November 23, 2020 by Peter B. Laird
Monitoring Your Health: Benefits and Limits of Wearable Devices
To appreciate the explosion of wearable devices devoted to health that has occurred over the past decade, you need only to visit your mobile device’s app store and scroll through the numerous applications available.
Simple step counters, BMI calculators and heart rate monitors have been replaced by apps connected to point-of-care technology that tracks blood glucose, blood pressure, oxygen saturation and heart rhythm with little disruption to life.
A paper published in the June 2019 edition of the journal “Nanomaterials,” and shared by the National Institutes of Health’s National Center for Biotechnology Information, highlights some of the latest wearable, implantable and ingestible devices that are being used by patients and providers.
Doctors of various specialties, including cardiologists, who rely heavily on technology for diagnosing cardiovascular conditions and diseases, have found an ally in wearable devices and tout their potential impact on screening, monitoring and early intervention. However, doctors also caution that these devices are not medically approved diagnostic tools, and users should consult with their physician if they have an underlying health condition they are monitoring.
“We’re seeing more and more wearable devices on the market as we move toward personalized care,” said Mario Pascual, M.D., a cardiologist and cardiac electrophysiologist at Miami Cardiac & Vascular Institute. “These app-based devices provide immediate and long-term data that we, in the medical community, have wanted to be able to capture. There’s also an increased interest from patients, setting up a trend for the future of medical care.”
Wearable Medical Devices Help Doctors
Dr. Pascual sees promise in the consumer-focused wearable technology for measuring and monitoring cardiac biometrics, such as blood pressure, heart rate and heart rhythm, especially over longer periods of time. Instead of capturing these measurements during an office visit, when the patient may not be experiencing any problems, wearable devices can record infrequent symptoms that may still be problematic, he says. Detection of these problems would be limited even with a medical-grade wearable device, such as a Holter monitor, which is used to track heart rhythm for one to two days and diagnose heart rhythm irregularities.
“These devices, which are smaller and more convenient for patients to use from the comfort of their own home, help us visualize trends that may signal problems,” Dr. Pascual said. “From this data, which we access from the patient’s app, we can determine if patients need diagnostic testing, including an EKG, stress test, echocardiogram, electrophysiology study or a cardiac catheterization.”
Similarly, but with a hospital- and physician-driven focus, Baptist Health’s hospital Emergency Centers and Urgent Care Centers recently began using a remote patient monitoring device from medical technology company Masimo to monitor some COVID-19 patients who meet certain criteria. The patients wear a device placed on their finger and wrist that allows critical care staff at Baptist Health Telehealth Center to track key vital signs, such as oxygen saturation, respiration rate and pulse rate. If any clinical deterioration of the patient occurs, the team at Baptist Health can take appropriate action to get the patient back to the hospital.
Wearable Technology Motivates Patients
Dr. Pascual also values wearable technology for motivating patients to make and maintain lifestyle changes. The constant feedback at your fingertips and the ability to get in groups with friends and family members helps to keep users on track with goals through friendly competition. Some devices track activity, calorie intake and burn, sweat and hydration and reward leaders in the group with virtual bragging rights.
Limitations of Wearable Devices
Dr. Pascual welcomes the data that this emerging technology provides and encourages his patients to use them appropriately. But he also warns them of their limitations.
“Wearables are excellent screening tools,” he said, “but they are less of a diagnostic tool. For diagnostic purposes, we still rely on FDA-approved medical devices, like a Holter monitor.” He also explains the consumer-focused devices’ data may not be accurate because of various factors. They may be difficult to place effectively or the applications themselves may have clinical shortfalls, especially if not FDA-approved.
He also cautions that false positives can be detected, which can lead to inappropriate testing. For these reasons, he says it’s always best to let a doctor evaluate your symptoms and the data to determine the next steps. “I am a huge fan of wearables, but we haven’t proven yet that they will lead to positive changes in behavior or patient outcomes,” Dr. Pascual said.