The widening world of wearables

FitBits, telehealth, remote data gathering—those wireless and mobile tech capabilities are all right here, right now. But what to do with all those data? It must start with a robust information technology architecture that can handle the new data influx that is coming and still deal with quality care, says John Derr, president of JD and Associates Enterprises.

Although wearable technology has been around for several years, it reached the general consumer level in 2014 and took off like a rocket. Today’s wearables can count heartbeats, measure blood pressure, check glucose levels and track locations. But the wearable frenzy boils down to the same problems healthcare has had with its data for decades: Just because we can capture data elements doesn’t mean they’re translatable to our health record systems, and just because we can translate the data into a “permanent” record system doesn’t always mean we have efficient ways to use or analyze them for better benchmarking or quality care.

All new healthcare technology goes through a “whistles and bells” period, then often settles into actual, valuable applications that can improve healthcare delivery in the mainstream. Although many providers hail the adoption of this type of technology as a huge milestone in patient engagement if nothing else, others are looking toward wearables as potential goldmines of data on residents as they live their daily lives, filling in the crucial gaps between physician visits.

Gathering routine data on blood pressure, for example, can help balance the effects of what physicians call “white coat hypertension,” or the phenomenon of a person’s blood pressure rising to an uncharacteristically high level simply because he or she is undergoing a medical exam. In many cases, better 24/7 data could show physicians that treatment for hypertension is not actually necessary. For older adults with chronic diseases, such as diabetes, chronic heart conditions and many others, wearable data capture could greatly enhance providers’ understanding of residents’ own experience with their conditions throughout the day or week, leading to better care plans, including better medication management.

Current wearable technology apps include these, among others:

• Tech that tracks location. With long-term care’s (LTC’s) initiatives for wander and falls management, technology that can is of keen interest. Mature RFID’s technology tracks a resident’s location and/or position to warn staff of a perimeter breach. Other wearables include shoe insoles with GPS; there’s even a cane with GPS.
• Tech that captures health data. Fitbit Inc. and many others made a huge splash in 2013 with bracelet-based tracker systems. These offerings have expanded to several models with varying features that can track anything from heart rate to sleep cycles. And Google has been tinkering with wearable data capture for years. So far, however, few healthcare providers have been able to put technology such as Google Glass to mainstream use. Others companies have spent years examining the risks of gait versus falls risks. As one example, BioSensics offers a wearable cuff that analyzes gait against measurable goals and provides a report via wireless portal.
• Tech that translates health data. Among the movers and shakers for wearable diabetes data is Abbott Diabetes Care, already a kingpin in the diabetes strip-testing industry. The Motion Analysis Lab is working on capturing motion data to monitor residents with Parkinson’s disease, including how motion/rigidity changes over the span of the disease progression. Also, Google is working on wearable tech that can measure glucose levels/A1C through the eyeballs of people with diabetes, using high-tech contact lenses. And, rather than tracking caloric intake or warning against fatty foods, a young California startup has developed BitBite, a tiny in-ear wearable device to observe how a person eats, including chewing data.

WORKING TOWARD ADOPTION

As a pharmacist, one of Derr’s own personal windmills is the cross-continuum inclusion of medication management, not just the reconciliation of a meds list; so he gives this example on electronic health records (EHRs) working within the bigger picture of long-term care: “If you want to do true medication management, you have to look at diet, the therapy, the meds and the labs. Even with the best EHRs, those things are still separate and siloed. No one is really looking at all of them at once.”

So, many obstacles still remain for LTC providers: Some medical device charges are easily reimbursed, such as glucose testing strips; but reimbursements for other processes do not necessarily apply. A 2014 IDTechEx report predicts that wearable technology will reach $70B by 2024, with much of the action happening in North American markets. Although IDTechEx includes all types of wearables (including “smart fabrics”) in its predictions, for the LTC market, the most common first adoptives will probably be bracelet- or sensor-based form factors.

Many new tech advancements are here now, Derr adds. “We used to say, ‘when will this technology happen?’ Well, it’s happened now. So get on board. Yes, our staffs have to watch out for their F-tags and their daily data, but they also have to prepare for longitudinal person-centric care and transitions of care.”

Pamela Tabar

Pamela Tabar was editor-in-chief of I Advance Senior Care from 2013-2018. She has worked as a writer and editor for healthcare business media since 1998, including as News Editor of Healthcare Informatics. She has a master’s degree in journalism from Kent State University and a master’s degree in English from the University of York, England.