Q&A: The future of wearables in HIT

The following is a question and answer session between Dave Boerner and Drew Ivan, two HIT industry experts.

Moderator: Current projections show sales for wearables increasing at a 35% growth rate - do you see this trend continuing?  https://www.businessinsider.com/the-wearable-computing-market-report-2014-10

Dave :  Yes, in fact I could easily see this accelerating. As we move more and more towards an IoT (Internet of Things) ecosystem more and wearables and apps are going to be developed to reap the information being collected. Up and coming generations are more connected to each other than ever before in ways that break traditional paradigms, like gamification, where they compete for prizes on step counts or weight loss. A huge pool of wearables is coming down the pipe to collect and distribute this data.

Drew : Yes, I think wearables are here to stay, and there is a lot of growth left in the market before it levels off, but I’ll be interested to see how long wearables continue to exist as their own category. It seems like they’ll soon be embedded in your phone, watch, shoes, belt, and everything else to monitor various aspects of life.

Dave: Great point and I think Drew really hit on the transition of the wearables industry. In the future it will be centered around an IoT’s that you already own. Why should you have to buy a specific good to measure a few pieces of data? In the future it will just be understood that most objects are collecting data in the background passively; your bed will weigh you every night, your shoes will transmit step counts, your belt will collect your blood pressure, your medicine cabinet will report medication adherence, etc.

Drew: Having so many of your personal activities measured and sent to various clouds brings up obvious questions around privacy as well as available bandwidth to transmit all that data, but that’s starting to get off topic. https://www.nature.com/news/what-could-derail-the-wearables-revolution-1.18263?WT.mc_id=TWT_NatureNews

Moderator: So do either of you use wearables?

Drew: I use one app on my phone to track jogging and another for manually-entered types of daily data, but I don’t use single-purpose wearables.

Dave: Yes I do. Passively my iPhone has been collecting steps and I’ve also been using a fitbit to track my sleep.

Moderator: Dave do you find any value in that?

Dave: Yes, I do check my Health app most days just to make sure I’m hitting the 10,000 benchmark, if I’m short I consciously decide to walk somewhere. With the fitbit there’s a feature where it will set off an alarm when your body is naturally coming out of a deep sleep cycle which helps you wake more gently. These have together been helping me stay active and feel more rested.

Drew: I don’t find much value in the data I’m capturing. I chiefly use the running app to know when I have run the distance I set out to run, not to track progress over time. Although I usually check the stats at the end of the year, I don’t use the data to set goals or compare myself to others.

Moderator: What is the future of wearable devices as they relate to healthcare?

Dave: As I already mentioned I do see it growing for a number of reasons. I think where we’ve just begun to scratch the surface is in how we use the data for predictive analytics. Right now all that information is basically going nowhere, but in the not too distant future all kinds of information will begin to be used to help stratify people along different risk factors and intervene when they are in danger of crossing into a new risk classification. For example patients that are at risk for heart disease may soon be getting reminders or touch points when their wireless scales show dangerous increases in weight in conjunction with decreases in steps.

Drew: Using wearable devices to monitor activity for wellness purposes is one use case, but I’m not sure it’s interesting in the long term. After establishing your baseline level of activity for a couple weeks, and then going through a process to increase your baseline, do you really need to record the number of steps you take every day for the rest of your life? Signs point to no. Endeavour Partners found that a third of wearable users give up on their devices within six months, and a majority stop tracking their activity by 18 months. https://endeavourpartners.net/assets/Endeavour-Partners-Wearables-and-the-Science-of-Human-Behavior-Change-Part-1-January-20141.pdf As low-cost wearables begin to track data that’s more clinically interesting – like weight, blood pressure, blood sugar, etc. – we may begin to see better stickiness for certain market segments. But measuring multiple data points for every person all the time, I think, is a long way off, because even though it’s getting much easier to track that data, people won’t care enough to collect it unless they can see a benefit.

Dave: As we move into the brave new world of Big Data and predictive analytics, the more we can collect the faster we can transition from chronic treatment to preventative healthcare. I’m in agreement that a huge amount of data being collected today seems useless, but you never know what future cures or treatments might inadvertently be related to that data revealed through clinical studies. As HealthCatylst points out Evidence-based practice and new research is coming out every day. https://www.healthcatalyst.com/5-reasons-healthcare-data-is-difficult-to-measure For now it’s best to passively collect as much as possible and let the chips fall where they may in the future.

Moderator: So Dave you think the value is in the data?

Dave: Absolutely, the industry has pivoted towards Population Health. If the goal is to be able to prevent disease instead of treat it then we need the data to see where trends develop. Furthermore as we collect increasing amounts of data, correlations between different activities that didn’t seem obvious at first but led towards desirable or dangerous outcomes will come to light, such as drug interactions.

Drew: I see huge value in the data for certain segments or stratifications of users. For example, a pre-diabetic patient might want to record his blood sugar and level of activity very closely in order to stay healthy. Or, a post-operative patient might be prescribed an activity monitor to use for several weeks to make sure she is getting back to a normal level of activity after a knee replacement. Those are the kinds of use cases where a clinician’s interpretation of patient-collected data can make a big impact on the patient’s health.

Moderator: Closing thoughts please.

Drew: Anytime a game-changing technology emerges, there’s a rush to use it for anything and everything imaginable, which is where we’re at with wearables. Over time, we learn which use cases are valuable and which ones aren’t working. As the low-value use cases get weeded out, we begin to see the true potential of a new technology. Gartner Group calls this the Hype Cycle, and in August of this year, they estimated that wearables are just past the peak of inflated expectations. https://www.gartner.com/newsroom/id/3114217 This means we are still in the “try everything” phase, but we’ll soon start learning what isn’t working. After that we’ll learn what is working and optimize those use cases until we’ve reached the plateau of productivity, which Gartner estimates is 2-5 years out.

Dave: The world is changing at a dizzying speed and our interconnectedness is only going to increase. Perhaps not all the data we collect or devices that are created will have value but many will. We should operate in a free-market approach and let the cream rise to the top. Of course there are safety and privacy concerns that will need to be managed along the way, and there will be bumps on the road, but I think the overall goal is worth the risk.