In 2008, Fitbit launched their first activity tracker – a simple clip-on device that tracked steps and movement. Since then, wearable devices, wearables, have progressed from tracking steps to tracking location, heart rate, and even sleep patterns as people have become more interested in personal fitness, diet, and wellness programs.  This increase in technological capability has led to a surge in the popularity of wearables. The wearable technology market is currently on pace to be valued at $34 billion by 2020 (Forbes). PwC’s surveys in the The Wearable Life 2.0 show wearable usage has more than doubled from 2014 to 2016, with many respondents answering that they own not just one but multiple wearable devices.  The same survey found that the primary reason for buying a wearable device was to improve personal health. Respondents also stated that they would be most excited and trusting of a wearable acquired through their physician.

Currently, wearables are well-suited for tracking fitness and exercise.  But what about as clinical devices, collecting clinically accurate information in real-time?  Could wearable devices gather information regarding someone’s blood pressure, glucose levels, and electrocardiography? Will these devices be able to track this data while you are driving to work or running in your neighborhood? What if we knew as much about our physiology and body chemistry while we were walking down the street as a fighter pilot knows mid-flight about his plane and environment? Well buckle in, because we are going on a tour of how far health and fitness devices have come, where they are going, and what impact they will have on your health and healthcare.

From Accessories to Apparel

The original activity trackers were purpose-built to track your steps and provide insight into the time, distance, and speed of your movement and exercise.  As the size and cost of components decreased, these devices became more and more capable. Functionality like GPS and heart rate tracking are now commonplace, if not expected by consumers.

Devices today are transitioning from being solely accessories (like bracelets and watches) to being embedded in apparel.  At the high-tech training end of the spectrum, technology company Hexoskin sells “smart shirts” that provide deep insight into heart rate and breathing rate for athletes, fitness buffs, and researchers. Clothing manufacturers have started embedding RFID (Radio Frequency Identification) devices into apparel for tracking, identification, and security.  In the future, these embedded devices will undoubtedly track activity, temperature, heart rate, and breathing rates, like the Hexoskin technology already does. The devices themselves will also become tiny as thread and inexpensive enough to be disposable.

Moving from Activity to Physiology Tracking

Just on the horizon are solutions that provide definitive, non-invasive insight into your physiology and body chemistry.  Wearable devices will capture your health data without drawing blood, much like the pulse oximeter clamped on your fingertip at the doctor’s office is used to check your blood’s oxygen levels.  For example, Verily is working on sensor patches and contact lens which continuously track your glucose levels.  Eliminating the need to prick your finger for blood to check your glucose will make a lot of diabetics very happy!

Embedded and Swallowed Monitors

If you haven’t seen the pill camera yet, check out this BBC YouTube video.  Although the video is a bit much to watch after eating, having a small, swallowed capsule film the journey through your digestive track is remarkable.  Analyzing the chemical composition of your digestive track becomes very feasible when it only takes swallowing a pill-sized device. What happens when you can embed the device in your body?

In countries like New Zealand and Ireland, dogs must be tagged with a RFID device so that they can be identified. Tesla & SpaceX founder Elon Musk and his neurotechnology company, Neuralink, want to hook your brain up to a computer for human-machine interfaces. So, it is not too big a leap to see a wave of embeddable devices in the near future.

The value of a pacemaker is hard to dispute, and most of us would welcome the insertion procedure if necessary.  DexCom’s G5 Mobile Sensor inserts under the skin to provide glucose monitoring via an Apple or Android phone and in 2018 on Fitbit’s new Iconic smartwatch. But what if you could have a tiny device constantly monitoring your blood chemistry?  Swiss researchers have already created a “tiny lab” that monitors your blood and then radios back the analysis. Before long, we will be detecting other biomarkers, macronutrients, vitamins, minerals, and micronutrients without drawing blood or needing a doctor’s visit for a lab test! Empowered with this valuable information, you may one day know exactly what that burger and fries did to your thighs – or at least your bloodstream.

Devices Become Clinically Accurate

Point of care, mobile, and in-home diagnostics are now as accurate as formal lab tests, as previously discussed in Expansion of Low Cost Diagnostics.  Many embeddable devices are already clinically-accurate, and our wearables will be moving to clinical accuracy in the near future.  It won’t be long before clinicians have clinically accurate, real-time insight into our physiology and body chemistry.  This insight will accelerate our understanding of human biology, and real-time health information could help catch sicknesses in the earliest stages – well before patients notice symptoms.

The average citizen will be able to track their glucose, micronutrients, microbiome, biomarkers, immune system, and infectious agents. This depth of information, compounded with the breadth of data gathered across the population, will provide a far better understanding of the variations of human biology between individuals.  This level of accuracy, breadth of information, and near real-time nature of the data captured will usher in a new era of medicine.

Monitoring Your Health Like an Autonomous Vehicle

Much like sensor technology has completely changed the way complex systems like cars, trains, and planes are monitored for issues, wear and maintenance, our bodies will be able to be monitored with precision and robustness.  Car technicians have progressed from manually troubleshooting our vehicles, to attaching diagnostic equipment to the engine, to being told what is wrong by the car’s engine and electric system.  Soon autonomous vehicles will use an array of sensors to understand both their status (speed, gas levels, engine temperature) and the environment surrounding them. It takes a supercomputer to process all that data fast enough to make the correct decision about speed, direction, and acceleration in real-life driving scenarios.

Healthcare must adapt to the enormous volumes of data which will be generated from these new digital health devices. This health data is orders of magnitude more complex than the systems in the world of transportation.   Empowered by this depth of insight into individual’s reactions to diet, exercise, and medical treatment, medicine will be quickly propelled into the much-anticipated arenas of personalized, precision medicine.

Time to Embrace Real Health Outcomes – Next Articles 

Our next article, Embracing Real World Evidence, will address the acceleration of healthcare and improvement in quality that results from access to individualized, real health outcomes. You can find all the published articles at Articles and Essays.




by Matt Larsen, Principal, Healthscient

LinkedIn: Matt Larsen
Twitter: @matthewrlarsen

Published on August 29, 2017

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