Welcome to the Age of Biosensing Wearables

Increasingly sophisticated wearable devices can now measure heart rhythms, glucose, and more, but what will it take to get consumers and health care providers to adopt them?
When I was 10 years old, I had a crush on a girl named Mary. Mary knew my love was real—when I saw her, my mood ring would turn from a swirly green to a wavy, purplish-orange. As an adult, I now have more sophisticated tools—tools that measure information related to my health and fitness. I’ve traded in my mood ring for my Fitbit®, which I have on from the moment I leave the house to walk our dog, Tarot. Tarot has an activity monitor too, which tracks his location by GPS in case he runs off. And, at the end of the day, my wife compares my results to Tarot’s on her smartphone and decides who sleeps on the floor. Wearables have changed our lives.
The past few weeks have brought forth announcements by major technology companies touting new smart watches and digital platforms, while smaller innovators are releasing a range of new wearable (and ingestible) devices. Wearables are now moving beyond the well-established realm of tracking movement, and new entrants are developing devices that continuously monitor a broad range of physiology—from posture to brain activity—and convert the information into a signal output. With greater connectivity and computing power in our pockets and on our wrists, we seem to have entered a new era: Welcome to the age of biosensing wearables.
Given the potential of these devices, one obvious question is if and when will health care take advantage of them. Unlike blood pressure cuffs and other devices that are driven by physician utilization, consumers appear to be driving the growth and use of wearables, and investors are taking note. According to Rock Health, venture funding of biosensing wearables has risen from $20 million in 2011 to $229 million in 2013.¹ Wearable devices are becoming increasingly sophisticated, now measuring heart rhythms, oxygenation, glucose, blood pressure, and more.
What might it take to get consumers to use these devices for their health—not just for fitness and wellness?
Convenience. If it isn’t easy, people probably aren’t going to use it. Many of us have tried a traditional pedometer at one point in our lives, and just as many of us abandoned it within two weeks of starting. Through wireless data collection, made possible with low energy Bluetooth, data appears automatically with these new devices, and tracking is simplified, requiring little to no intervention by the user.
Interoperability. Many consumers want a seamless experience. Having to switch from app to app to see the outputs of various sensors can be a recipe for frustration and confusion.
Privacy. While consumers may be perfectly happy to share their step count with friends, co-workers, and even strangers, they might be reluctant to do so with their employers or their insurance companies. Moreover, they may have no reservations about sharing their physical activity on any given day, but they might feel less inclined to reveal their glucose or blood pressure readings.
Motivation. While each of the prior issues matter, perhaps the most important factor leading to the continued use of a tracker is making it social. Whether users are motivated by sharing, competing, or obtaining rewards, the use of social media platforms has been cited as a strong determinant of ongoing use and achieving goals.²
As consumers get onboard, what might it take for the health care industry to recognize the value in these devices?
Rationale. Just as consumers need to be motivated, health care needs a reason to adopt new technology. While innovation is exciting, unless there is a clear return on investment (ROI), few often embrace it. With the rise of value-based care and its focus on population health, prevention, and outcomes, new opportunities could arise. Consumer engagement for health promotion and medication adherence, management of chronic disease, and remote monitoring now present clearer paths to ROI.
Validity. While the makers of biosensors make many claims about their accuracy, some are no more precise than my old mood ring. If medical decisions are going to be made based on these devices, they will need to truly reflect what they purport to measure. Some companies and developers have gone as far as to get approval from the U.S. Food and Drug Administration (FDA), and many more may follow.
Reliability. The data needs to flow consistently and accurately in order to be useful. Gaps introduce errors and a degree of uncertainty that may often be acceptable to consumers, but can render the data useless to clinicians and researchers.
Evidence. Amid the excitement over the potential of these sensors and companion apps, right now there is scant evidence that they contribute to improved outcomes. And, as I have said before, just because I have a fitness app on my phone, it does not make me an athlete. Thankfully, a number of pilot studies have been launched to understand what devices have an impact under what circumstances.
Finally, as biosensing wearables work their way into health care, industry stakeholders should consider asking if they are measuring the right things. Physiologic signs would seem to provide incredible insights. However, if I wanted a sensor to alert me to potential problems with my aging parents, I might glean more from a sensor on their refrigerator door than a continuous heart rate monitor. Tracking my steps is one thing—but it doesn’t tell you, like my credit card does, that my walk included purchases at a fast food restaurant and a cupcake bakery.
No matter what, these devices are probably here to stay, and more are on the way. How they address the needs of consumers and the health care industry will determine which are truly effective, and which wind up in the doghouse.
— By Harry Greenspun, M.D., Senior Advisor, Deloitte Center for Health Solutions, Deloitte LLP

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