So far this blog has highlighted a number of consumer and clinical technologies that monitor and sense people's activities and vitals. We have seen a few different trends in this space:
- Initially 'superficial' activity monitoring for the 'digitally fit' - largely pedometer based
- Technologies developing for more 'casual' or 'non-intrusive' monitoring / sensing. From the DHI project portfolio, Smartcough offers the ability to monitor coughing persistently over weeks from a phone in your pocket.
- Environmental monitoring - We spoke last time about how the DHI Resbosk project demonstrates the ability to monitor blood oxygen saturation and heart rate from a camera. Elsewhere, a new capability for heartbeat monitoring using milometer-wave radar, when combined with special algorithms to filter out other signals, will allow for heart beat sensing without anything worn at all.
- Biological / sub cutaneous monitoring - that there are a number of capabilities that stretch the definition of wearables, building on pacemakers and other well established technologies to support people with deeper biomedical needs.
When you see this continuously evolving monitoring and sensing capability, the question arises - what are we doing with all of the emerging data?
Private sector use
The private sector is off the mark already with tangible use of wearables to provide or safeguard value. A common question now heard is 'What will happen if health / life insurance companies follow the example set by the car insurance industry - where digital devices monitor the quality of your driving and use this to assess risk and set premiums.
It doesn't take a big leap of the imagination to see this being adopted for people by monitoring a combination of vital signs and activity. This in part fuels the high levels of distrust expressed by people in the sharing of their wearable data.
Equally new employee wellbeing programmes have begun popping up. The more physically active employees are, the more points they get, and points mean prizes of various descriptions. This sounds good, but there is a darker side to it - what if punishment is doled out for those less active? This wouldn't have to be a conscious act by the employer. If as with some schemes, the corporate objective is to reduce their own insurance premiums by demonstrating a healthy workforce, then at what point do overhead costs of employees get broken down to individual employee level and begin to in any way inform recruitment and retention policies?
However, this abstract thinking may not mean anything to most at the moment. A PwC survey found that 68% of consumers would wear employer-provided wearables streaming anonymous data to a database in exchange for breaks on insurance premiums.
Public sector use
Unfortunately there is very little to report on public sector use of wearable data feeds to inform care. Indeed public sector offices have yet to come to grips with the impact this technology will have for their own office environments, with 85% stating that they have yet to work out the network implications of wearables and other smart devices used by staff. So it is unrealistic to expect front line services to have the infrastructure to handle wearable data as point of care any time soon.
Of course other barriers exist too:
- front line practitioners aren't trained to handle these emergent technologies as part of their clinical practice.
- Most of the potential of these technologies can't be realised - as yet there is no model to translate submission of wearable data into a reduction in demand for face to face consultations.
- Significant trust issues still remain around patient recorded information on the part of clinicians.
This feels like a big missed opportunity. Work by KPMG demonstrated that 78% of respondents would share data from a wearable with a GP. With 1 in 5 adults now owning a wearable - shouldn't we be figuring out how to use this data to improve service delivery and care outcomes?
Thanks for reading, and as always, questions and thoughts welcome