Written By: Dr David Owens, Specialist in Family Medicine
There have been significant advances in wearable technology over the last few years. The goal of personalised health data facilitating proactive, individualised health care is already a reality. These devices enable real-time tracking of essential health metrics. As wearables become more accessible and integrated into our everyday software and personal devices, their presence in our daily lives grows, expanding health data collection beyond traditional clinical settings. This evolution brings new opportunities and challenges, shaping the future of healthcare and opening up new avenues for managing health.
The evolution of wearables has increased the monitoring of key health indicators such as metrics of physical activity, sleep quality and ECG offering real potential for the early detection of health issues. A groundbreaking study published1 in Circulation with over 400,000 participants showed that smartwatches can detect atrial fibrillation with remarkable accuracy. This capability underscores the potential of wearable devices to offer early and, in some cases, life-saving interventions. I have personally seen patients who have had their diagnosis made or confirmed by smart watch. However, the data does have the potential to cause anxiety and my own experience is that currently, the majority of patients presenting with ECG data do not have a significant health issue. The challenge of increasing accuracy is likely to be driven by advances in technology in addition to AI driven algorithms.
Significant strides have also been made in non-invasive glucose monitoring. Nature Medicine featured the development2 of a watch which is capable of assessing blood glucose from sweat with 84% sensitivity. Accuracy is likely to improve significantly as technology improves. This breakthrough is particularly promising for individuals with diabetes, providing a non-invasive, real-time solution for monitoring glucose levels. Moreover, this technology signifies a move toward more autonomous health management, as it not only monitors glucose levels but also delivers feedback through electrical impulses.
The integration of data from wearable devices with Electronic Health Records (EHRs) signifies a major leap forward in personalised healthcare. Apple's HealthKit initiative is one example of this trend. Health data collected by the Apple Watch is synched with EHR systems used by healthcare professionals. This integration has been made possible through partnerships3 with healthcare institutions, such as Johns Hopkins Medicine. At OT&P we have already explored this option via our App and envisage having this functional in the not too distant future.
The benefits of this type of integration are supported by research and pilot programs. For instance, Cedars-Sinai Medical Center's study4 found that incorporating wearable health data into EHRs significantly enhances patient engagement and outcomes. This integration has shown promise in improving the management of chronic conditions and overall health awareness. Additionally, leveraging patient-generated health data has been shown to improve the efficiency of healthcare delivery, according to a report5 by the Healthcare Information and Management Systems Society (HIMSS). This approach not only reduces the burden of data entry for clinicians but also increases the accuracy of health records and enables more timely and targeted interventions, ultimately contributing to better patient outcomes and cost savings for healthcare systems.
It is clear that these devices have value beyond fitness tracking; they have the potential to drive positive behavioural change encouraging users to take charge of their health and adopt healthier lifestyles. By providing immediate feedback on physical activity, sleep patterns, heart rate, and more, wearables motivate individuals to increase their daily activity levels.
The importance of physical activity in reducing the risk of chronic illness and enhancing health is well recognised. Wearable devices have been shown to increase physical exercise. For example, a study6 published in The Lancet Digital Health found that users of wearable activity trackers showed a significant increase in physical activity—equivalent to nearly an extra day of walking per month compared to non-users. This boost in activity is associated with reduced rates of heart disease, stroke, and diabetes in addition to improved metrics of psychological well-being.
A 2022 survey7 revealed that 46% of respondents in China wore smartwatches, while another8 found that 63% of the Hong Kong population owns an activity tracker and/or smartwatch, highlighting the growing reliance on these devices for health monitoring.
The rapid adoption of wearable technology raises significant ethical and privacy concerns, particularly regarding the management and protection of personal health data. Notable incidents, such as Strava's unintentional disclosure of sensitive military locations in 2018, highlighted the potential security risks associated with location data. Medical data breaches have been described all over the world including in Hong Kong. These episodes have ignited a global dialogue on the importance of data privacy and security in today's digital age.
As wearable technology continues to evolve, it seems to me that integration into healthcare systems is inevitable. This progression promises more sophisticated tools for health monitoring and disease prevention. Challenges remain, especially in terms of data security but also in optimising health and well being without creating an epidemic of the 'worried well'. Ultimately wearable techology will be adopted as a health care tool and along with other medical and technological advances will accelerate the transition to a new paradigm of individualised health care.
Chang, T. et al. (2022) ‘Highly integrated watch for noninvasive continual glucose monitoring’, Microsystems & Nanoengineering, 8(1). doi:10.1038/s41378-022-00355-5.
How Apple’s Health Records is reshaping patient engagement at Johns Hopkins Medicine (no date) NGPX. Available at: https://patientexperience.wbresearch.com/blog/apple-health-record-strategy-reshaping-patient-engagement-at-johns-hopkins-medicine-clinic (Accessed: 15 March 2024).
Dinh-Le, C. et al. (2019) ‘Wearable Health Technology and Electronic Health Record Integration: Scoping Review and future directions’, JMIR mHealth and uHealth, 7(9). doi:10.2196/12861.
Demiris, G. et al. (2019) ‘Patient generated health data use in clinical practice: A systematic review’, Nursing Outlook, 67(4). doi:10.1016/j.outlook.2019.04.005.
Ferguson, T. et al. (2022) ‘Effectiveness of wearable activity trackers to increase physical activity and improve health: A systematic review of systematic reviews and meta-analyses’, The Lancet Digital Health, 4(8). doi:10.1016/s2589-7500(22)00111-x.
von Kameke, L. (2023) Asia: Share of smart wearable owners by country 2022, Statista. Available at: https://www.statista.com/statistics/1344514/asia-share-of-smart-wearable-owners-by-country/ (Accessed: 15 March 2024).
Slotta, D. (2023) Hong Kong: Ownership of Wearable Tech 2022, Statista. Available at: https://www.statista.com/statistics/1058302/hong-kong-ownership-of-wearable-tech/ (Accessed: 15 March 2024).