Wearable technology, also known as “wearable devices” or simply “wearables,” generally refers to any miniaturized electronic device that easily can be donned on and off the body, or incorporated into clothing or other body-worn accessories. While wearables have established utility in the fitness, gaming, and entertainment industries, their role in the healthcare environment remains less clear. According to a manuscript published on March 10, 2021 online in the journal npj Digital Medicine, to date most commercially available wearables are limited in scope, tracking one or two health-related variables, and have yet to produce accurate measurement of many markers of health status that they attempt to assess such as heart rate variability, nutrition, and mood. To the extent that wearables overcome these limitations, they hold much promise towards expanding the clinical repertoire of patient-specific measures. They are considered an important tool for the future of precision health. For example, physical activity is a well-established marker of current health status and future health risks, it is a useful estimate of real-life functional performance, and it has been tracked in health research using body-worn sensors for many decades. Given the ubiquity of physical activity monitors, it is surprising their effective incorporation into clinical care remains a challenge, especially in face of the multiple known health benefits of physical activity and the many healthcare scenarios where physical activity information has a clinical use.
Two of the NIH’s Big Data to Knowledge Centers of Excellence organized a workshop on potential clinical applications of wearables to address various challenges. A workgroup from diverse backgrounds (hospital administration, clinical medicine, academia, insurance, and the commercial device industry) discussed two successful digital health interventions that involve wearables to identify common features responsible for their success. Seven features were identified including: a clearly defined problem, integration into a system of healthcare delivery, technology support, personalized experience, focus on end-user experience, alignment with reimbursement models, and inclusion of clinician champions. For each feature, problems are outlined within the patient domain that are addressed per feature and specific representative examples of solutions are provided for these problems by the two sample digital health programs. Health providers and systems eager to establish new models of care inclusive of wearables may consider these features during program design. A better understanding of these features is necessary to guide future clinical applications of wearable technology.
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