The Health Section

Wearables, technology: Changing health care from reactive to proactive

Fitness trackers have evolved from counting steps to being able to monitor sophisticated data and can tell if someone is getting sick by measuring such things as heart rate, blood pressure and skin temperature. Products have also been created to help manage specific chronic conditions, such as diabetes. Now, researchers and doctors are trying to find ways to use data and evolving technology to transform health care to help you stay healthy, rather than just treating when you’re already sick.

“We have to move from reactive, episodic care to being more proactive,” said Madhavi Vemireddy, M.D., chief medical officer and head of product management at ActiveHealth Management. “We need to stop being 100 percent dependent on patients first coming to doctors when something is already wrong, which is what happens today.”

Wearables and tech can give insight on everyday health metrics

Wearables, a category of products which includes fitness trackers and smartwatches, is an increasingly popular category. The use of wearables more than doubled in two years, from 9 percent in 2014 to 21 percent in 2016, according to a Accenture Consulting survey in 2016.

Use of health apps, which can be used on a smartphone to track health metrics such as steps and heartrate, also more than doubled in two years, from 16 percent in 2014 to 33 percent in 2016, according to the Accenture survey.

The survey also revealed that most consumers – 78 percent of survey participants – would wear, or would be willing to wear, a wearable for health tracking.

In 2017, ActiveHealth completed a wearable study that found over 18,000 members connected a fitness, nutrition or medical device in MyActiveHealth. Of those members, 55 percent were using the device for seven months or longer.

Stress and obesity were also common conditions among the members. Ninety-eight percent of those using a device were eligible for lifestyle coaching and/or condition management. Vemireddy said this goes against the perception only healthy people use trackers and that incentives can encourage a broader population to use them.

In the early days of wearable technology, these devices tracked how many steps a person took in a day and some also offered sleep tracking. Since then, the technology has evolved to allow for more in-depth health metrics, such as continuous heart rate monitoring. This feature allows a person to see their resting heart rate, while also knowing when it spikes throughout the day.

Other connected devices can also provide important data to help people manage chronic conditions. For example, some devices send glucose levels to a smartphone or computer, which can be used to help a patient manage diabetes.

Using health metrics to be proactive

Wearables and other connected devices that send information to a database that can be analyzed can have a significant impact on how health care is delivered to patients, according to Paul Mendelowitz, M.D., MPH, medical director of health informatics for ActiveHealth Management.

“This is really where a huge impact is going to occur because the optimization and the management of people with chronic conditions is really where we can impact health and the quality of care delivered,” Mendelowitz said.

Technology and health apps can also improve communication between clinicians and patients.

“When a clinician has access to metrics, they can use push notifications or reach out to the patient to let them know they may need to act upon something,” Vemireddy said. “When we reach out to  an individual about their results or data soon after they happen – we drive greater engagement.”

“The analytics allows you to monitor the population and identify folks that are getting into a certain risk level,” she said. “Now you can leverage the connections you have through mobile to connect with that patient to get key information from them and chat with them to schedule an appointment.”

For example, a physician can look at a person’s glucose levels and if they’re not within a healthy range, can reach out to the patient to help avoid complications. This can simultaneously influence costs.

“If the use of these new technologies allows us to prevent hospital admissions, emergency department visits or avoid readmissions, this impacts costs,” Mendelowitz said.

Artificial intelligence can help clinicians, patients

Artificial intelligence continues to be evolve over time. Although it’s being used various devices, such as smartphones and even home speakers, the technology is also being utilized in health care.

“We have been watching the evolution of artificial intelligence technology and its applications in health care with great interest,” said Jay Rajda, Aetna’s chief clinical transformation officer. “Particularly intriguing is the application of artificial intelligence is in imaging analytics and visual diagnostics, where companies like Google have made significant progress in the last few months.

“A recent research paper showed how this technology can be used to detect the presence of advanced retinal disease in patients with diabetes. The technology has also been applied for diagnosis based on pathological findings on microscopic exams.”

Steven Blumenfrucht, a medical director at Aetna, said artificial intelligence is being used in small scale applications. The technology can help clinicians with diagnosing. In radiology, for example, it can be used to read mammogram data to detect calcification.

“Some calcification is hard to see with your eyes, but with a computer it’s easier to detect mathematically,” Blumenfrucht said. “The data is presented to a radiologist who decides whether it’s clinically relevant or not.”

In addition to helping with diagnoses, artificial intelligence can expand consumer engagement, according to Rajda. Using machine learning algorithms, artificial intelligence can be used to communicate with people, Rajda said.

For example, a person can chat with what they believe is another person, but is really an algorithm-driven interaction without a human being at the other end. Such technology has advanced to a point where it is able to show substantial improvement in the engagement of some individuals.

As wearables and technology continues to evolve, clinicians will continue to investigate how it can be used to help treat patients.

“We have to figure out how we can use technology, big data and artificial intelligence to improve the quality of care,” Rajda said. “And we need to see how it can minimize unnecessary services and detect error and fraud. There’s a tremendous opportunity.”