Obstacles to adoption
Although health IT experts say wearables can help improve patient outcomes, there are stumbling blocks to that success. The ability to take in and make sense of the data produced by wearables is the biggest obstacle.
"Say it's been three months since your last visit or a year since your last checkup, what can be done with this incredible volume of data? What can be done to provide some meaningful data points that a physician can quickly look at, absorb and figure out how to integrate them into the session through, say, tailored counseling to a patient?" Gualtieri asks.
Patients can't easily send the data to their physicians. And even if they can send the data, for example, via one of the few apps that allow for such sharing, physicians can't easily import the data to their EHR systems nor easily produce reports from the information to gleam useful insights from it, she says.
"The part no one has solved yet is the analyses of those data and the presentation for some sort of insight," Kvedar says. "That is the biggest barrier: the normalization of data and decision support being applied to these streams and streams of data."
Economics are also a barrier to more widespread adoption of wearables in healthcare, Kvedar says. Traditional fee-for-service insurance plans don't cover the time a physician would spend reviewing data from a patient's wearable, even if that helps improve patient care. Nor does insurance usually cover the actual cost of wearables for those that can't afford them.
Ledger says liability questions have surfaced, too, further tempering physician enthusiasm for wearables. He says some physicians wonder if they could be held liable if they miss something problematic in a patient's wearable data stream.
Value in the data
Gualtieri says she believes data from wearables have real value in a medical setting, particularly when compared to information provided by patients (who tend to be more positive in their own self-reports than reality warrants).
"Trackers are providing the potential for objective data that shows patterns over time," says Gualtieri. For example, wearables can show physicians when a patient has a sudden decline in physical activity, perhaps after reaching retirement. The data presents both the information indicating a problem and an opportunity for the physician to probe further to identify problems and then suggest solutions.
"With the more accurate information, the counseling that the physician provides goes beyond 'You need to exercise more' to 'I see you are exercising in the warm weather but you need to exercise year-round' or 'I see you exercise during on weekdays but you need to exercise on the weekend, too. Here's a suggestion on what you might try to do,'" Gualtieri says.