However, the question remains that as insurance agencies collect this data, will they use it to eliminate coverages based on early-stage detection of potential issues? Insurance uses data for risk analysis. The degree to which a person signs away their privacy rights in the name of cheaper insurance premiums requires discussion. New regulations in insurance must be reviewed and adapted to ensure that the data gathered will not violate any human or privacy rights.

The Militarization of the Healthcare Industry

Wearable technology is no different from any other technology in that it has the potential to be compromised and used for malicious purposes. An attack, whether from an individual hacker or a State-sponsored attach, could be fatal for the individual in instances of wearable technology which controls insulin release or regulation of the heart. A Cybersecurity report released in 2018 details out the potential for these attacks. Concern remains that the healthcare market is slow to respond to any security risks due to development and regulatory compliance times. Addressing these vulnerabilities are paramount to the long-term success of the wearable technology in healthcare industries.

Keep Moving Forward

Despite the potential within the insurance and military for adverse consequences, wearable technology in healthcare initiatives will continue to move forward. Addressing security gaps is critical, while the privacy and rights of the individual must be protected as insurance companies gather massive amounts of data. The ability to provide monitoring and care for a patient remotely is invaluable to the healthcare industry. We must continue to expand our realm of possibilities to provide this care globally.