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Wearable devices like the Apple Watch and Fitbit are increasingly popular methods for individuals to keep track of their own health. Yet when it comes to use in the clinical setting, wearable device health data has a long way to go.
While wristband gadgets benefit individuals by keeping tabs on the number of steps they've taken or monitoring their heart rates, most wearable device health data hasn't reached the point where it can be used by clinicians to help make a diagnosis, said Jagmeet Singh, M.D., associate chief of the cardiology division at Massachusetts General Hospital's Corrigan Minehan Heart Center.
"At this juncture, it's certainly not something that doctors are routinely using for monitoring their patients," Singh said.
Wearable device data: Where it stands today
Singh said wearable device health data today has the biggest impact on the patient side, and the data is not typically incorporated on the clinical side due to a number of variables, including patients not always adhering to their devices, limits on tracking heart activity and lack of data showing wearables are clinically valid tools that affect clinical outcomes.
"I have a lot of patients who have Apple Watches and Fitbits and other pedometers, and they oftentimes come in with their data suggesting what their heart rate changes were, the number of steps they've taken," Singh said. "So it has influenced lifestyle changes within our patients. But again, that's at the patient end of things. The data is not being used on a routine basis by our practice nurse."
Even devices such as the recently released Apple Watch Series 4, which touts an FDA-approved electrocardiogram monitor, have not yet reached the point where data it collects is viable in the clinical setting, Gartner analyst Alan Antin said.
The healthcare community generally accepts wearable devices that encourage patients to be more active or make them more aware of their health, but believes the devices don't provide enough information to form an accurate assessment of a patient's health, Antin said.
"The new Apple Watch offers a single-lead type of test; you would typically in a doctor's office have a 12-lead test," Antin said. "There are other products in the market that will often give you a single-lead test that are FDA-cleared devices, and that's good information, but still for the most part the medical community is going to want to evaluate potential issues with more robust testing."
A lead is a look at the heart's electrical activity from a specific angle. In a 12-lead ECG, a doctor sees the heart's activity from 12 perspectives, while a single-lead ECG can typically be used for basic heart monitoring.
Some companies, like AliveCor, are working on developing wearables that would feature more robust, six-lead testing. Once products feature tests that emulate what happens at a clinical level, Antin said acceptance will be much stronger among the healthcare community, but it's something that could take years to accomplish. Antin said before wearable device health data reaches that point, the focus will be more on awareness, prevention and putting power into the hands of end users when it comes to their own health.
"That should definitely be a big step ahead for wearables in terms of moving them to having greater health utility than activity tracking," Antin said. "We're in the early innings still of this part of the ballgame."
The future of wearable device health data
Despite the fact that wearable device data collected now may not yet be usable at the clinical level, Singh said wearable device health data points to the future of healthcare.
Jagmeet Singh, M.D.associate chief of the cardiology division, Massachusetts General Hospital
"Wearable devices will have the ability to measure ... things like temperature, blood pressure, respiratory rate, heart rate," Singh said. "I think wearables, depending on what information they're gathering, will certainly have a role to play in the future."
Singh said before wearable device data becomes widely accepted in the healthcare community, vendors need to develop and validate the right sensor technology, show the devices have an impact on clinical outcomes, provide evidence that can be reproduced consistently and have a strategy to integrate wearable device data into clinical workflows.
Antin said he believes the future of wearable devices lies in augmenting healthcare workers and helping them provide better services to patients by giving them a broader scope of information.
"You need to see things come into the marketplace that are able to provide a lot of health tracking that are invisible to the outside world, like a Spire Health Tag, to serve like Band-Aid size devices you affix to the inside of your clothes and they're health-tracking for you and they send data to an app," Antin said. "Or you see ... smart watches that have specialty functions like the Omron blood pressure monitor. That's really where it's going to go ... whether you're talking about at the physician level or the nurse or PA level."