A bold statement indeed. But the following is designed to prove my point. First, it is important to get out of the way precisely how the wrist can predict health. It isn’t some newly discovered “zone” of the body with mythical powers. It is also not the focus on some previously undiscovered correlation between health and the human wrist. It is instead the recognition that wearable technologies such as smart watches, Fitbits, and other technologies hold the key to tracking and managing health-related data, and if used properly, can harness the technology of the day for improved health overall.
To be clear, this is not a revolutionary concept. Fitbit’s primary focus was on tracking aspects of life that can impact fitness. In fact, for years, items such as heartrate monitors were used by athletes to optimize performance and fitness. What is different, however, is the breadth of what can be captured by a wearable device, and the application of these newfound capabilities.
Innovation is rarely revolutionary. Nearly all innovation comes from a gradually evolving set of capabilities. In fact, most technologies today are derived from the desire to accomplish what was previously done manually, but to do so through technology. The primary difference between yesterday and today has become scale. Scale to reach a greater number of people, scale to increase the number of practical “observations”, and scale to process the information gathered in the time needed to make this information actionable.
The answer is simple. For centuries humans have strived to identify ways to track health. The stethoscope, for example, was invented over 200 years ago in order to track sounds of the human heart and lungs. While blood pressure was ascertained in a number of ways over the years (some a bit too invasive to discuss in this article), it was the combination of the blood pressure cuff and the stethoscope that made the external method of divining this vital statistic mainstream. The Spirometer, a method used to gauge the effectiveness of the lungs, was invented around the same time, however relied heavily on breathing through a tube into a bucket of water to determine the volume of air in the lungs. For literally centuries we have developed methods to track and monitor human vital signs in order to understand how these signals effected health, and to then intervene and make positive changes as early as possible.
With the state of technology today, we are now at the precipice of the next generation of healthcare. While no mainstream wearable device today tracks lung capacity, there are a wide range of capabilities that do in fact track among the most important vitals such as heart rate, blood pressure, blood oxygen levels, blood glucose (through a combined pseudo implant approach), as well as other vital signs. However, wearables also provide access to other important information previously difficult to ascertain, such as sleep, activity levels, stress, and more. While many of these additional “vitals” have been known to impact health, the gathering of such information was always subject to personal observation and reporting… at least outside of a clinical environment.
Again, as described earlier, innovation is evolutionary. Another important case in point is what is now known as remote monitoring (more formally known as Remote Patient Monitoring, or RPM). Remote monitoring was initially performed by providing the appropriate hardware for a person to use for taking measurement and a manual logbook to record results. For example, a blood pressure cuff and a piece of paper could be used to track a person’s blood pressure and heartrate when not at the doctor’s office. This more consistent monitoring was helpful in better understanding the health of the individual over time, and not just during annual (often less, but sometimes more) doctor’s visits. The same applies to diabetes, with the ability to check blood glucose levels via a finger prick to track levels at key times during the day. Remote Patient Monitor, or RPM, has also evolved over time, with medical quality of devices allowing individuals to capture critical vitals at home. And through the Internet to provide this information to their doctors near real-time. The value of this more consistent set of readings is tremendous. Not only does it help to paint a more complete picture of the individual’s health, but it also allows for alerts to be set when readings fall outside of the normal ranges, in order to address pending issues in a timely manner.
RPM continues to evolve with the best devices providing an assortment of capabilities and doing so wirelessly and via blue tooth over cellular service. Even power outages don’t impact the ability to capture critical vital signs. The importance of RPM as a tool for health as been further validated through the continuing addition of reimbursement codes provided by Medicare, Medicaid and third-party insurance companies, all pointing to the desire to shift care from the traumatic episode (episodic care), to a proactive and predictive model. But even then, other technologies have emerged that also serve to focus on the episode, the emergency. Personal Emergency Response systems (PERS) have become widespread in an effort to alert others to a critical event such as a fall, an accident, or other critical health events. So, technology now supports the ability to address both critical episodes, as well as predictive and proactive care.
As you can probably predict (see how the logical gathering of information can allow you to draw certain conclusions?), the wearable device can now be used to track critical vital signs, activities of daily living such as sleep and physical activity, as well as a range of other critical indicators of health. What makes them perhaps the most valuable, however, is the continuous nature of the data that can be made available. While current medical devices may not be replaced anytime soon, the wearable device offers an augmented and frequent set of data that can be used to overlay medical data to paint a complete (or nearly complete) picture of health, and to reinforce the ability to proactively engage with the individual.
Years from now we will likely look back at today’s technology somewhat bemused. The size and types of sensors will continue to evolve, and it is quite possible that many if not most of the reading capabilities of the current wearable will be provided through implant technologies, with direct communication to the individuals phone or other device (which could of course still be classified as a wearable). However, regardless of form factor it is safe to assume these capabilities will exist on the then current Internet of Things (IoT) backbone and provide even more accurate and advance features. But for now, the wrist holds the future of medical care.