Communications of the ACM
A Healthy Dose of Wearables
Wearable devices and technology are reshaping medicine in significant ways.
Credit: Heres Arantes Junqueira
The idea of carrying around a small device to monitor a person's health and spot potential medical problems is not new. From the 1960s television show Star Trek, which featured a fictional handheld scanning device called the Tricorder, to more recent smartwatches and wearable devices, portable technology that aims to improve medicine and healthcare has advanced steadily.
However, wearables are now reshaping medicine in significant ways. Last September, for example, Apple announced it had received approval from the U.S. Food and Drug Administration (FDA) to include medical-grade heart monitoring features in its Series 4 Apple Watch. This included an electrocardiogram (EKG), along with the ability to detect irregular heartbeats. In addition, the watch detects falls, and can alert emergency responders if such an event takes place.
Manufacturers are also introducing glucose and blood-pressure monitoring, breast cancer detection, and more advanced sleep monitoring and feedback into wearables. Embedded sensors, along with wireless technology and the Internet of Things, are pushing the boundaries of medicine into new frontiers.
Not surprisingly, the data collected from these devices is unleashing further changes. Says Dr. Steven Strongwater, president and CEO of the Atrius Health medical group, which delivers care to more than 720,000 patients in eastern Massachusetts, "We are reaching an inflection point where the technology is driving changes in the delivery system."
Smarter Medicine
The impact of smart watches and wearables that monitor health is profound. These devices can spot potential medical problems, improve patient behavior, and boost compliance. The Apple Watch is perhaps the highest-profile smart wearable device—and it has already been credited with saving lives—but numerous other manufacturers and devices are now streaming into the market with wearables that address an array of health challenges.
For example, iSono Health has introduced a three-dimensional (3D) ultrasound system that uses a bra to transmit data to a smartphone or tablet about women's breast health; it detects unusual lumps and masses without having to visit a doctor or clinic.
Medical device maker Omron has received FDA approval on a blood pressure monitor that looks like a smartwatch and connects to a smartphone. It provides clinically accurate readings and offers insights into how behavior and lifestyle can impact heart health.
"These devices change healthcare in significant ways," says Arielle Trzcinski, a senior analyst at Forrester Research. "An individual gains greater insight into what is happening inside his or her body without having to visit a doctor and sit in an exam room. Whether the goal is weight loss, managing blood sugar, or keeping an eye on blood pressure, these devices can alert people—and healthcare providers—before they hit the danger zone."
Connected wearables offer other advantages. One of the most significant is access to data that was not previously available—or feasible to collect. For instance, the Apple Heart Study, conducted by Stanford Medicine, now has more than 400,000 participants, making it the largest screening study ever conducted for atrial fibrillation. "We hope this study will help us better understand how wearable technologies can inform precision health," noted Dr. Lloyd Minor, dean of the university's School of Medicine.
Meanwhile, pharmaceutical firm Johnson & Johnson is using the Apple Watch to determine whether heart data may indicate a person's risk for stroke. It is conducting a randomized clinical trial using aggregate data.
Rx for Healthier People?
Smart watches and other wearable medical devices—along with the data they collect—may lead to different treatment approaches, and introduce insurance rates at least partially based on patient incentives. "These devices and technology in general can aid in patient care and help alleviate burnout for clinicians. But these systems must be designed so that clinicians don't spend hours reviewing meaningless data," says Adrienne Boissy, a neurologist and chief experience officer for Cleveland Clinic Healthcare systems.
There are other concerns, too, especially if the goal is to spur adoption within medicine. Not surprisingly, the quality of data and whether it can be used to accurately identify and diagnose specific issues is critically important. Unlike fitness devices, medical devices must be precise. But security and privacy concerns also exist, including who controls and owns data as it streams across devices, systems, and companies. Finally, Trzcinski says, it forces organizations to reexamine "the dynamics of how clinicians and patients interact" and how billing and reimbursements take place.
Nevertheless, the march toward wearable health technology continues. Smart watches, flexible bands, sensors woven into clothing, and various other devices that connect to smartphones via Bluetooth or cables represent the future of medicine. The ability to integrate these devices into people's lives could change thinking, behavior, and actions—and ultimately lead to healthier, happier people.
Concludes Trzcinski, "We're going to continue to see remarkable innovation. We're going to see devices that are smaller and smarter. As the technology improves and underlying algorithms become more precise and accurate through machine learning, the chance to actually improve people's lives will grow."
Samuel Greengard is an author and journalist based in West Linn, OR, USA.
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