Imagine going for a run while wearing a smart watch that can track your pace as well as your calorie intake and activities. Later that day you receive a text message from your physician informing you that your glucose levels, as reported by your new contact lenses, are fine. You also receive an email from your health insurer notifying you that your co-pay has been reduced as a reward for meeting this month's fitness goals, based on an app's report.
Such a scenario could become a reality as advances in mobile technology usher in wearable devices that collect more data than ever about an individual's health. Data from wearable devices that can be shared with other people, like doctors, offer numerous benefits as well as implications for consumers.
Healthcare providers and insurers are examining connected devices for their potential to improve patient outcomes and lower treatment costs and premiums.
Access to such personal health data also gives rise to a host of questions about the value of the information, consumer privacy, and other issues that intersect Silicon Valley and the healthcare industry.
Wearable devices generated more than $1.6 billion in sales last year and are expected to reach $5 billion by 2016, according to Gartner. Data giants such as Google, Apple, Samsung, and Microsoft are betting on technology that collects biometric and other health data, which could draw in more users and grow their market share.
Google has already tried its hand at aggregating health data. In 2008, the company rolled out a project called Google Health that was designed to let users connect medical records that were stored in different places by different providers. The project did not catch on with users, however, and Google shuttered Google Health in January 2013.
Google is trying again, this time with a platform called Google Fit that it unveiled in June. The platform allows app developers to share data between other apps, such as other fitness trackers and monitors, to give users a fuller picture of their health and fitness levels. Several companies have pledged their support for the platform, including Nike, Adidas, HTC, LG, Motorola, Runtastic, and RunKeeper.
In addition, Google partnered with the pharmaceutical company Novartis in July to create contact lenses that connect to mobile devices to report the wearer's blood sugar levels in near-real-time.
Apple is also positioning itself as a health data hub. At its Worldwide Developers Conference in June, Apple rolled out HealthKit, a new function on iOS 8 that centralizes health and fitness data from various apps and monitors. Apple also partnered with the Mayo Clinic and Epic Systems, a large supplier of electronic medical record systems, on an initiative that would allow smartphone users to send healthcare providers data about their heart rate, blood pressure, and other vital statistics.
Samsung is making its own bid on health data. In June, the company debuted Simband, a monitor that looks like a wristwatch that can track biometrics like heart rate, blood pressure, and temperature. Microsoft is also getting into the health data game. The company registered a patent in May for a "wearable personal information system" that includes sensors for tracking calories and the user's heart rate.
Measuring the Value of Health Data
As more companies explore ways to collect, measure, and transmit health data to other systems, consumers may soon be able to share this information with doctors. Doctors for example, could monitor patients' conditions remotely and reduce doctor visits, points out Bill Fera, MD, Ernst & Young principal for the Americas Health Care Advisory.
"Many people are only incentivized to take care of their health when they visit a doctor and learn something is wrong," Fera says. "It's exciting to think of the immediate feedback that doctors can give to patients who are wearing these devices, instead of reminding patients to make an appointment every three months."
In addition, the Patient Protection and Affordable Care Act (PPACA) is incentivizing hospitals and health systems to increase outpatient services, which could make health trackers appealing to healthcare providers and insurers.
The PPACA also allows insurers to increase wellness incentives (e.g., reductions on premiums) for healthy behavior such as exercising, which in turn could lead employers and insurers to encourage employees to use fitness trackers like Fitbit and other digital trackers.
Last year, Aetna began letting its employees incorporate information from wearable devices like Fitbit, JawBone, and MapMyFitness into the company's wellness program. Approximately 27 percent of more than 24,000 participants in the wellness program have logged into their devices, according to the company.
"Encouraging people to track their progress and see how they compare with their friends and colleagues is one step to helping people stay healthy," says Paul Coppola, Aetna's head of wellness program and strategy. More employers are also starting to consider implementing health trackers into their wellness programs, adds Coppola. "We've seen about 5 to 10 percent [of Aetna's employer customers] start to bring in health devices into their companies and that's continuing to grow," he says.
It is too soon, though, to determine how valuable these apps and devices are, comments Harry Greenspun, MD, senior advisor for Deloitte Center for Health Solutions.Companies are still "in the hype zone" when it comes to measuring the usefulness of health trackers, Greenspun notes.
"The app or device might be cool, but does it make me healthier? Does it improve my hemoglobin A1c? We don't know yet if this data makes a difference," he says. More contextual information and analytics need to be applied to the raw data to make it useful, Greenspun adds.
Niels Rosenquist, MD, and co-founder of Janys Analytics, agrees. "The challenge with wearable devices is making sense of the data," Rosenquist says. "It's not enough to say you walked 10,000 feet in one day, people want to know how that correlates with other aspects of their lives."
In addition, physicians and payers need to approve of the data from wearable devices. "Any products that are seeking to make a dent in the huge healthcare industry need the approval of three sets of individuals: physicians, patients, and payers," Rosenquist adds. "And the last thing most clinicians want is data that is not interpretated or integrated with the rest of a patient's history."
App developers must overcome numerous challenges before they can integrate data from a wearable device with a user's medical history, however. One such obstacle is the Health Insurance Portability and Accountability Act (HIPAA), which restricts the collection, storage, and transference of medical data.
Companies that want to make data from a fitness monitor accessible to doctors, for example, are subject to HIPAA compliance rules. In addition, government organizations have only begun to examine issues related to health data generated from wearable devices.
The Federal Trade Commission held a seminar on consumer-generated and controlled health data in May and the Food and Drug Administration has begun laying out a framework for how smartphones and other devices can transmit medical data, but neither agency has announced a specific action yet.
Uncertainty around HIPAA regulations and a lack of standardization poses a challenge for developers to move forward with their products, says Jason Wang, CEO of the startup TrueVault, which offers a database-as-a-service for health app developers to store their user data in a way that is compliant with HIPAA regulations.
"Developers want to get their healthcare apps out there, but there's no guidance on how they can be HIPAA compliant unless they're audited," he says. "It's a muddy area."
In addition more consumers need to use the devices to make it sustainable.Approximately one in 10 American adults own a fitness tracker, according to Endeavor Partners, a consulting firm for mobile technologies. "Many of the people who use fitness trackers are probably already focused on their health," comments Rosenquist. "They're not the people the health industry is worried about."
Despite the challenges, experts are bullish on the implementation of wearable devices into healthcare programs. "Just follow the money," says KPMG partner Ash Shehata. "When a health insurance company or a hospital can tie the use of these devices to better financial measurements, those financial adoptions will drive adoption rates," he says.
Shehata also notes that "established players" like pharmaceutical firms or health insurers who are accustomed to navigating compliance regulations will be able to push innovations in wearable devices further. "So far we haven't seen anything beyond pilots, but once the healthcare industry embraces Google and Apple and startups, you'll see a fast path to commercialization," he predicts.