Physician, technologist and health services researcher David Rhew, M.D., recognizes the value of wearables when it comes to keeping patients in shape and out of the hospital. But for the majority of people, simply providing a device doesn't lead to increased fitness and improved health.

“Gamification, behavioral nudges and incentives need to be incorporated into the design and implementation of the technology in order to achieve sustained use and clinical benefit,” Dr. Rhew explains. “For instance, one of the more powerful motivators is the patient’s desire to please their doctor. When patients are closely monitored by health care providers using wearables, patients tend to feel better connected with their health care provider and stay adherent to their regimens.”

Making devices better

Although most wearables can measure steps and heart rate, clinical trials are evaluating the use of non-invasive sensors that measure EKG, blood pressure, glucose and other diagnostics.

“The key challenges will be in improving the accuracy and reliability of the readings, extending the battery life, maintaining an appealing form factor and working with the medical community to redefine standards for how we measure vital signs using advanced wearable sensors.”

"When patients are closely monitored by health care providers using wearables, patients tend to feel better connected with their health care provider and stay adherent to their regimens."

Another area of innovation involves wearables that help seniors live independently. Personal emergency response systems are available on selected smart watches; if a senior needs help, then they can notify emergency contacts with the push of a button. Alternatively, if the senior is unable to push the button, advanced analytics may potentially help automate the emergency notifications. GPS features can also help caregivers identify when a senior has moved outside a specified range.

Virtual reality

Dr. Rhew notes that while we usually associate virtual reality with entertainment, it can actually be used to treat post-traumatic stress disorder, blindness, dementia, spinal cord injury, stroke and pain.

Researchers at Cedars-Sinai Medical Center have recently demonstrated that virtual reality treatment reduces pain by up to 50 percent in hospitalized patients with moderate to severe pain, as compared with watching similar content on a television screen. Virtual reality applications have also been shown to restore vision (while wearing the headset) for patients with macular degeneration and other conditions affecting sight.

With respect to wearables, Dr. Rhew says clinical programs such as cardiac rehabilitation can now be “virtualized” on a smart watch.

“Cardiac rehabilitation is an exercise program typically performed in the setting of a rehabilitation center. Completion rates for a six- to eight-week program are low, typically less than 50 percent. However, recent findings have demonstrated a greater than 80 percent completion rate for low-risk cardiac patients. According to the medical literature, for every 17 patients who complete cardiac rehabilitation, we can save one life.”

The future of fitness technology

Dr. Rhew envisions a time when features on a wearable may be customized based on age, health condition, fitness goals, personal needs and/or preferences.

“Imagine being able to swap out medical-grade sensors on a wearable to enable a more customized experience. Imagine a wearable that allows you the ability to control an FDA-certified medical device that has been placed in or on your body.”

Says Rhew, “This type of new health care wearable could then be used to help us maintain our fitness goals, but in the context of what is medically appropriate for each of us. Fitness and health care are rapidly converging, and the wearable represents an ideal form factor that could allow individuals to maintain proper fitness and good health.”