Your smartwatch talks a lot but may not say as much as you believe with regard to health. Constant data collection from wearables claims to improve medicine at large. Is the “quantified self” the next evolution or a gimmick for patients?
Imagine your sleep and heart data beamed straight to your medical record. Your care team might notice a red flag and schedule a virtual appointment immediately. Health care wearables, meaning tech that you can put on like clothes, can make that happen. Apple Watches can take your heart rate and track exercise goals but can’t time your insulin as a continuous glucose monitor does.
Patients can miss that nuance because technology blurs the line between wellness and medicine. The FDA pays close attention. You might see your doctor once to twice a year and have your vitals measured (e.g., height, weight, blood pressure).
Pro-wearable users argue that smart devices are a complement for the other 363 to 364 days a year you aren’t seeing the doctor. Sensors continuously generate health data, and we take our devices everywhere. Doctors and patients can then form custom health and wellness goals from these vectors.
Regardless of whether you have a consumer-grade (e.g., a Fitbit) or medical-grade device (e.g., a glucometer), someone has to curate the data. In most situations, patients and their doctors take a passive approach if wearables are in play.
The heart-rate data from a chest monitor can transfer itself to your medical record, and new care gets organized if your provider notices something wrong. For other measures, patients can report their own data (i.e., active monitoring) to a physician or health system.
This is where the use case for wearables loses ground — patients don’t want to spend extra time entering info. Smart health care devices are supposed to draw a better landscape of health automatically. Patients who have to enter data themselves to transmit it to a doctor can lead to major technical errors. Some people could be wearing their device upside down. The data could be pristine, but the algorithms calling out red flags (e.g., high/low blood sugar or interrupted sleep) may be inadequate. Not to mention that companies or bad actors might capture and resell your data. Your doctor might also feel that a bunch of circuits and wires intrude on their expertise. More research is necessary for everyone to have better confidence in wearables.
When visiting your doctor, a few questions are worth discussing if you think wearables might help an issue. Is a given product recommended by a physician you trust? Does the FDA approve that device for XYZ indication? Are there any replicated, peer-reviewed studies demonstrating effectiveness?
Even if a smart health device works, the decision-making aspect of the wearable matters.
Can the doctor make a medical diagnosis and treatment plan based on any given reading? If so, you have a clinical wearable. Otherwise, your device is a consumer-focused wellness tool.
All of that being said, don’t let your wearables control you! It’s easy to overreact to a blip, but reach out to your PCP if there are serious concerns. A wearable manufacturer has to spell out what the data tell and don’t tell you. Check if a company openly admits vagueness or disclaimers for readouts (e.g., Apple’s “Apple Watch never checks for heart attacks”).
Source: The Journal of Nurse Practitioners Patient-Wearable Engagement
Even if an over-the-counter wearable gives directional advice without any medical leverage, how should we treat our health care data properly? The Journal of Nurse Practitioners argues that we’re in the midst of a “quantitative self” movement. Patients feel empowered with data to participate further in care while allowing providers access to the statistical landscape of patients’ health. This sounds cool, but there are tradeoffs we shouldn’t be quick to forget.
Wearables themselves don’t create incentives to oversee one’s health — in fact, it’s easy to fall off the grid with following up on your health data if a long enough string of readings look normal.
Those benefiting most from wearables (i.e., rural and elderly patients) may not have tech-savviness or access to the internet to best use such technology.
Overreliance on data and self-diagnosis can also be an issue — you still need a licensed professional to make sure everything you observe checks out. Here’s another worrisome thought: should the insurance and medical industries have greater access to your data, even if you save money or find better health from sharing that info?
Source: Deloitte Insights on Wearable Data Concerns
According to Deloitte’s recent Connectivity and Mobile Trends Report survey, four in ten U.S. consumers using smartwatches or fitness trackers are “very” or “somewhat concerned” about their data privacy (in relation to such device usage).
Information consent issues stem from data moving to third-party companies. Insurance firms of all kinds can raise your premiums if your medical data suggests a propensity for certain issues. You might get unwanted ads or attention due to health stats implying that you’re sedentary or have a chronic condition.
Employers could subvert you from full-time work on the basis of data-driven medical insights. Smartwatches and fitness trackers operate in a gray area not fully accountable to HIPAA. These concerns lead to a probable reality for all patients.
Of course, the better doctors of tomorrow should embrace technology, including wearables. If you’re unsure if your new phone app or smart headband paints a clear picture, ask your physicians if a given stat or device (e.g., Apple Watch ECG, blood pressure sticker, continuous glucose monitor) meets their standards — let wearables’ health care data be the tool you use rather than a tool using you.
Rushi Nagalla is co-founder of a dermatology practice.
Image credit: Shutterstock.com