Talking HealthTech: 318 – The wearables revolution. João Bocas, Digital Salutem

Podcast Home >

  

So, are we on the brink of a revolution in healthcare? The wearables revolution? 

It feels like we’ve talked about it for the last decade, but in the last few years in particular, with the advancements in technology, increase in utility and broader adoption of wearables — are we at a tipping point where they become mainstream across healthcare systems globally?

Joining Pete for this episode is João Bocas from Digital Salutem in the UK. In this episode, they look at the rise of wearables, their practical application, the barriers to wider adoption and what the future might look like.

Meet João Bocas

João Bocas, who is also known as the wearables expert, is the CEO of Digital Salutem. He is a wearables expert and digital health influencer. João is on a mission to fix healthcare. He is a Portuguese National based in the UK for the last twenty-one years. João has been in healthcare for over twenty-five years, but for the last seven years, he’s been heavily involved in digital health, health tech and wearables, working globally. 

João and Wearables 

We have seen wearables progressing and coming into the care space for quite some time. Now, we are approaching a point that could be tipping over to the adoption phase because we’ve been talking a lot about using wearables and maximising them and leveraging them. However, it is possible that wearables will be a crucial vehicle for care delivery in the future.

Wearables in the future can be applied so that patients and users can proactively manage their health and long-term conditions. As a lover of sports and fitness, João has been doing research on wearables and has also been using them for quite some time. As such, he has done quite a number of small and large-scale projects, including a lot of research about the wearables marketplace.

The Relevance of Wearables in Healthcare

Wearables can be divided into two main categories- non-medical devices, such as fitness and health trackers, and then there are true medical-grade devices. But, sometimes, it’s very difficult for clinicians to see the value and also to target a specific condition with a specific type of dataset. The value is usually through a correlation to a different dataset. So, for example, if you have a heart condition, you might be interested in heart rate variability and even the resting heart rate. So, it’s a correlation through data, but there is a lot of value.

Even pharma companies are now doing virtual clinical trials using wearables and tracking patients remotely. Therefore, wearables certainly bring a lot of value and potential.

Wearables and Telehealth

Due to COVID-19, over the past few years, we have seen a significant increase in telehealth services and virtual care. Wearables play a very essential role in these aspects of healthcare as they facilitate remote capability. 

With the pandemic, two things stood out: One, the digital world and two, the telehealth/telemedicine. But also that remote capability for a few months. For example, the global lockdowns prevented many from visiting a GP or a hospital. Consequently, the world’s awareness broadened, and we were also pushed to start doing things differently- wearables certainly fell into that category.

What is Being Tracked Through Wearables?

A lot more than heart rate can be tracked using wearables. In fact, there are some very interesting studies supporting the varied use of wearables. For example, the smart ring from Oura can detect body temperature fluctuations and provide early COVID diagnosis for the wearers. There is also more recording of sleep data.

Wearables seem to be moving away from the typical 10,000 steps counter because it is a bit obsolete. The fact is wearables on their own are not a miracle. The miracle is the human being driving the change of behaviour and what needs to happen is the change of behaviour combined with the data, combined with the wearable.

But wearables also now provide a lot of behavioural input, such as alerts to meditate, move your legs and sleep. Therefore, wearables are starting to give actionable data and alerts. If they are used accordingly, one can get quite a lot out of them.

What Other Technologies Work with Wearables?

Artificial intelligence is no doubt a big buzzword that is quite often misused. But the combination of artificial intelligence and wearables will be the true game-changer in healthcare. Interestingly, João actually wrote a book chapter on this topic. 

A few years ago, we were not ready. For example, when the Google Glass came out in 2014, it was a major failure because the market was not ready. They were extremely expensive, and clinicians were not going to purchase them for $1,500 or $2,000. 

Now, the market is ready for adoption, certainly for wearables. Technology has progressed even though it was ready probably ten or fifteen years ago. But now, the combination of both is really happening, and there is a lot of data. Artificial intelligence, the capabilities in technology and wearables will be a true revolutionary combination.

Are we Closer to having Wearables Trusted by Clinicians?

There are always user-related concerns around privacy, security and data accuracy. There are very relevant concerns because they are not very accurate; they also show discrepancies between 10 or 20% from wearable to wearable. For example, if you have a tracker, you get up in the morning, and it says two hundred steps, but you haven’t got out of bed yet. This is a result of the movement technology used. For that reason, it is very difficult to rely completely on the data from wearables. 

On the other hand, in healthcare, a discrepancy of 10 or 20% is a very wide gap for error. Also, clinicians don’t have the right expertise, and they don’t have the time to deal with analysing data, go through your pattern of behaviour and retest during a consultation. 

So, what can be done to remove that trust barrier and the need to retest? The majority of systems are not actually using wearables, and clinicians are very new to them and reluctant to use them because they are not yet embedded in the full healthcare continuum. 

Funding and Paying for Wearables 

Currently, there are no reimbursement systems for wearables, but the path is headed in that direction. It would be ideal to turn this dynamic in healthcare and give the power to the patient. So, for example, a patient who tracks their health is showing progress and positive signs. Based on this, they should be able to negotiate with the health system, insurance company or private provider for a discount or healthcare benefit. 

The US market is very different from all the other markets because it’s fully privatised, but they’re lagging behind everywhere else. Notwithstanding, wearables are not embedded in any systems. Even in the UK, the NHS is not fully embedded in wearables though they are doing some research and small projects. 

One opportunity being missed is implementing preventative measures that encourage people to use wearables. 

Vitality, a private insurer in the UK, has implemented a benefits policy where if you use a wearable and if you show health behavioural changes, such as going to the gym, you are allocated a number of points. It is surprising that other insurers and corporations are not implementing this system because investing in health has long-term benefits and long-term savings. 

The issue of payment and upfront investment is always a major barrier. Due to the old-fashioned method of getting things done in healthcare, there are no developments around wearables funding. 

How to Increase the Adoption of Wearables

For more meaningful change to take place within this space, the policy and decision-makers need to see more examples and research demonstrating the effectiveness and potential of wearables. 

Though things are starting to move, there certainly need to be changes. There needs to be more investment in innovation that actually delivers results, not just talk.  Nordic countries, such as Estonia, which is completely digitised, allow startups to ‘dip their toes’ into the systems. Additionally, Nordic countries invest in innovation quite heavily and offer a lot of incentives, facilitating startups’ access to people, money and things. They also plan ahead, and this is a good example for other countries to follow. 

The Future of Wearables

Wearables can change the world and certainly the healthcare world. In the ideal world, more investment in health education would be a priority as it was around twenty years ago. The lack of support, direction and guidance is one of the major barriers to consumers actually using health devices. 

_{Source talkinghealthtech.com}