Can Apple Watch and Other Wearables Improve Health of Sickest?

The year of the wearable device is underway. By 2019, there could be more than half a billion wearables in use every day.

I’m asked all the time about the wearable device impact on health – do they really help people lose weight? What do you use? What are they missing when it comes to monitoring health? What will they look like in five years? Who will have a bigger impact on health – Google or Apple? When will devices be implanted into the body? There is no shortage of questions or opinions on the topic but one thing is certain: wearables will disrupt how we manage our health.

At Humana, we’ve been able to extrapolate data from these wearable devices to help our members improve their health. HumanaVitality, our wellness rewards program, collects data through the many devices with which it integrates and uses it in three critical ways. Most importantly, the data is presented to members in a simple, easy-to-interpret manner through the HumanaVitality app, webpage or through the Apple HealthKit to help them track progress along their path to health.

As a data-driven and highly measurable program, HumanaVitality also uses collected data to reward members for reaching daily activity goals such as walking 10,000 steps. Finally, we also provide employers with aggregated, privacy-protected data and analysis for the purpose of optimizing their wellness program.

While many of these wearables focus on activity tracking and may not be ready to disrupt today, the trends are where the tide is.

It’s Booming in Fitness

Take a stroll into any big box retailer – Best Buy, Dick’s or Sports Authority – and you’ll find an entire section or small aisle dedicated to wearable devices, aka activity trackers. Fitbit is encouraging people to “find their fit” across different sports; Samsung is already off to the races with its wearable offerings. And it goes without saying that we should always keep an eye on Google.

Recently, Apple showcased some unique aspects of Apple Watch and has already made waves with its HealthKit app. While we’ve been pleased with how our members have used our HumanaVitality app for HealthKit, we’re now working on an app for the Apple Watch.

Helping people start to easily measure their health while they’re young, active and motivated to stay in shape is essential in turning the tide of obesity. If healthy tracking becomes part of their lifestyle today, it will stay with them well into the future. Understanding how they consume information differently from other groups – through the power of data analytics – will be essential in how they use wearables to improve their health.

But let’s be honest. Convincing weekend warriors who train for marathons, triathlons and other sports to spend a few hundred dollars – or more – on the latest and greatest wearable device is easy. The sales projections speak for themselves.

These people – myself included – take their fitness very seriously. They’re already in good shape and are looking for how new wearables can help them better measure their performance and gain that extra edge.

Progress is Taking Place

I’ve seen these fitness devices time and again help with behavioral changes, and I blogged about my own experience last year. When you know your numbers, whether it’s from a Fitbit or another activity tracker, it pushes you to be more active and change your not-so-good behaviors. Companies like Fitbit and others have encouraged step challenges, using social platforms to encourage active users to compete to see who takes the most steps in a day or a week.

Helping people establish an active, healthy lifestyle when they’re young – and are being introduced to the sedentary environment of an office – is important. You don’t need a wearable on your wrist to know that your body was not designed to sit eight hours a day. Even weekend warriors are not immune to the “sitting is the new cancer” concept that Apple CEO Tim Cook reminded everyone of recently and how they hope to address this problem with Apple Watch.

Wearable devices that primarily track steps today will evolve to help people in ways we haven’t even seen yet. But making an impact on health goes well beyond fitness communities. It starts in the homes of people who – one might argue – need the technology more than these other communities.

The Real Opportunity

This raises a question: Is enough attention being paid to the market where these types of devices can make a real impact in the health of consumers?

A few months ago, J.C. Herz wrote an insightful column about the audiences that really needed to benefit from wearable devices: older people living with chronic conditions who have limited financial means. It’s a very rational argument, when you consider that the majority of dollars spent on health care are related to chronic conditions.

Many of these people – quite a few of them are our members – are seniors living with multiple chronic conditions and are confined to their homes. They don’t get out much and when they do, their movements are few. It’s not easy for them to move from one room to another let alone walk around the block. When it comes to their health, these people are primarily concerned with not having a fall so they can stay in their homes and out of a hospital. And their families and caregivers deserve a means to stay connected to them.

But, like their younger family members who care for them, seniors want to achieve their best health. While a fitness tracker does not provide the type of self-monitoring they need, devices that are easy to use that monitor their glucose levels; check their pulse and/or blood pressure; and determine how many times a day they access the bathroom can deliver a great value.

In other words, it’s not always about a device that a person wears on his or her wrist. Devices that take into account the “home” environment, as Nest is attempting to do with energy and AT&T with security, may be where the device can truly make an impact in health. Given that Nest is a motion sensor device, Nest and other devices can function in a way to help with in-the -home health monitoring as well.

Making it Happen

So how can these devices help seniors living with chronic conditions? It starts with personal devices tracking vital signs and other forms of monitoring in their homes.

There has been solid momentum thus far. For example, NeuroMetrix’ Quell is a wearable device that’s designed to provide relief for chronic pain. At CES, Mobilehelp and Honeywell teamed up to showcase Mobile Vitals, a “small wearable device that provides long-term vitals monitoring.” Startups like Lively are extending monitoring to caregivers as well. Smart innovators like the ones above have put a stake in the ground to service the seniors with chronic conditions.

Innovation is likely to come from combining two or more things with seemingly divergent objectives to form a viable innovation. For example, Apple combined two or three concepts, with the AppStore at the center to do something viewed as truly innovative. This is similar to what MobileHelp and Honeywell are trying to do with in-home monitoring and security system monitoring.

The potential health impact could be significant. For example, an easy-to-use heart monitor in the home of a senior could monitor beats per minute. If it gets out of that range, the heart monitor is securely integrated into the primary care physician’s network. The heart monitor notifies the physician of the irregularity. A scale could notify the primary care physician if the patient begins to experience significant weight gain or loss. The same would be done for blood pressure. When you collect the data from these wearable devices, you further augment the physician’s ability to use that data to identify and focus on the most meaningful needs. This enables physicians to apply what they learned at a moment of influence where they can make an impact on that person’s health.

As more devices are utilized, and these devices are integrated into the system, these examples will become more frequent.

Making a Difference

If devices can improve the health of the individuals who need it the most, there are five key areas they will need to address:

• Capture the critical data – For many seniors with chronic conditions, health tracking starts where they spend the majority of their time: the home. Devices, wearable or home-based, that help these folks stay safe/avoid falls are critical in improving health. In addition, devices that monitor their movement, or lack thereof, and their blood pressure in real-time can enable their primary care physician to act. When it comes to data, we need security across the ecosystem; devices that are easy for these seniors to use; and data analytics to help these people achieve their best health.
• Help physicians use the data – You can collect all the data in the world from these devices, but if primary care physicians can’t use the data to help their patients get healthy, it’s irrelevant. Real-time access of the data from the devices, whether they rest in the home or on a person’s wrist, is essential for helping physicians get people on the path to better health. This is data analytics in action, and it’s used to deliver an easy-to-use experience.
• Enable action in real-time – The more advanced the device and the more frequent data is collected, the more data there is to analyze. Time will always be of the essence. More timely and detailed personal data will be generated. The velocity of the data generated will be extreme, so it’s imperative that the data analytics capabilities are powerful enough to identify abnormal variables and these devices continue to be easy to use.
• Empower self-care – Self-care for people through machine learning and language and artificial intelligence will also be incorporated into the devices, which will also generate a new tsunami of data. More active management of care that will enable self-care will also lead to more empowered consumers who will provide unique feedback that can usher in a new era of the quantified self. And as these devices create more data, we can use data analytics to help these people identify new ways to improve their health.
• Engagement is essential – Lastly, the effectiveness of devices in the elderly population is similar in the younger group. If you want results, you need to have engagement; easy to use devices; and you need to meet people where their health is. Wearables/in-home monitoring meets – and engages – the individual where he or she spends the most time. Without engagement you won’t get the change in behavior necessary to make a difference in one’s health. It’s more than just monitoring the elderly. Like the younger and the athletes, you need engagement, and it starts by meeting people where their health is.

Let’s be clear: wearables or home devices themselves won’t save the world. It’s about using the device to identify gaps in care where a senior with a chronic condition is facing a health risk; integrating the data in real-time with the primary care physicians and nurses who can act; and helping these seniors feel more connected and safe in their homes as they manage their own health.

With the right integration with the person’s primary care physician and achieving widespread ease-of-use and adaptability, personal devices can help people in their health journeys get – or stay – on the right path.

We know it can help because we have seen it with our Humana At Home members who have participated in pilot programs created through our partnerships with HealthSense and Pharos Innovations. These programs use in-home monitoring devices to report changes in members’ normal patterns of movement and activity. The devices measure and report routine daily activities such as sleeping, eating and medication adherence. After establishing what is routine for an individual, passive monitoring can identify when a routine is disrupted. This can be a signal that a member may need assistance. As one of our members told us, the remote monitoring makes her feel safe and comfortable staying in her home because she knows the device will send an alert if she falls or doesn’t move for any length of time.

This technology also has the potential to help patients self-report health information, such as blood sugar and blood pressure, to their physicians without leaving home. This closer connection provides a greater sense of security to our members and helps them live independently in their home instead of at a home or a hospital.

Looking Forward

Recently, Google Chairman Eric Schmidt talked about how the Internet will eventually disappear because it will be integrated into so many different aspects of life. We won’t see it but we’ll know it’s there. For example, Gartner predicts that the Internet of Things (IoT) will grow to 26 billion units by 2020. And this does not even include smartphones, tablets and personal computers.

Think about what this means for the future of wearables. In the future, wearable devices won’t be something you just slap on your wrist or eyes; they’ll eventually disappear into clothing and most will be easy to use. You won’t notice if it’s on your wrist or is a patch on your shoulder. While it’s safe to say that the 2015 generation of wearable devices won’t evolve this quickly, health care’s embrace of disruptive technology is moving us toward this reality day by day.

Is it perfect? No. There are improvements to make, including ease of use, cost, data management and data analytics. The future is promising and offers hope for those who simply need a nudge to get up off the couch and take control of their own health as well as for those who need a helping hand as they struggle to manage their chronic conditions and everyday life. For the latter, it has the potential to give them a closer connection to their providers or caregivers and offers hope for a greater sense of security, independence, and overall well-being.

Wearable technology is an exciting opportunity that is already positively transforming the way we see and manage our own health. Shouldn’t we pursue any opportunity that will move us forward on our journey to a healthier, happier future?