Healthcare

The Physician and the Fitbit: Why Doctors and Administrators Don’t Love Wearables

You may love your Fitbit…but does your doctor? The complicated world of wearable data may make their lives harder.

How many doctors encourage patients to use fitbits and wearables? Well, Hawley Montgomery-Downs, an associate professor of psychology at West Virginia University, studied Fitbit’s capabilities. In her words: “I have a heebie-jeebie factor about somebody using them in their science.” Her study ended up pinpointing some of the wearable’s many inaccuracies.

The wearables industry has focused on consumer’s daily lives, how to integrate social connections, and gamification. Making that data medical or useful on a larger scale was not quite on the agenda. The goal was self-help. One positive result is that the wearable craze helped many people see their health in a new way. They could assign numbers and amounts to food and activities. Several popular renditions of “What Does 200 Calories Look Like?” still circle the social share-sphere. With this knowledge consumers could, hopefully, take back power.

General wearables are not, however, accurate enough for medical assertions to be made. Fitbit hasn’t even been clinically validated to conform to U.S. Food and Drug Administration medical grade devices. They are judged by the slightly friendlier “wellness” rubric. Many users do, of course, realize their tech nicknack is not medical grade. Yet many still assume data (no matter the size or form) is useful.

What do doctors see when they look at your Fitbit?

Andrew Trister is an oncologist at the nonprofit medical research organization Sage Bionetworks. His opinion seems to be part of a growing majority of doctors who, despite a desire to help, simply can’t do anything with that data. “I’m an oncologist, and I have these patients who are proto ‘quantified self’ kinds of people…They come in with these very large Excel spreadsheets, with all this information—I have no idea what to do with that.”

As doctors repeatedly lament, there isn’t much to be learned from how many steps someone has taken in a day. People exercise for different reasons, and in different ways. The lack of standardization in this information, as well as a general uncertainty of what specifically to do with it, makes it all incredibly precarious. Wearables are fabulous for self-helpers because the onus is on the user to glean information. A doctor cannot, and should not, rely on information they aren’t prepared to deal with.

Incorporating information into electronic medical records will take time. There is a huge amount of data in the healthcare industry, and finding a way to standardize is not easy. Only in recent years have Electronic Health Records become common. Penalties for not effectively using EHR will only start this year. Turning the “self-help” wearables into a tool is not easy—especially the standardization of data.

When is wearable data helpful?

Many doctors do, in fact, use wearables. But it’s not what you expected. There are two very different usages of wearables. One, the generalist that tells the user every little thing in an effort to help them live better. Two, the illness-specific. Wearables are great for tracking blood pressure, weight, pulse rate, and other factors after cardiac surgery or heart failure. There will be a future for wearables related to asthma, mental illness, and other specific illness. Together, the Michael J. Fox Foundation and Intel Corporation studied wearables and their ability to detect Parkinson’s disease. We already know that data is helping fight major illnesses, like Ebola and Sepsis, and wearables can be part of that movements. Hospitals may even be nudged to incorporate wearables in order to keep patients from being readmitted. With accountable care organizations, and programs that reward hospitals for having a good track record, they may be more inclined to track wearable data. Maybe.

The bulk of wearable data will end up in a closet alongside the abandoned Fitbits, Jawbones and Misfits, themselves. Endeavour Partners conducted a survey to find out just how long users use their fitness trackers. Over half of those surveyed admitted to dumping the device—one third of them did so within six months of receiving it. One big reason for this is that, while there is a lot of data, it doesn’t mean anything at the moment. Relatively healthy and normal people will find that their device offers little more than a push in the right direction. This data can also be compiled into truly inspiring infographics. Companies can see when people exercise, or when they sleep best. But that information does not immediately help in a doctor’s office. It seems, for every bit of data wearables offer, it adds just as many questions. Dr. Kimberly Dennis, CEO and medical director of rehabilitation center Timberline Knolls, estimates that 75% of her young-adult patients use their apps in ways that facilitate eating disorders. Ordinary physicians may learn how many steps a patient took in a day, but “techorexia” will continue to rise as technology develops.

Doctors’ and Administrators’ data fears

While it may seem dandy for patients to get to point to a wealth of new information, the endless data creates a new set of fears for administrators in the industry. Data is one more liability. One source from Venture Beat hit the nail on the head: “what if an ambulance chaser (FitBit chaser!) claims we should have taken action for a patient who stopped walking daily?”

Moving data from private devices to hospital systems also means worrying about security issues, and causes plenty of headache for administrators. The wearable-dream is that data can be sent passively without any work by the consumer. It can be hard enough to keep medical data safe as it is, having vast amounts eternally transferring or even simply being stored means more possibilities for breaches. Doctors and healthcare administrators, alike, have their hands full trying to tackle existing procedures and politics. Dr. Bob Watcher, professor of medicine at the University of California, San Francisco put it bluntly: “Most primary care doctors I know, if they get one more piece of data, they’re going to quit.”

The wearable market continues to grow and permeate into different industries. Juniper Research predicts global smart wearable device shipments will more than quadruple by 2017, reaching 116 million units. One day, wearables may play into White House’s new Precision Medicine Initiative and allow doctors to fully understand a patients’ history, and even foresee problems before major symptoms appear. Still, until the technology is greatly updated, and until there is not only a streamlined way to get data to doctors but for that data to be interpreted, general wearables will remain a “self-help” technology.

image credit: Fitbit

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