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In the right hands, wearables could revolutionise healthcare
We spoke to Prof Amitava Banerjee, a cardiologist and clinical data scientist, to better understand how smartwatches and fitness trackers could change medicine
For years now, smartwatches from various brands have allowed you to track your health and wellness. They let you count your steps, check your heart rate and set reminders to stand up now and then or, if you somehow forget, they’ll give you a gentle nudge to breathe.
But recently, the likes of Apple, Withings and Fitbit have begun to move from wellness to more detailed health analysis. You can perform an ECG, monitor for irregular heart rhythms and, most recently, measure your temperature to track ovulation.
These advances take health tracking into a new, grey area. As well as providing basic measures of fitness and performance, they’re now starting to gather the kind of data that could be used to predict illnesses or health issues.
In fact, companies including both Apple and Fitbit have already been involved with studies to see if their trackers can be used as diagnostic tools.
So can your new health-tracking smartwatch spot an abnormality simply by keeping an eye on your heart rate and activity levels? And, more importantly, can this information be used to inform a conversation with your doctor? We spoke to Prof Amitava Banerjee, a cardiologist and professor of clinical data science, to find out…
CAN BIG TECH AND DOCTORS COLLABORATE?
“Until any device, algorithm, or statistical model has been externally validated and I’ve seen the data or it’s in the public domain, I can’t trust the producer of the watch to tell me that it’s going to make my health better. There needs to be published data, ideally from clinical trials,” says Banerjee.
For a big tech companies, the first step into health and diagnosis is research. Some of the major companies in health tech have performed studies, but Banerjee believes that this existing research hasn’t been rigorous enough and needs improving if it’s going to be trusted.
Even with further research, there’s another issue for tech companies entering the medical field to deal with: the use of the data they’re creating in a practical setting. Will the information they can provide be useful for doctors, or is it more likely to interfere with their work?
“First, show whether your algorithm works, then go to the doctor and see how they would use this. If you look at pulse checkers for example, they can affect the doctor’s workload adversely, by bringing in people who are the ‘worried well’ every time their pulse goes over 70. You might divert care towards the people who don’t necessarily need it, and potentially cause further inequality in the healthcare system.”
PUTTING THE USER FIRST
There are three parties in the debate over health tech advancements: the tech companies, the healthcare practitioners and, most importantly, the users. For wearables and health tech to work, the user needs to come first.
“The digital health market is huge, and the [media] coverage focuses on all the money to be made. The starting point should be about helping people and bettering their health,” Banerjee says.
All the brands operating in this field are targeting a niche group of people, more specifically those who are in good health. These people are then fed large amounts of information without a full explanation of what to do with it.
“These devices aren’t necessarily reaching the people who I most want it to reach – the people that need the healthcare most. The people who are being reached aren’t being given full information, either. I’m able to buy the right phone, but I might not be able to know what makes the tracker I’m interested in good. Or I might not be able to find out what makes one ovulation checker accurate versus another one. There isn’t enough information.”
The other problem the tech companies face is the need to create an ecosystem that includes the healthcare practitioners and the users. Banerjee hopes for a co-designed model that could help everyone involved.
“It has to be good for the patient, but it has to also be usable by the healthcare providers. If we’re going to a place where the patient owns – or at least can manage – the data, that could be a good place.
“It’s becoming difficult in healthcare to have all the information we need. It’s hard to have all the things I need to know about you when I see you in the clinic. If you had all your medical information in one place it would make it a lot easier. But of course, there are concerns over a company holding all of your medical data.”
THE FUTURE OF WEARABLES AND HEALTH
Despite his concerns, Banerjee believes that tech companies have the potential to greatly improve the health and diagnosis industry.
“Phones and wearable technology are some of the most scalable things that we could have in healthcare. People are right to be hugely optimistic about what we could do with them. We just have to overcome some barriers first.”
Moving forward, Banerjee believes that tech companies can bring funding and innovation to the field that wouldn’t otherwise be achievable. This would first take more public research, communication with medical professionals, and a leap into regulation.
“Wearable companies need to be brave and leave the health and wellness space to enter the medical and the disease arena. There’s more regulation but a much greater impact. Apple and others are doing things that traditional medicine could never do. We can’t publicly fund this level and scale of innovation. With a little more communication with medical professionals, health tech could be great.”
