Healthcare + Reducing costs = Wearable technology.
A visually disturbing equation that, under the present circumstances dictated by the COVID-19 pandemic, is registering unprecedented booming, leaving patients crave for quality, empathic medical assistance and marginalizing those patients who lack digital literacy. While the purpose of this article is not to undermine the benefits of wearable technologies, we deem necessary to shed some light on the long-term side effects on patient’s health and quality of life.
The supposedly ‘patient empowerment’ concept is not a new one. It has been around since the late 90s. However, the latest healthcare technological advancements compounded with people’s growing interest in personal health and wellbeing, have taken this concept to a completely new level, giving birth to an advanced ecosystem of two interrelated components: healthcare and IoT.
According to Gartner, in 2021, end-users are expected to spend the impressive total of $81.5 billion on wearable devices.
Worldwide Wearable Devices End-User Spending by Type, 2019-2022 (Millions of Dollars)
| Device Type | 2019 | 2020 | 2021 | 2022 |
| Smartwatch | 18,501 | 21,758 | 25,827 | 31,337 |
| Wristband | 5,101 | 4,987 | 4,906 | 4,477 |
| Ear-worn | 14,583 | 32,724 | 39,220 | 44,160 |
| Head-mounted display | 2,777 | 3,414 | 4,054 | 4,573 |
| Smart clothing | 1,333 | 1,411 | 1,529 | 2,160 |
| Smart patches | 3,900 | 4,690 | 5,963 | 7,150 |
| Total | 46,194 | 68,985 | 81,499 | 93,858 |
Given these tendencies, there is no wonder that wearables opened their way into healthcare too.
Devices that promote remote medical services
Wearable healthcare technology refers to devices that users wear on their body (head, wrist, feet, ear, eyes, or even as fabric) to monitor their health and track a wide variety of metrics: hydration, heart rate and blood pressure, body temperature, respiratory rate, blood sugar levels, sweat levels, etc.
1. Smartwatches
Smartwatches provide consumers with smartphone-like features, providing easy access to fitness and health information. Despite their increasing popularity, only a selected few entered healthcare and are generally geared toward specific diseases. For instance, Apple’s Apple watch monitors functions such as irregular heart rhythm and electrocardiogram. Even if it is not FDA approved, it was subject to FDA clearance in 2018. Here are two more examples: the smartwatch developed by PKvitality is able to monitor glucose levels, while Empatica’s smartwatch can detect epileptic seizures by monitoring sweat levels.
2. Smart eyewear
Given the steady development of VR and AR technologies, the presence of smart eyewear in healthcare is getting more and more prominent. Commonly used as assistance and training tools in hospitals, the usage of medical smart eyewear addresses health sensing, facial recognition, first-person imaging, or enhanced turn-wise directions. Tech giants such as Microsoft, Lenovo, or Epson are taking the wearables marketplace by storm.
3. Smart ear-worn devices
Originally thought out to enhance hearing, hearables currently perform a wide variety of functions in the area of fitness and healthcare: brain waves analysis, sleep monitoring, heartbeats, steps, and burned calories monitoring, or providing relevant data related to cognitive decline or dementia. The integration of virtual assistants such as Alexa or Siri allows hearables to perform tasks such as reading messages or perform real-time language translations.
4. Biosensors
Biosensors are self-adhesive patches that collect biometric data on patients’ heart rate, movement, temperature, respiratory rate, blood sugar levels, sleep, etc.
The dark side of remote medical care
The use of smart sensors, IoT, big data, AI, or robotics in healthcare has given birth to a trend that is expected to skyrocket in the coming years.
It is true that these devices allow for RPM (remote patient monitoring) and come with a series of benefits, especially in the case of patients suffering from chronic conditions such as asthma or diabetes:
● Lower healthcare costs by enabling personalized, remote patient monitoring
● Detect risk indicators and prevent complications (especially in vulnerable patients)
● Ensure early diagnosis
● Improve the adherence to medication
● Ensure more accurate diagnosis based on the recorded data over a specific period of time
● Facilitate clinical research by validating real world data (RWD)
● Allows insurers to create personalized plans, thus increasing the quality of the offered services
Despite their growing popularity and benefits, patients’ understanding of the functions of wearable healthcare devices is still limited. According to a survey conducted in the U.S. on 4551 respondents and published by JMIR in 2020, less than one-third of the respondents use these devices regularly. According to the findings, only young, healthy, wealthy, with a certain degree of education, tech-literate adults use medical wearables. All the other groups were left behind. The recorded data demonstrates that the usage of wearables significantly declines with age. Adults aged 18-34 years are more likely to use wearables than adults aged >50 years. The household income also influences the use of wearables. It was found that households that enjoy annual incomes superior to US $75,000 were prone to using wearables. Considering these findings, we wouldn’t be too wrong to conclude that there is a usage-related gap that needs to be addressed.
But there are other shortcomings we can add to the list:
Technical difficulties that may lead to misdiagnoses
The recorded data may not always be accurate due to the device’s faulty performance and functionality. A poor design of the device may be sensitive to external factors such as weather conditions or even sweating. In order to be comfortable to wear, devices need to be small. Unfortunately, the smaller the device, the shorter the battery life.
Are wearables a synonym of hypochondria?
Having access to too much information may trigger an obsessive and even hypochondriac behaviour from the patient’s part, leading to addiction, unnecessary stress, and unfounded fears that negatively affecting the quality of life.
Ethical considerations regarding Quality of life Vs. Length of life
This is a very tricky aspect, almost as questionable and problematic as euthanasia. While prolonging someone’s life is – at least at an objective level – a positive thing, medical wearables cannot really monitor a patient’s quality of life, mining the subjective dimension of the story.
Potential dangers created by EMFs
Our bodies produce Electro Magnetic Fields by themselves. Add those to the EMFs derived from natural phenomena (e.g. electrical storms) and those produced by electronic devices and you obtain a cocktail that has been repeatedly related to health conditions such as antibiotic-resistant bacteria, cancer, mitochondrial disruptions, chronic headaches, etc. Here you can find a very interesting article that will shade more light on this matter.
Barriers related to cost
Patients are reluctant to using wearables for various reasons: high cost, complicated and unclear reimbursement policies, privacy concerns, limited (or even non-existing) technological literacy, lack of solid evidence that supports the benefits of wearables, etc.
To sum up…
Technology is meant to make our lives easier and safer. But we all have a pending task: find the right balance between leading a life free of technology and benefitting from those techs that actually help us live healthily. Even though healthcare wearables are still in their infancy, there is no doubt that they will reshape the future of healthcare. The benefits provided by wearables are difficult to argue against. But that must not automatically imply that there are no drawbacks or concerns.
