Medical Professionals’ Caution Towards Wearable Health Devices

Wearable technology, predominantly smartwatches, constitutes a multi-billion dollar sector heavily concentrated on monitoring health. Numerous high-end devices assert their capability to precisely monitor aspects such as exercise regimens, body temperature, heart rate, menstrual cycles, and sleep quality. Health Secretary Wes Streeting has discussed a proposition to distribute wearable devices to millions of NHS patients across England. This initiative aims to allow patients to monitor symptoms, including responses to cancer therapies, from their residences. However, a significant number of medical professionals and technology specialists express reservations about utilizing health data collected by these wearables. The author recounts an experience with a smart ring from Ultrahuman, which appeared to detect an illness prior to the author’s awareness. The device issued an alert one weekend, indicating a slightly elevated temperature and restless sleep, suggesting a potential illness. The author initially dismissed these alerts, attributing them to perimenopause symptoms, but subsequently developed gastric flu two days later. The author questions whether, had medical assistance been required, the wearable data would have aided healthcare professionals in treatment. Many wearable manufacturers promote this practice. For instance, the Oura smart ring provides a feature allowing patients to download their data as a report for their doctor. Dr. Jake Deutsch, a US-based clinician and Oura advisor, states that wearable data allows him to “assess overall health more precisely.” However, not all medical practitioners consistently find such data genuinely beneficial. Dr. Helen Salisbury, a General Practitioner at a busy Oxford practice, observes that while few patients currently present their wearable data, its incidence is rising, which she finds concerning. She states, “I think for the number of times when it’s useful there’s probably more times that it’s not terribly useful, and I worry that we are building a society of hypochondria and over-monitoring of our bodies.” Dr. Salisbury explains that numerous factors can lead to temporary abnormal data, such as an elevated heart rate, which could stem from a physiological anomaly or a device malfunction, with many instances not necessitating further medical inquiry. She expresses concern, stating, “I’m concerned that we will be encouraging people to monitor everything all the time, and see their doctor every time the machine thinks they’re ill, rather than when they think they’re ill.” She further emphasizes the psychological tendency to use this data as a safeguard against unexpected health diagnoses. Dr. Salisbury notes that a severe cancerous tumor, for instance, would not necessarily be detected by a smartwatch or an application. Wearable devices primarily serve to promote healthy habits. However, Dr. Salisbury suggests that the most valuable takeaway from them aligns with long-standing medical advice. She adds, “The thing you can actually do is walk more, don’t drink too much alcohol, try and maintain a healthy weight. That never changes.” The Apple Watch is recognized as the global leader in smartwatch sales, despite a recent deceleration in growth. Apple declined to comment, but the technology company incorporates verified accounts of individuals whose lives were reportedly saved by the device’s heart tracking feature in its promotional materials. The author also notes having heard numerous anecdotal reports of such incidents, but lacks information on the frequency of false positives. Frequently, when patients provide their wearable data to healthcare professionals, clinicians opt to re-measure the parameters using their own medical equipment instead of solely relying on the data recorded by the wearable device. Dr. Yang Wei, an associate professor in wearable technologies at Nottingham Trent University, attributes this preference to several practical factors. He explains, “When you go to hospital, and you measure your ECG [electrocardiogram, a test that checks the activity of your heart], you don’t worry about power consumption because the machine is plugged into the wall.” He adds, “On your watch, you’re not going to measure your ECG continuously because you drain your battery straight away.” Furthermore, Dr. Wei notes that movement, encompassing both the device’s motion on a wrist and the wearer’s general activity, can “create noise” within the collected data, thereby diminishing its reliability. Dr. Wei indicates the ring on the author’s finger, stating, “The gold standard to measure the heart rate is from the wrist or direct from the heart.” He clarifies, “If you measure from the finger, you’re sacrificing accuracy.” He explains that software is intended to compensate for these data deficiencies. However, there is currently no international standard for wearables, applying neither to the sensors and software powering these devices nor to the data itself, including its collection format. The accuracy of a device’s data generally increases with consistent wear. Nevertheless, a cautionary anecdote illustrates potential issues. Ben Wood’s wife received a sequence of alarming alerts from his Apple Watch while he was out, indicating he had been involved in a car crash. The device recommended texting him instead of calling to keep the line open for emergency services. These alerts were authentic and sent to her as his emergency contact, but proved to be unneeded. Ben was at a race track operating high-speed vehicles. He conceded that he “wasn’t very gifted” at driving them but affirmed he felt secure throughout. In a blog post, he wrote, “The boundaries between incident and alert need to be managed carefully.” He also expressed, “I’m curious to see how device-makers, emergency services, first responders and individuals think about this technology in the future.” Pritesh Mistry, a digital technologies fellow at the Kings Fund, concurs that substantial challenges exist in integrating existing patient-generated data into healthcare systems. He notes that this discussion has persisted for several years in the UK without a definitive resolution. Mistry suggests there is “a good case to be made” for incorporating wearables into the UK government’s ongoing initiative to shift healthcare from hospitals to community environments. However, he cautions, “But without that underpinning foundation of technology enablement in terms of the infrastructure, and supporting the workforce to have the skills, knowledge, capacity and confidence, I think it’s going to be a challenge.”