November 6, 2019 – DCRI researchers discussed challenges and opportunities associated with using wearables in caring for patients with heart failure.
Researchers from the DCRI are optimistic about the opportunities that wearable devices present in caring for patients with heart failure; however, they also recognize that challenges must be overcome to successfully interpret and act upon patient data collected from wearables.
In a paper recently published in Journal of the American College of Cardiology: Heart Failure, DCRI faculty Adam DeVore, MD, MHS (pictured left), and Adrian Hernandez, MD, MHS (pictured right), along with DCRI fellow Jedrek Wosik, MD, provide an overview of available data on wearable devices and a discussion of the potential applications in heart failure.
The researchers conclude that although wearables provide data that is of interest to both patients and clinicians, there is limited evidence that shows that information derived from wearables leads to improved patient-centered outcomes. This could change as further integration of wearables in people’s everyday lives results in opportunities for continuous data collection and allows clinicians to determine what patients are experiencing outside of the clinical setting.
Wearables are becoming even more prevalent as consumer goods incorporate devices into accessories like watches or wristbands. The paper addresses everything from emerging technologies, such as the Apple Watch Series 4 with its built-in ECG feature, to clinically validated wearables, such as a vest with sensors that monitors lung fluid volume and was approved by the FDA after being tested in a clinical trial. Both of these examples have potential but need further study, the authors note.
The paper also addresses challenges to implementing data collected from wearables into patient care. It is difficult to translate this data into common electronic health record systems, and additional software is often needed, which presents an extra cost. Moreover, technology is advancing more quickly than health systems can develop methods to use the data optimally. Technology also moves more rapidly than clinical trials do, which makes it difficult to clinically evaluate wearables as they may become obsolete before the trial is complete.
Adoption of wearables may also be a concern. Heart failure is most common in patients aged 65 or older, and this population is less likely to use a smartphone. “Understanding the adoption of smartphones and other commercial wearable devices, as well as how to integrate these devices into HF clinical practice, is critical to the future of medical wearables,” the authors write.
Researchers and other stakeholders will also have to proactively push for representation in studies that use wearables to ensure that their use does not increase health disparities due to geography or socioeconomic status. “The HF community, including professional societies, will need to partner with patient advocacy groups to ensure the appropriate and equitable distribution of these technologies,” the authors write. “Patient and caregiver perspectives should be incorporated into these initiatives to ensure adequate representation of all patients in wearable studies (e.g., minority populations).”
Ultimately, the study authors see great potential for the future of wearables in heart failure care. Wearables may be able to measure changes in everything from speech breathing patterns to heart vibrations to the physiological makeup of the retina to identify patients with worsening heart failure symptoms. The researchers imagine an environment in which real-world data from sources in addition to wearables is also taken into account to monitor patients’ progress—for example, internet searches and social network interactions.