As an otherwise healthy adult, I was alarmed when I started having episodes of tachycardia in my late-teens. I tried to explain how I felt during these episodes to help my doctor diagnose my condition and identify its triggers. As I graduated from college, my mom and step-dad gifted me an Apple Watch, a novel device at the time, which allowed me to monitor my heart rate and record when these episodes were occurring. Wearable technologies have opened opportunities for people to effortlessly monitor their health and provided a unique avenue for new medical delivery systems.
The availability of wearable devices outfitted with health monitoring technologies, such as heart rate and blood pressure monitors, has dramatically increased. More than 1 in 5 Americans wears a fitness tracker (Vogels 2020) and Apple Watches are now sold in higher numbers than the entirety of watches sold through the Swiss watch industry (Statt 2020). These devices target a plethora of audiences. They allow fitness monitoring, which is a critical part of a healthy lifestyle for active people while also informing the average user on the adjustments to be made to daily activity and exercise that enable short- and long-term goal setting (Bireline 2017). The single largest cause of death in this country is heart disease, with roughly 660,000 Americans dying from cardiovascular-related issues each year (Centers for Disease Control). The ability to keep tabs on one’s cardiovascular system by monitoring it through a user-friendly device could help alleviate the ever-increasing number of cardiovascular disease cases in society. One study showed that patients with wearable devices were more likely to receive treatment for previously diagnosed atrial fibrillations than patients without the devices, implying an improvement in monitoring these patients’ health compared to patients without the devices (Wang 2021). This logic is perhaps the reason for the high marketability of wearable device technologies. For instance, Apple has announced functional supplementation with new temperature and pressure measurements being possible in the next iteration of their Watch, allowing users to collect thermal and manometric data in real time (Landi 2021a).
As an individual with a heart arrhythmia, I opted for a watch that included an electrocardiogram function that helped my cardiologist diagnose my specific subtype of arrhythmia. The use of cardio-monitoring devices is now suggested by some healthcare professionals. Susanne Haaser, an occupational therapist at Sharon Health Care Center in Sharon, Connecticut, states, “I have definitely recommended Fitbits before to my cardiac patients,” and the benefit of using these devices is even more obvious in the COVID-19 era. An ever-increasingly important function of wearable technologies is the oxygen sensor, as low O2 content is a critical symptom of COVID-19 and can help someone diagnose a possible infection (Weller 2021).
Wearable devices, such as the Apple 7 smartwatch, can monitor blood oxygen. Printed with permission under: CC BY-NC-ND 4.0 (Creative Commons).
Wearable devices are useful for general monitoring and for specific healthcare needs as they can also inform, treat, and prevent disease progression for illnesses ranging from diabetes to mobility-related disorders such as Parkinson’s Disease. Here are some examples of devices for medical needs:
Continuous Glucose Monitor (CGM): A CGM is a small wearable device that tracks a diabetes patient’s glucose levels throughout the day, notifying the person of their highs and lows and giving them a clear picture of their blood sugar levels, without the need for finger pricks (U.S. Department of Health and Human Services. Continuous glucose monitoring. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved November 1, 2021, from https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring.) The technology helps patients better manage their glucose levels, and reduce the number of blood glucose emergencies. Additionally, recent advancements in technology and CGMs have enabled insulin pumps, which provide automatic insulin delivery, to also significantly advance. With near-continuous monitoring of glucose, smaller computers, and better software, a main goal of diabetes technology is to become essentially autonomous, like an artificial pancreas, to allow for minimal impact on the lives of diabetes patients and a better quality of life (Zipp 2021).
Drug-dispensing contact lenses: The company OcuMedic is developing drug-dispensing contact lenses. By developing a polymer network with a high affinity for a drug, the company’s researchers can administer a variety of drugs to a patient’s eye, including anti-inflammatory and antibiotics, before and after ocular surgeries (Geffen 2020). The rationale for the contact lenses is that the lenses can provide a continuous dose of the drugs, yielding better intake and treatment results.
Gait-monitoring for Parkinson’s disease: GaitQ, an Oxford University spinoff, is recruiting patients to test a new technology that can alleviate sudden motor freezing, known as “gait-freezing”, associated with Parkinson’s Disease (gaitQ 2021). The device is worn on each of a patient’s legs and provides vibration cues to the patient when a gait-freezing episode occurs. The vibrational cues help the patient overcome their freezing, have better motor function, and a better quality of life. Preliminary data on the device showed a 55% decrease in gait freezing and 73% reduction in the duration of gait freezing events (gaitQ 2021). The company was recently awarded £135,000 from the UK’s National Institute for Health Research in addition to £625,000 in seed funding to develop this device.
Early Detection of Neurodegenerative Disease (EDoN): EDoN is a project led by Alzheimer’s Research UK to develop an innovative approach to detect Alzheimer’s disease and other neurodegenerative diseases years before symptoms appear. By collecting data on personal health information gathered from volunteers’ wearable technologies and smartphone apps such as sleep, cognition, mood, navigation ability, gait, or heart rate, they are hoping to identify patterns to allow for early detection of the disease (cited from “Early Detection of Neurodegenerative Diseases”).
Sony Smartwatches are one type of wearable device with potential medical uses
While there are clear benefits to these new technologies, there are also some limitations and concerns that comes from using these devices. One of the main disadvantages associated with wearable devices is privacy. As a main purpose of many of these devices is to record and store patient data for personalized fitness goals, constant recording can pose a threat to one’s medical privacy. Furthermore, the large amount of data that is collected poses a cybersecurity threat (cited from “A Double-Edged Sword: How over-the-Counter ECG Devices Are Impacting Cardiac Care”). Currently, there are no Health Insurance Portability and Accountability Act (HIPAA) regulations that apply to wearable devices if the data is used only for personal use. For many people with such devices, this opens the door for their information to be more easily targeted. This came to fruition in 2021, when an unsecured database containing over 61 million records related to Apple Watch and Fitbit wearers’ health was exposed to online hackers (Landi 2021b).
An additional disadvantage is what is known as the “WebMD effect” – where people to search symptoms on their own without a medical provider, and oftentimes misdiagnose and/or inflate the seriousness of their ailments (Brownell 2011). Despite these limitations, the use of wearable devices in medicine will likely continue to rise. In 2019, the wearable technology industry was worth an estimated $32 billion, and this is expected to balloon to $104 billion revenue by 2027 (cited from “Wearable Technology Market Size: Industry Report, 2020-2027”). These devices will become major contributors in the medical field over the coming years, and ideally enable users to stay healthier and increase their standard of living.
Edited by Andreacarola Urso
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“Continuous Glucose Monitoring.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, June 2017, www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring.
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