How Wearable Fitness Devices Actually Affect Patient Health

The consumer wearable device market is predicted to exceed over 4 billion dollars this year. With roughly one in five adults already owning a consumer wearable device, it’s evident that putting hard numbers behind trends of daily life, (whether they be clinical or not), entices consumers with the promise of a sense of identity and self-knowledge.

But what does this mean for patients and healthcare providers who are partnering to manage chronic diseases?

We know that current consumer products on the market are not medical grade devices – these are designated consumer lifestyle / fitness products that lack comprehensive calibration and specificity.  Device measurements such as “steps” can differ based on the location where the device is worn, stride length, amount of arm swing, etc. Given the inconsistencies with current consumer wearable devices, they lend themselves to be more appropriate for general health and wellness as opposed to someone looking for a true assessment of their health for a medical purpose, relative to a specific disease. (We’ve seen this line blurred most recently in the class action lawsuit against FitBit regarding the accuracy of their “PurePulse” heart rate tracking.)

What the patient can get from these consumer devices is an awareness of the delta, or the relative change in the metrics they’ve paid to track – the change in their steps, heart rate, sleep, etc. over time.  Comparisons beyond this personal self-quantification circuit, (i.e. to norms and standards through the device’s app or considering a look into big data), may make little sense without the additional context of that patient’s daily life.

Wearing a wellness tracker may encourage engagement from patients, but the act of wearing is not enough to promote a behavioral change.

A recent clinical trial at the University of Pittsburgh showed that “devices that monitor and provide feedback on physical activity, may not offer an advantage over standard behavioral weight loss approaches.” The capacity of the device is overshadowed by the fact that humans need to mentally commit to a new routine and mentally learn a new feedback loop to make it a habit.

The sheer act of acquiring a wearable device could be enough, for some patients, to be a motivational push toward becoming more engaged in their wellness. However, motivational power can wear off unless a patient knows how to effectively make change and establish new routines. Numbers alone from a consumer wearable device can’t give insight into the:

  • Current barriers patients face when trying to achieve their wellness goals
  • Emotional needs and support required to effectively make a change in their lives
  • Household dynamic and cultural influences on their path to managing their disease

How can device manufacturers, (and pharmaceutical companies interested in partnering with them), help patients successfully take a step toward improving quality of life, when they are not clear of the obstacles and burdens patients face? It is critical to be humble (listen to patients) and to be curious (understand their challenges), before proposing a solution.

For instance, telling a patient that they didn’t sleep well the previous night isn’t enlightening. Showing the quality of sleep, tracked through a consumer wearable device, is merely validation of the experience, but it doesn’t provide the reasoning behind the poor sleep, how to fix it moving forward, or how to motivate the patient to practice better sleep hygiene. Who is there to connect the dots for patients?

In order to implement a behavioral change, patients need personalized recommendations beyond the device – education along the way, support, intervention, and ways to annotate to provide much needed context when partnering with their healthcare provider.

Get physicians on board; otherwise don’t expect to see consumer wearable devices incorporated into disease management.

In the current managed care setting, health care teams do not have the infrastructure to support discussion of consumer wearable device data with their patients. The data presented by the patient lacks context (and therefore meaning), and exists without guidelines, markers, or norms for comparison. Even if the inconsistency of data collected between patients (and various devices) were not an issue, the data would still need to be integrated into current healthcare management systems to possibly become applicable. As it stands, most healthcare providers have a 20 minute window to spend with their patients, and don’t have the additional time or compensation to interpret results from a consumer wearable.

So what would be of clinical value to healthcare providers? As described by a study in BMC Medicine, it’s necessary to figure out the “key patient-centered issues relating to usefulness in care, motivation, the safety and privacy of information, and clinical integration,” in order to make these devices work for patients suffering from chronic conditions and the physicians who treat them. Solve against the clinical impact that needs to be met for a healthcare setting, otherwise healthcare providers will not integrate these devices as part of disease management, resulting in a loss of legitimacy as part of a care regimen.

Consumer wearable devices seem to be here to stay for the time being, and while the technology and accuracy will continue to improve, it’s not there yet. Patients and physicians need to be actively engaged to develop and enhance programs surrounding current devices in order to produce positive wellness outcomes in those living with chronic conditions.

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