IT Forefront

Beyond 10,000 steps: How wearable technology can improve health care delivery

by Peter Kilbridge and Sophie Ranen

The rapid adoption of connected wearable devices offers health care organizations (HCOs) opportunities to increase patient satisfaction and engagement, and improve care management practices.

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If you haven't already, take a look at what your coworkers, friends, and family are wearing on their wrists. We bet you'll see more than a few people wearing an Apple Watch, Fibit, or another similar device.

Overall, according to a 2018 Accenture survey, the number of consumers who use health wearables increased from 9% to 33% between 2014 and 2018. The increasing diversity of wearable sensors on the market will not only continue to drive that upward trend—it will also expand the realm of wearable data capture from traditional measures, such as activity level, heart rate, and sleep, to new measures, such as acceleration, altitude, glucose levels, respiration rate, temperature, and hydration.

Opportunities for HCOs

The proliferation of wearable technology presents many opportunities for HCOs to improve patient care and support several overarching business strategies. Two particularly promising opportunities include:

  • Boosting patient engagement: Wearables offer HCOs an additional avenue for engaging patients with technology. "Quantified selfers"—healthy, active patients who enjoy tracking their fitness and health metrics—have been among the hardest to engage, as medical care needs frequently are not top of mind for them. But recent studies suggest many wearables owners believe their activity data could improve their engagement with their care, and many would be interested in sharing activity data with their physician.

  • Avoiding costly care episodes: HCOs also can incorporate wearable devices into chronic disease and high-risk care management programs to improve outcomes and reduce costs among these at-risks populations. The patient-generated health data (PGHD) collected via wearables enables providers to develop a more comprehensive view of their patients than has traditionally been possible. With this new source of data on a patient's health between visits, providers can better customize care plans and intervene when patients go off-track—potentially helping patients avoid costly readmissions or ED visits.

How HCOs are leveraging wearable technology

Providers have begun to test and implement wearables-based remote monitoring programs.

Stanford Medicine, for example, is collaborating with Apple and the telemedicine vendor American Well to evaluate the efficacy of the Apple Watch to identify users experiencing irregular heart rhythms and virtually connect them with a physician. The study—which kicked off in November 2017, and which will continue until January 2019—was initiated due to a large volume of responses from Apple Watch users who claimed the device helped them identify a previously undiagnosed heart condition. 

Separately, Atrium Health, formerly known as Carolinas HealthCare, incorporates data from wearable devices into its care management program—and a prime target is their heart failure patient population. The program uses their MyCarolinas Tracker app, which collects data from a variety of consumer health and fitness devices and connects with Atrium's EHR. The app provides data visualizations that show whether a patient is on track according to his or her goals, informs care managers about a patient's condition between visits, and alerts providers when an intervention is necessary.

Is your organization interested in incorporating wearables into clinical practice?

If you're mulling whether to employ wearables within your organization, here are three factors to consider:

  • Data management: HCOs must implement effective data management systems to turn the large volumes of new data generated by wearables into actionable information. These systems must collect, aggregate, filter, store, and analyze these data, and integrate the resulting information into clinical workflow. At the point of care, clinicians should see relevant analytic results that identify trends and alert them of significant changes in a patient's condition. Depending on the situation, it may be best for providers to review wearables-derived information on an independent platform, or it may be integrated into the enterprise EHR system and viewed alongside non-PGHD. Both options have advantages and disadvantages; for example, EHR integration may simplify the clinical workflow while potentially raising data quality and liability concerns.

  • Security and privacy: Providers must address the lack of built-in security of most wearable devices and their associated HIPAA issues. Under HIPAA, a device that is selected by the patient is considered a consumer product and HIPAA requirements do not apply. But if a device is ordered or prescribed by a provider, HIPAA does apply. Additionally, the vulnerability of wearables could compromise a system's network, underscoring the need for a secure interface between these devices and the health system, as well as additional security and privacy investments.

  • Programmatic considerations: Wearables should be used as part of a clinical program for wellness or disease management and not as stand-alone technology. Other programmatic elements must include the human touch—provided by care managers, online communities, or health navigators—and should include some kind of incentives for patients to continue to utilize the devices. Patients who purchase wearables and who are not involved in reinforcing programs tend to stop using them after a short time.

Despite the challenges HCOs must address to integrate PGHD effectively into care management and delivery, providers who do this successfully can advance both their population health management and consumerism strategies. Wearables are just one source of patient-generated data—others include mobile apps, home monitoring equipment, and patient portals, just to name a few. The increasing volume and variety of PGHD, along with new analytics capabilities that allow organizations to better act on these data, make it imperative that HCOs begin to lay the groundwork for PGHD integration into the clinical workflow.   

For an in-depth review of wearables and their implications for HCOs, see Health Care IT Advisor’s Incorporating Wearables Data into Clinical Practice: Opportunities and Challenges report.

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