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Health-Related Wearables Can Track Data for Your Doctors

New devices can take EKGs, measure blood pressure and oxygen levels, monitor glucose

spinner image from left to right siren socks then lingo biowearable then omron heartguide wristwatch
Siren / Abbott / Omron Healthcare

 

You wear a sensor on the back of your arm that continuously monitors your blood glucose level and dispatches alerts if a reading is too high or low.

You don “smart” socks that may help you avoid diabetic foot ulcers, or perhaps a smart ring on your finger that tells you your heart rate and how well you’re sleeping. And the increasingly intelligent watch on your wrist flags irregular heartbeats and summons help should you fall and become incapacitated.

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Activity trackers, smartwatches and other health-related wearables do a lot more these days than count steps or let you see how many calories you’ve burned. A host of devices available now or that are in the pipeline are more deeply rooted into all aspects of your personal well-being. And in certain instances, they provide U.S. Food and Drug Administration (FDA)-approved medical grade features for people with diabetes, hypertension and other conditions

spinner image an apple watch showcasing an e c g function and a mindfulness function
Apple

Mass-market smartwatches go all in on health

You may have bought an Apple Watch, Samsung Galaxy Watch or Fitbit (now owned by Google) as a motivator to get off your duff and crush your exercises. Or maybe you got a wearable device for features having little or nothing to do with health — such as to get notifications from your boss or to listen to music when you’re not carrying a phone.

 But the smartwatches introduced in the past few years have gone all in on health, with a gaggle of potentially lifesaving medical improvements. Devices today include electrocardiogram features that can detect atrial fibrillation (A-fib), an irregular heart rhythm that is a common cause of stroke, as well as monitors for blood oxygen levels that can indicate early signs of circulatory, heart or lung function issues such as anemia, neurological problems or sleep disorders.

More than 18 million workouts, mainly consisting of people walking, running and cycling, have been logged with the Apple Watch and other data sources in the Apple Health app, as part of an ongoing, voluntary Apple Heart and Movement Study. Apple is conducting the study, launched in November 2019, along with Brigham and Women’s Hospital in Boston and the American Heart Association.

Older Americans are exercising

Preliminary data revealed that 54 percent of participants age 65 and older were most likely to complete more than 150 minutes of activity a week, the recommended amount for general health, according to Calum MacRae, M.D., principal investigator of the study and an associate professor at Harvard Medical School.

What’s more, 41 percent of participants 60 and older met criteria for an “above average” level of cardio fitness, or more than 200 minutes of activity each week; 27 percent of this group met “high” level criteria, or more than 300 minutes. People in the 65-and-older cohort had a much higher percentage of walks as their most common activity compared to younger folks.

“We were excited to see that so many of the older study participants were achieving the recommended exercise metrics.”

— Calum MacRae, M.D., Harvard Medical School

“We were excited to see that so many of the older study participants were achieving the recommended exercise metrics,” MacRae says. He thinks that older people could be the most active for several reasons, among them the possibility that people who are retired may have more time for exercise.

At the end of September 2021, more than half of U.S. adults 55 and older are indeed now retired, according to a recent study from the Washington-based Pew Research Center.

“We’re only scratching the surface of what we can learn from the Apple Heart and Movement Study, and we’re looking forward to digging in further to understand the basis of these and many other observations,” MacRae says.

At the very least, wearables may give you and your doctor a greater visibility into your body that was not as readily apparent before because they let you capture data more frequently. What you see may trigger alerts if potentially serious health issues percolate.

“Whether it’s a wearable or not, just collecting data from home, I’m making my patients healthier,” says Richard Milani, M.D., chief clinical transformation officer at Ochsner Health System in New Orleans. “The question is, how can I collect more information than these isolated events when you show up in my office — that can provide us a better way to keep you in good health and avoid you from getting into trouble?”

spinner image a woman wearing a lingo device that connects to an app to measure health data such as glucose and keto levels
Abbott

Other health wearables on the cusp

During the recent CES trade show (formerly called the Consumer Electronics Show) in Las Vegas, Swiss start-up firm Aktiia announced plans to bring its automated wrist-worn 24/7 blood pressure device to the United States. The company has about 15,000 customers in Europe. In the United Kingdom, it sells for 200 pounds, or about $275. CEO Michael Kisch says Aktiia’s goal is to get FDA clearance in the next 12 months.

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“In the U.S., maybe 30 percent of people who have high blood pressure will measure their blood pressure in a month. That’s it,” Kisch says. “With our product … people on average will check their blood pressure 15 to 20 times a week. The coolest thing to come out of that … is for the first time ever, you can present to the consumer what percentage of your day or week or month you are in a target range.”

Omron Healthcare, a global electronics firm based in Japan, already sells an FDA-approved HeartGuide wristwatch for $499 that can monitor blood pressure. A key difference: You must initiate pressure readings manually, which you can then send via Bluetooth to an app on your smartphone.

Health care giant Abbott announced a new line of consumer “biowearables” at CES under the Lingo brand name, designed to continuously track signals in the body for glucose, ketones, lactate and eventually alcohol levels. These latest biowearables are an extension of Abbott’s FreeStyle Libre 2 continuous glucose monitoring system that has been in the U.S. market since 2017 and is used by nearly 4 million people globally.

Worn on the back of the arm, FreeStyle Libre is about the size of two stacked quarters. A tiny sensor filament, about the width of three human hairs, is placed just below the surface of the skin, where it measures molecular biomarkers. Data is sent via Bluetooth to an app on your smartphone every minute, giving users insights into what’s going on in real time. It’s available by prescription and lasts 14 days. Then the user peels it off and applies a new one.

Lingo devices won’t require a prescription. They are “about learning your body’s unique language — a language that most of us have not yet learned how to speak. What if we could decode the message our body is trying to send us as a way to maintain and improve our health?” Abbott chairman and CEO Robert Ford said during remarks at CES.

Abbott plans to sell the Lingo ketone biowearable in Europe this year but hasn’t said anything about U.S. availability.

Nor has Tokyo-based health care start-up Quantum Operation, which says it has developed a noninvasive glucometer wristband that can sense glucose in the bloodstream without having to stick in a needle. Now a prototype, the device hasn’t yet gone through the required medical certifications in Japan, the U.S and elsewhere.  

Getting data from the foot

San Francisco-based Siren is producing a wearable for your feet: machine-washable socks for people living with diabetes and neuropathy. The socks come with a Bluetooth hub that plugs in the wall and lets a team of nurses monitor the temperature of the foot, which Siren says has been shown to reduce diabetic foot ulcers by up to 87.5 percent.

These socks have been around for about five years, and Medicare can cover the cost. You need a prescription, but you don't need a smartphone.

“Everybody in our team is dedicating all of their time to prevention and using data and easy-to-use tools to prevent the complications caused by chronic disease and aging,” says Henk Jan Scholten, Siren's chief operating officer. “If people can use a very simple intervention — just putting on socks — I think it’s worth pursuing. We see really good outcomes with our patients.”

Patients receive five pairs of socks at a time. The embedded electronics do not have to be charged, and the socks, which come in black or white, are replaced after normal wear and tear. Medicare patients who have secondary insurance typically have no copay, Scholten says. Those who don't have insurance pay about $20 a month.

While experts celebrate the boom in health-care-related wearables, such devices can leave consumers with several questions, especially among older folks who may be a bit less trustful when it comes to technology.

spinner image a woman wearing an aktiia blood pressure monitor on her wrist
Aktiia

Is the information generated accurate?

There are no guarantees, but you generally can put more faith in a device that your doctor prescribes or recommends, or that has the blessing of the FDA. You’ll also want to investigate the science whenever possible: Were clinical studies done, and did respected peer reviews validate the device?

It isn’t always clear if a device has medical-grade bona fides, which is not to suggest that a wearable that lacks them is without merit. And not every feature on a single device may be regulated. While the EKG feature on the Apple Watch did require FDA clearance, its fall detection — Apple will call emergency services if you take a hard spill and need help — and blood oxygen features did not.

Aktiia's Kisch draws the dividing line between a consumer wellness device and clinical wearable by asking this question: Is the device producing data that a physician is willing to base a medical decision on? Aktiia plans to make its blood pressure watch available through doctors rather than as a direct-to-consumer offering, at least initially. The company is engaged in clinical partnerships and pilots in the U.S., including a study with hypertension patients at Brigham and Women's Hospital.

Can I understand what the data is telling me?

You don’t want to overreact or get too weirded out by a single reading or temporary blip. At the same time, you shouldn’t ignore serious warning signs. When in doubt, reach out to your doctor.

 The onus is on the makers of the wearable to explain in plain language not only what the data means, but also potentially what can you do about it. It's equally important to spell out how to properly take measurements. You should also be informed on a devices's limitations. When you launch the ECG app on the Apple Watch, for example, a note appears that says "Apple Watch never checks for heart attacks."

“There’s promise in all of this technology, but also peril. ... I always say proceed with caution and have some curiosity.”

— Patrice Harris, eMed

It's equally important to spell out how to properly take measurements. For example, you need to stay as still as possible when counting down the 15 seconds the Apple Watch requires to measure your blood oxygen, a point Apple makes clear.

Omron’s HeartGuide watch is meant to be worn snugly, but not too snugly, about an inch above the wristbone. “We’ve got a reminder every time someone goes to use HeartGuide that you have to hold the device at heart level, almost like a reverse pledge of allegiance,” says Carol Lucarelli, the Illinois-based executive director of marketing and e-commerce at Omron Healthcare.

Omron also tries to add context behind the numbers. You may receive notifications along the lines of, “We also noticed that your average blood pressure reading yesterday was higher than your typical average for a Thursday,” Lucarelli says.

Is your information private and secure?

Ask the device makers and medical providers you share data with how they plan to safeguard the information and keep it confidential. Where is the data stored? How is it protected in transit? Read privacy policies carefully.

The Federal Trade Commission affirmed in September 2021 that health apps and connected devices that collect or hold fertility, glucose level, heart health and other health data must notify consumers in the event of a breach.

“There’s promise in all of this technology, but also peril,” says Patrice Harris, chief executive officer and cofounder of digital health care company eMed and former president of the American Medical Association. “I always say proceed with caution and have some curiosity.”

This story, originally published Jan. 20, 2022, has been updated with information from the Apple Heart and Movement Study.

Edward C. Baig is a contributing writer who covers technology and other consumer topics. He previously worked for USA Today, BusinessWeek, U.S. News & World Report and Fortune, and is author of Macs for Dummies and coauthor of iPhone for Dummies and iPad for Dummies.

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