WEARABLE HEALTHCARE TECHNOLOGY

Learn more about Henry Schein’s solutions provider by calling your local representative or visiting HenryScheinSolutionsHub.com.

Discover. Connect. Transform.Learn more about Henry Schein’s solutions provider by calling your local representative or visiting HenryScheinSolutionsHub.com.

Discover. Connect. Transform.

Learn more about Henry Schein’s solutions provider by calling your local representative or visiting HenryScheinSolutionsHub.com.

Discover. Connect. Transform.

Wearables have gained significant popularity in recent years, with many individuals recognizing the benefits of having a greater understanding of their fitness level and other lifestyle factors. Beyond the benefits seen by the wearer, when the data gathered by these devices is shared with the individual’s physician, the capacity to see health benefits only increases.

In this eBook, we’ll take a look at wearable healthcare technology overall, starting with the kind of devices that are on the market today. From there, we’ll look at what wearables offer in regards to healthcare, focusing on their impact, what they track and monitor, and how they can be integrated, among other items. Finally, we’ll examine the future of wearables in healthcare and what we can expect to see in the coming years.

introduction

There are a number of wearable and smart medical devices on the market, ranging from the familiar to those that haven’t yet gained in mainstream popularity. Among the more familiar of wearables are fitness trackers. These devices monitor and track metrics related to an individual’s fitness level such as number of steps, distance walked or ran, amount of calories taken in, and in some cases sleep statistics and heart rate. These devices build on the foundation of pedometers, providing a greater overall view of an individual’s fitness level and activities. As these devices continue to advance, some of the newer models are coming close to being classified as Class II medical monitors, meaning that they would be able to alert you and your physician of a medical problem should one arise. The most popular fitness trackers are likely those made by Fitbit, but there are a number of brands that make similar products at a variety of price points.

Another popular type of wearable is the smart watch. Smart watches are essentially computers that you wear on your wrist, often with a touchscreen interface for the wearer to interact with. These devices not only tell time, but they typically track the same metrics as fitness trackers do, as well as connecting to the individual’s cell phone providing for the

ability to make and receive calls and texts. Most smart watches also feature a GPS, allowing for a more accurate measure of distance walked or ran, and a number of these devices also feature training programs to not only track an individual’s workout but actually guide them through it as well. The most popular

smartwatches on the market today are made by Apple, Samsung, and

Fossil, with the specific styles and functionality varying

based on manufacturer, with some difference

in price among the makers as well.

One of the less popular smart medical devices on the market is

the wearable ECG monitor. These aren’t

unpopular because of not being useful, but more

so because they perform a specialized function that isn’t needed

by everyone. These devices will take an actual electrocardiogram (ECG) from the wearer’s wrist or chest, allowing the patient to monitor their own health and also allowing doctors to keep a closer eye on patients with conditions such as AFib by receiving that data directly from the device. There are a number of brands that are making ECG specific monitors, from Welch Allyn to Polar, while many of the smart watch and fitness band manufacturers are also working to build this functionality into their wearables as well.

types of wearables and smart medical devices on the market

Another more specialized type of smart medical device is the wearable blood pressure monitor. Patients with hypertension need to have their blood pressure monitored regularly, particularly if they’re undergoing treatment and want to keep an eye on how effective that treatment is. Having a wearable blood pressure monitor, one that has been certified by a reliable medical institute as having accurate readings, can help a patient to determine times when their blood pressure peaks as well as how best to work around their symptoms. Currently, there’s only one wearable blood pressure monitor that has passed FDA clearance, and that is the Omron HeartGuide. This device looks just like any other smartwatch, but the display screen defaults to show not only the date and time, but also the wearer’s most recent blood pressure reading and current pulse rate. It works to get a blood pressure reading essentially the same way any other blood pressure monitor does, by restricting blood flow with the inflation of an internal bladder. The HeartGuide, though, requires the patient to raise their wrist up to heart level before a measurement is taken, thus dismissing most concerns that arise when talking about a wearable blood pressure monitor.

Another wearable that’s likely to increase in popularity in the coming years is the biosensor. A biosensor is a device that monitors and analyzes the vital signs of the wearer. Typically these devices are quite different from fitness trackers and smart watches, even though some of what they monitor can be the same. One example is the Philips Wearable Biosensor which is self-adhesive and continually measures a patient’s vitals, such as temperature, respiratory rate, and heart rate as they go about their day, allowing for potential issues to be caught and treated early.

Finally, there are now wearable devices that are essentially wireless, in-ear computers. These devices are designed to enhance the user’s listening experience, but many of them are now coming with added features such as heart rate monitoring as well. There are two types of companies producing these hearables; hearing aid companies and those who create commercial headphones. The potential for benefits with these devices is significant as they have ability to provide more accurate vital signs for the user, enhanced activity tracking, better hearing, and even in-ear translation. There are a wide variety of manufacturers creating hearables today, each with its own specific set of features, meaning there’s really something for everyone in this particular market.

types of wearables and smart medical devices on the market, cont’d

...let’s explore how these goals are accomplished.

wearables can accomplish

a number of goals...

positively impacting health

tracking and monitoring important health metrics

integrating important health data into your physician’s EMR

increasing practice efficiency

improving lifestyle and exercise level

catching diseases at an early stage

reducing healthcare costs

what can wearables do and offer?

To start with, wearables have the ability to make telecare more accessible and sophisticated. Telecare allows providers to care for patients who are physically unable to get to the office through remote means, helping these patients continue to experience the level of care they need while not placing the burden of difficult travel on them. Using wearables along with telecare takes this a step further, allowing for near-constant monitoring of a patient’s condition with the ability to take swift action should a concerning change occur.

Another way that wearables impact health is by encouraging proactive healthcare. Too often patients approach their health in a very reactive fashion. They avoid going to the doctor until they reach their own personal level of feeling too sick. With wearables, though, patients can take action in the early stages of illness, when they first notice a small change in their health metrics. This promotes better health outcomes. Additionally, wearables can alert the wearer of an emergency as soon as they begin, allowing that individual to seek help earlier and, again, see a better outcome.

Next, wearables help patients to stay engaged. Essentially, when patients are monitoring their own health status with the use of wearables, they’re taking an active role in their own care. This gives them a greater feeling of control and can also be motivating to help patients strive for a healthier life. For example, if the individual notices that they aren’t

sleeping very well from their wearable data, they may take steps to get better sleep and thereby improve their health.

Wearables also benefit healthcare providers. As wearables provide patient health data on a more regular basis, providers are able to gain a more thorough understanding of their patients’ health status. This allows for more accurate diagnoses and more effective treatment plans, without seeing a decrease in efficiency.

Finally, wearables are revolutionizing how providers monitor vulnerable patients. Doctors have never before been able to keep near-constant tabs on their most at risk patients from a distance, but wearables have changed that. Now, providers are able to monitor vital signs of chronically ill patients, as well as patients who have recently been discharged from inpatient care to ensure that no complications occur as they continue their recovery. This increases satisfaction for both patients and providers by allowing the patients to be in their own home without sacrificing quality of care, and giving doctors a more efficient way to follow up with these patients.

how do they impact health?

Each specific wearable will track and monitor its own set of metrics, and no two devices have exactly the same capabilities, however there are a number of metrics that one can reasonably expect to be addressed with the use of wearables, especially the more readily available consumer wearables such as fitness trackers and smart watches. The first and, arguably, most basic metric is the number of steps an individual has walked in a day. Most wearables include an accelerometer that allows for the measurement of movement and a tally of the number of steps taken. Additionally, many wearables will use that same accelerometer to translate the number of steps taken into the distance that individual has traveled over the course of that day. Some wearables include an altimeter along with their accelerometer, allowing for elevation to be measured and for a readout of the number of flights of stairs the wearer climbed in a day to be available as well.

Most wearables will include a calculation of the number of calories burned each day. This statistic is particularly useful for individuals who are seeking to lose weight. Other exercise related metrics that are measured include the number of active minutes

a person had throughout the day. This measure helps individuals to be more intentional about living a less sedentary life.

A lot of wearables will track the wearer’s sleep time and quality. This is accomplished through the use of movement sensors, meaning that if you wake up in the night and sit up or even just move enough to trip the sensor, that time would show as an awake period and would be deducted from your total nights’ sleep total. While this isn’t the most accurate way to measure sleep time and quality, it’s good enough to give the wearer a general idea as well as a starting point from which to improve.

Finally, many wearables will monitor heart rate, including both resting beats per minute and mid-workout heart rate. While these devices typically aren’t as accurate as a chest strap heart rate monitor, they do give the average patient enough information to be generally informed about their cardiac health. If a patient has a greater need for accurate heart monitoring due to a documented heart condition, there are devices on the market that are designed specifically to monitor these conditions in a more thorough way.

what do they track & monitor?

In order for the patient data obtained through the use of wearables to have the greatest possible impact in the healthcare industry, it must be integrated into the provider’s EMR. There are a number of action steps that physicians need to consider relating to this integration:• First you must establish if your specific

patient population would benefit from this integration. Generally, the answer is yes, specifically for family medicine, pediatrics, and gerontology practices, as well as certain practices that treat patients with chronic conditions such as cardiology, rheumatology, endocrinology, and pulmonology.

• Next you’ll need to discuss the availability and cost of wearable integration with your EMR vendor. They may or may not offer an interface for wearable devices, and if they do you’ll want to understand how the data is incorporated into your system, how it will be seen by clinical staff, how it will be analyzed, and what kind of costs will be associated with these services.

• You may want to consider targeting certain patients in your practice for this service. Your patients who are trying to lose weight, especially for health reasons, and those dealing with chronic conditions such as hypertension and diabetes would be the ideal candidates for interfacing between their wearables and your EMR, as capturing relevant health data for these patients can help you care for them more efficiently.

• Next, determine how this will affect your clinic’s workflow. Obviously, once patient data has been imported to your EMR it will need to be reviewed and someone will need to determine what, if any, actions should be

taken based on that data. Create a process for this task and assign staff to these tasks so that nothing falls through the cracks.

• It’s also incredibly important to ensure that the data you’re receiving from your patient’s wearables is reliable. If you’re making care and treatment decisions based on this data you don’t want to be using inaccurate values. The best way to do this is to have a patient who is using a wearable send you data just before a scheduled in-office appointment. Then, when they arrive for their appointment, measure that same metric in office and compare the values. If they match, the wearable is reliable. If not, that will need to be considered as a factor on using that particular device.

• Make sure that your practice is both analyzing and addressing potential security risks from integrating wearable data. This is part of remaining HIPAA compliant. Remember, any time data is received into your system from an outside source it brings the risk of unauthorized disclosure. Make sure that you have proof that you considered these risks and took adequate steps to mitigate them so you don’t get hit with a HIPAA violation.

• Once you’ve accomplished all of this, you’ll want to engage your patients in the program. Share the benefits of this data sharing with your patients and get them enthusiastically on board to see the greatest amount of benefit.

systems of use and integration

Utilizing the data provided from a patient’s wearable device can take some of the guess work out of that patient’s care. As humans, we tend to have a bit of an attribution bias, and in general we will report things in a way that is favorable for us, even if they aren’t entirely accurate. With this in mind, a lot of patients when left to their own devices will over-report exercise and under-report things like calorie intake and alcohol consumption. Even if patients report these things as accurately as they can, without objective data the provider is still working with an approximation. Using the data from wearables allows providers to work with actual concrete numbers, and those numbers are provided seamlessly to the provider when integration is in place, allowing the physician to make better care decisions in a more efficient time period. Additionally, when providers are using data generated by wearables when caring for chronically ill patients, they can notice even the slightest changes in patient condition and start treatment early, avoiding time consuming and costly interventions such as hospitalization.

Using the data from wearables allows providers to work with actual concrete numbers, and those numbers are provided seamlessly to

the provider when integration is in place, allowing the

physician to make better care decisions in a more efficient

time period.

increasing practice efficiency

Wearables also offer the opportunity to help patients improve their lifestyle and exercise. When patients are engaged and seeing clear, objective data they’ll have a deeper understanding of their condition and what they can do to improve that condition, including making better lifestyle choices and being intentional with exercising more frequently and effectively. Patients are also able to see progress through the use of wearables, and we all know that one of the most frustrating parts of making improvements in our lifestyle or starting a new exercise regimen is that often visible results are slow coming and that can be discouraging. Seeing changes in the data, however, can happen sooner and keep that motivation going for those early stages of change.

Many diseases can be identified early through small changes in vital signs that typically wouldn’t be noticed without the use of wearables. When patients are only checked at their in-office doctors appointments, which often have weeks if not months or longer between them, these small changes can be missed. This allows for unnecessary disease progression and a missed opportunity for early intervention, leading to the necessity for more intensive treatment and higher healthcare costs.

Speaking of healthcare costs, all of these benefits from wearables can lead to lower healthcare costs. Wearables enable early intervention for diseases and a greater level of preventive care, both of which help to make healthcare costs lessen. Adding to that the healthier lifestyles that wearables encourage and you have patients who need less intervention and therefore see lower healthcare costs.

improving lifestyle and exercise

catching diseases at earlier stages

impacting and reducing healthcare costs

With all the advancements that have already occurred with wearables and their relation to healthcare, there is more to come in the near future. First is greater ease in tying these devices into your practice’s EMR. This will happen through the increase in interoperability in general, something that is a major focus of many of the government regulatory programs right now such as MIPS, and will therefore continue to go into effect.

Another advancement that’s to come in the near future is predictive analytics. As these wearable devices become more advanced and their connection to providers’ EMRs becomes stronger, the data will be easier to analyze in order to create actionable insights. These insights will then inform healthcare decisions for the patients, aiding in the preparation of plans for patient treatment. This is possible because as providers are able to better

understand the full picture of their patients’ health, as they are with the use of patient generated health data, they can create more exact treatment plans and see a greater success rate.

Finally, the use of wearables will allow for more patient centered preventive care in the future, especially through better communication between patients and their providers and more thorough patient health tracking. As providers continue to integrate the use of wearables in their practice workflows, this will keep physicians and patients on the same page, giving a solid foundation for communicating about health issues and general well-being. This communication will provide more opportunities for stressing the importance of preventive care, again providing for better health outcomes overall.

the near future of wearable tech in healthcare

Wearables and smart medical devices only continue to grow in popularity, and providers are quickly learning the value they can bring to their practice for the purpose of more thorough patient care. The benefits to be realized by utilizing these devices are many and important, and they all boil down to better patient health outcomes, which is the biggest focus of healthcare today especially with the transition to value-based care.

As these devices continue to advance and the desire to directly use them in medical practices increases, their capability to add value to patient care will only grow. This is a recipe to improve patient health outcomes while also increasing provider efficiency, creating a true win-win situation.

conclusion

Learn more about Henry Schein’s solutions provider by calling your local representative or visiting HenryScheinSolutionsHub.com.

Discover. Connect. Transform.