Wearable Technology and Health Care

Fitbits and smartwatches are on many wrists these days – but do they have a place in a clinical setting?

Posted in Physician Connection on Wednesday, August 25, 2021

One in five Americans now monitor their health using a consumer-grade wearable device, such as a Fitbit or smartwatch.

At the outset, this is great news, as it demonstrates how people are empowering themselves to be active participants in their own health. For example, when Indiana University Health subsidized Fitbits through its employee wellness program, they found over a three-year period that “63% of employees in their wellness program were moving more, 67% better coped with stress, 67% were eating better and 68% had a greater handle on weight management. Diabetes management and prevention improved as well.”

Researchers agree that there are many ways wearables can be applied in clinical settings and within a diversity of therapeutic settings. But challenges exist and more studies are needed to distinguish between what’s “hype” and what represents sound clinical data. This includes more conversations between medical professionals and device manufacturers to “develop methodological approaches and shared understanding of the experiments is required to fulfill the requirements of analytical and clinical validation.”

The potential exists for wearable technologies to help predict clinical outcomes, but a recent literature review also reveals the need for further study. Researchers were only able to identify eight studies of “moderate quality or higher” that incorporated wearable technology data into predictive models and “thereby provide proof of concept for the use of wearable technology in developing models that predict clinical outcomes.”

Types of Wearables

Wearable devices are not regulated by the FDA as they are used for general wellness. If a device that performs these same tasks is implanted rather than worn, then the FDA will regulate it.

Wearables are electronic devices that collect data about fitness and exercise. Fitness trackers, such as Fitbits, have sensors that gather a variety of information, including the number of steps a person takes each day. Smartwatches, such as the Apple Watch, can monitor heart rate trends. These consumer-grade wearables are typically worn based on the individual’s choice. Medical-grade wearables, such as ECGs, glucose and blood pressure monitors are typically prescribed and closely monitored by a health care provider.

American Medical Association Recommendations for Augmented Intelligence in Health Care

In 2019, the American Medical Association (AMA) passed policy recommendations around the use of augmented intelligence (AI) in health care. Augmented intelligence is all about using technologies, such as wearable tech, to enhance how physicians are able to provide care to patients.

Specifically, the AMA supports usage and payment of AI systems to advance the quadruple aim, meaning systems should:

1. Enhance the patient experience of care and outcomes
2. Improve population health
3. Reduce overall costs for the health care system while increasing value
4. Support the professional satisfaction of physicians and the health care team

Gerald E. Harmon, MD and member of the AMA Board of Trustees, emphasized the importance of health care professionals working with tech experts to enhance patient experiences. In the 2019 policy statement, he’s quoted as saying, “Medical experts are working to determine the clinical applications of AI—work that will guide health care in the future. These experts, along with physicians, state and federal officials must find the path that ends with better outcomes for patients. We have to make sure the technology does not get ahead of our humanity and creativity as physicians.”

The statement outlines policies, regulations, mandates, and roles, and underscores the need for training for all health care professionals to effectively work with AI.

“To realize the benefits for patient care, physicians must have the skills to work comfortably with augmented intelligence in health care. Just as working effectively with electronic health records is now part of training for medical students and residents, educating physicians to work effectively with AI systems or—more narrowly—the AI algorithms that can inform clinical care decisions will be critical to the future of AI in health care,” said Bobby Mukkamala, MD, AMA Board of Trustees, as quoted in the 2019 policy.

Wearable 3-Part Series

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