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22 March 2019

Wearables net two wins in fight against medical community skepticism

The medical world has held a lot of doubt about the value of consumer electronics in the fight against disease and ill-health. The main concern is largely the accuracy of the data, and whether a doctor would be able to trust a wearable device to give insights into the patient’s life that could be used in a diagnosis. But things are on the verge of changing, with Apple and Fitbit both involved in two promising studies.

While wearables might bring data from outside the hospital into consideration, the other major trend in healthcare is the reverse dynamic – hospital devices being placed inside the home in order to provide telehealth and remote patient monitoring capabilities. Compliance with medication is a major pain point, but having monitoring devices in the home of a patient could provide a similar outcome as predictive maintenance does in the industrial world – spotting a small problem before it becomes a much more costly major one.

In time, we expect these two trends to converge somewhat, where the likes of Apple would be able to provide data from its device portfolio to the healthcare providers, and support an ecosystem of certified sensor devices that might be issued to the patient. Things like blood pressure, blood sugar, body temperature, and respiratory sensors could be incorporated into a smartphone or smart home ecosystem by way of Bluetooth and the necessary security hardware and services.

However, the healthcare industry is notoriously rife with standards and certification, a barrier to many startups that might have a great technology but don’t have the cash or experience to navigate the turbulent waters. Government regulations are another strenuous hurdle, and so it seems that only the largest players in their respective markets have a good chance of cracking the sector open. Some businesses will have plenty of opportunity in their own niches, but the major breakthroughs are almost certainly only going to go to the largest players – the likes of Apple, Google, Amazon, and perhaps Samsung, and those device makers that have strong cross-platform integrations, like Fitbit and Garmin.

This brings us on to the trials themselves. The first involves Apple, which partnered with Stanford Medicine to carry out the Apple Heart Study. It used Apple Watches to monitor users’ heart rates, to look for abnormal behavior that might require intervention. Apple’s ResearchKit platform is hoping to be the tool that more studies are conducted with, and the company has been pushing it enthusiastically.

The program had 400,000 participants in the US, in all 50 states, and lasted eight months. Specifically, it was looking for signs of atrial fibrillation, indicated by an irregular heartbeat. If any indication was found, the participant would be told via their phone, and a telehealth consultation could be booked, as well as having an ECG patch sent to the prospective patient.

The study found 0.5% of participants received the notification, with most of these then seeking medical advice to have better conversations with the doctor – effectively educating patients ahead of a consultation. Atrial fibrillation (AFib) is the main cause of strokes in patients, and in the US, attributes to 130,000 deaths and 750,000 hospitalizations annually.

“As physicians, we are always trying to find ways to offer patients health information that is meaningful to them for individualized care,” said Sumbul Desai, MD, Apple’s vice president of Health. “Seeing medical research reflect what we’re hearing from consumers is positive and we’re excited to see Apple Watch helping even more consumers in the future while collaborating with the medical community to further research.”

For Fitbit, the other wearable provider involved this week, healthcare is now a core strategic focus. After losing ground in the fitness band market to much cheaper rivals from the East, the company pivoted to focus on smartwatches, and then further committed to services and third-party integrations. One of the core services is healthcare, specifically in partnership with healthcare providers.

One such tie-up is a new one with Solera Health, a US provider of benefits programs used by healthcare providers and employers, which incentivizes positive behavior in exchange for rewards. Reaching a milestone, such as steps walked or calories burned, will see the enrolled patient provided with a reward, such as cinema tickets, gift cards, or even cash.

With Fitbit, Solera was looking to reduce type-two diabetes, via the US Diabetes Prevention Program (DPP). Solera found that the 1700 people who redeemed a Fitbit device through the Solera program, were significantly more active and lost more weight than those that did not.

The partnership is now expanding, with Fitbit offering its new Inspire and Inspire HR devices to all Solera’s DPP participants. As type-two diabetes affects 30mn US adults, costing $372bn in direct medical expenses each year. Further, there are apparently 84mn US adults that are at risk of developing the disease.

This is the driving force behind the DPP program, which was founded by the Center for Disease Control and Prevention. Its research found that a 5% body weight loss and 150 minutes of weekly exercise halves the risk of anyone with pre-diabetes from developing type-two. Gamification and notifications from a wearable device could provide the impetus to achieve those goals.

Solera’s findings, since beginning the project in 2017, show that after a year, Fitbit users had lost 3.38% of their body weight, compared to 2.27% of users without the wearable. They also had a 51% chance of hitting the 5% target, compared to just 36% for non-users.

Interestingly, the 60-69 age bracket was most likely to redeem a Fitbit in the program – perhaps surprising given the stereotypical aversion to technology. Solera notes that 61% of all diabetes healthcare costs are attributed to patients older than 65, so this higher rate of adoption might be in line with medical expectations.

“Solera is thrilled to enter a strategic partnership with Fitbit as there are many market synergies between what the two companies are doing to improve the health of those at risk for type-two diabetes,” said Brenda Schmidt, CEO of Solera Health. “Our unique ability to connect individuals with the best-fit DPP to meet their needs and preferences, paired with Fitbit’s easy-to-use wearable devices, has the potential to significantly alter how populations approach chronic disease prevention and management. We look forward to scaling this partnership further in order to help future program participants maintain and improve their health.”