Though technology companies are continuing to innovate in the wearable field, healthcare organizations are slow to adapt.
The healthcare wearables market continues to grow, as consumers become more empowered by monitoring their own health. Nearly 60 million fitness, activity, and sport trackers will be sold in 2016, valued at $3.8 billion. That number could balloon to 187 million devices, with the market valued at $6 billion, by 2020, according to the CCS Insight Global Wearables Forecast released in February 2016. In fact, the future of wearables isn’t just limited to wristbands-wearable cameras, virtual reality headsets, jewelry and clothing will be able to collect biometric data on users to send to mobile devices and cloud applications.
Though technology companies continue to innovate in the wearable field, healthcare organizations are slow to get on board.
Dave Mackey, spokesperson for OMsignal, which produces “smart” apparel-shirts and bras equipped with technology that monitors heart rate, breathing, calorie usage, and other heart variances-says that though the clothing is wired to collect fitness data and send it to smartphones, it isn’t yet used as medical device.
“The initial idea was to build the technology for the medical world, but that would’ve been a longer road to market,” Mackey says, noting that until the market becomes easier to navigate, the company will focus on fitness applications for smart apparel technology. “There are certainly medical applications for smart apparel. Patients who have had cardiac surgery can be monitored 24/7, and our app can push that data to the Web. A doctor can receive a notification if there is a drop in one of the metrics. We can also build in incentives to get people off the couch who are struggling with weight issues.”
OMsignal is not alone in its decision to focus more on the direct-to-consumer usage of wearable products than the use in medical care. This approach is just more profitable than attempting to work with the medical community, says Megan Ranney, MD, MPH, FACEP, director of Emergency Digital Health Innovation, and assistant professor in the department of emergency medicine at the Rhode Island Hospital/Alpert Medical School at Brown University.
“Most wearable companies are operating in startup mode. They don't have the budgets of pharmaceutical or medical device companies. Even if they wanted to do so, most aren't able to pay for the trials that are needed to create evidence around their product's usefulness, nor to comply with Food & Drug Administration and HIPAA regulations,” Ranney says. “It's simply easier and cheaper for many companies to focus on non-professionals-at least, for now. I can't blame wearable companies for this choice; they need to survive. I hope that over time, working with healthcare professionals will be more attractive.”
The healthcare industry is notoriously slow to adapt to technology changes, says Bill Balderaz, president and founder of Futurety, a healthcare consultancy that assists providers in adopting retail-focused technology.
“A healthcare tech startup company must be prepared to weather two years of no revenue if [it is] selling to hospitals,” Balderaz says, adding that security, background and credit checks involved with working with healthcare organizations are long and expensive processes. “Healthcare organizations, and hospitals in particular, have very long sales cycles. If you don’t make it into an annual budget you could wait a year to get a contract in place, even when the hospital is ready to buy.
Though many wearables are developed from a consumer standpoint, the needs of healthcare organizations are just as important for future adoption, Ranney says. “Right now, if a patient shows up in my emergency department, it is very difficult for them to share data with me. It should be easy. This is especially important for companies that are selling their wearables as a form of remote monitoring, or as an alternative to hospitalization.”
Improving interoperability is also important, and an application program interface that helps wearables work with other healthcare technology would assist with widespread adoption, Ranney says.
Balderaz says it’s important to ensure that wearable data will integrate with EHRs. “We need platforms and connectors to bring disparate tools together,” he says. “Today, it’s hard enough with patients having multiple EHRs, maybe one with a primary doc, one with a specialist, one with a healthcare system. Add in wearable data and it’s a mess. Whoever figures out the one platform to unite them will win big.”
Similar to reimbursement barriers associated with telehealth, lack of reimbursement associated with remote health monitoring could slow adoption, says Balderaz. “Ultimately consumer demand and the need to improve access to care will force the issue. My guess is we are two years out from telemedicine having national parity. Wearables will follow that.”
There is still debate on how usable wearable data can be to healthcare organizations. Devices attached or close to the body have a certain element of inaccuracy, Ranney says.
“Whether as patients or providers, we need to be able to trust that the wearable is actually measuring what it says that it’s measuring,” she says. “Relatedly, it's important to define what the measurements mean. For instance, we're not really sure what to do with a single spike in heart rate, or with a brief alteration in galvanic skin resistance. It's important for everyone to understand how to interpret the data. Validated predictive analytics or decision rules would be very helpful here.”
Ranney predicts that wearable adoption in healthcare will be slow until wearables can provide evidence-based value to healthcare organizations, either in preventive care or as an alternative to hospitalization. “And, even if a given wearable has been shown to be useful for preventive care, there is too much ‘churn’ in the market-individuals are likely to leave a plan before the value of prevention is realized.”
Still, Balderaz says that consumers’ appetite for wearables will continue to grow. “Patients and customers want these tools,” he says. “That debate is over. The choice the healthcare field has to make is whether or not to be part of it.”
Donna Marbury is a writer in Columbus, Ohio.