Wearables: Differentiating the Toys and Tools in Healthcare

One of the most transformative shifts we are starting to see in healthcare is the rise of the concept of the Internet of Medical Things. This entails any ecosystem of connected medical technologies supporting targeted health and well-being services. Within IoMT, wearables will play an important role. As “on-body” technologies, wearables go where the wearer goes, and intersect with various stages of the care continuum. 

When it comes to wearables technologies’ adoption across healthcare use cases, strong customer demand and surging sales are only parts of the story. The other factor is the highly volatile marketplace, where there is a revolving door of company entries and exits, due to intense competition. For example, Microsoft, a pioneer in the wearable space, recently reported it will discontinue its Band fitness tracker. Another factor, the advent of clinical-grade wearables is slowly changing the rules of the game.  It is increasingly important to distinguish consumer from clinical wearables, the latter of which are really starting to show its potential. Industry experts believe that healthcare wearable technologies are approaching a tipping point that will elevate the focus from fitness or activity tracking devices to clinically vetted devices with intelligence solutions for meaningful health use cases. Figure 1 depicts some of the characteristics of consumer and clinical health wearables.

Figure 1

The Healthcare Wearables Journey Is Still Far From Perfect
The human body's variety of vital signs make it a perfect biological data generating system. It is crucial for health wearables OEMs to base their device design on human anatomy. However, a majority of early wearable devices, specifically wrist-worn devices, were more focused on convenience attributes. As a result, the current market is dominated by the category of wrist-based wearables devices/smart watches (e.g. Fitbit, Apple Watch, Samsung Galaxy Gear S, Misfit, Xiaomi and several others). Further, lower regulatory hurdles and faster time to market continue to be the primary drivers for these consumer-grade wearable devices, which in turn have intensified the competition. Despite their initial success, from a clinical monitoring accuracy point of view, as well the lack of long-term “stickiness” (i.e. using wearables for several months or years), these consumer-grade wearables are facing the most challenges. For example, differences in skin pigmentation and narrow blood capillaries in the wrist make it difficult for wrist wearables to capture accurate readings for critical health vitals such as heart rate and blood pressure. 

As data becomes the Holy Grail for the healthcare industry (both from a provider and payer prospective), the bigger question posed to these emerging healthcare wearable technologies is: ‘How useful are these consumer wearables as a patient-driven, secondary diagnostic tool for more serious medical applications?” Unfortunately, a vast majority of consumer-grade wearables and smart watches available in today’s market are not capable of capturing health data in a meaningful way that would be consistent and reliable enough for making clinical decision making. This makes these consumer-grade wearables devices unreliable against the healthcare industry's gold standard tests.  By contrast, clinical grade wearables may be better able to overcome these challenges and weave in “intelligent” features to more concretely impact health outcomes (Figure 2).

Figure 2

The Future is Clinically Defined
Industry convergence and easy access to advancements around wearable electronics, sensors, alternate power sources, and wireless platforms are giving rise to a new breed of wearable technologies that are capable of addressing the unique needs and requirements of clinical care settings. Unlike consumer-grade health wearables, the newer breed of clinical wearable technologies are capable of capturing medical-grade information in a manner that is reliable, secure, and actionable by care providers. Additionally, the influx of non-traditional participants such VALIDIC, Medidata and Apple HealthKit/ResearchKit are creating an ecosystem to integrate wearable data and platform solutions to create value beyond device and hardware around clinical uses for wearable generated data. 

For wearable technologies, the use case often dictates the market positioning and key target audience. With the shifting focus towards more clinically meaningful use cases, wearable devices once seen as niche devices, appealing only to B2C gadget lovers and early adopters, are slowly entering the mainstream with broader application into the B2B healthcare arena. This necessitates health wearables to go beyond consumers and justify their value to other potential stakeholders (payers, patients, clinicians, hospitals, employers, etc.) to instill trust and buy-in for healthcare applications. Also from a data security regulation stand point, wearables are no exception like other connected health technologies and devices. Wearables device OEMs and platform developers must be predictive to what potential security compromising scenarios could be experienced by their device/platform and what precautions must be taken to prevent adverse breaches.

The burden of effective chronic disease management strategies is becoming critical for care providers as they seek to transition to outcomes-dependent compensation structures. The ability to accurately predict and prevent adverse events is an essential component of modernizing out-dated care models. Because most of these conditions are exacerbated by lifestyle choices and poor management, clinical-grade wearables technologies are uniquely geared to provide deeper insight for preventive care practice for remote and hospital care settings. In light of these focused healthcare use cases, wearables technologies are poised to evolve from technologies that simply reported real-time data to those that track, diagnose, and ultimately help in clinical decision making.

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