The impact
of healthcare
wearables
on telehealth

Wearable devices and telehealth have both seen huge rises in adoption levels in recent years. U.S. consumer use of wearables increased from 9% to 33% in just four years, while telehealth usage has stabilized at around 38 times higher than before the pandemic.

This naturally prompts the question of what impact healthcare-related wearables will have on telehealth. The global healthcare wearables market size is projected by Verified Market Research (VMR) to grow 13.1% annually from $13.8 billion in 2020 to $37.4 billion by 2028. This includes both consumer-oriented wearables such as smartwatches and sleep monitoring devices for infants as well as more hospital-driven wearables like heart monitoring and blood pressure devices.

VMR identified the following factors behind the growth of the healthcare wearables market:

• High frequency of disease
• Growing consumer demand to take ownership of their health
• Relatively low-cost of wearables
• Growth in features and innovations
• Wide range of use cases in remote health settings
• Rising disposable income

While all of these factors are important considerations regarding the impact of wearables on telehealth, the use cases in remote health settings are particularly relevant.

A major use case for wearables is in remote patient monitoring, with over two-fifths of healthcare providers using this modality. Wearables have the potential to help improve patient outcomes by monitoring physical health and equipping providers with data they otherwise may not have access to such as blood pressure or heart rate. A study by the Stanford School of Medicine found promising results for the ability of an Apple Watch to identify atrial fibrillation. Similarly, a recent umbrella review of the effectiveness of wearable devices in detecting and preventing falls found that "technology offers a low-cost and accurate way to effectively detect falls and summon for help."

Doctors can use data collected from wearable devices such as the Fitbit to personalize treatments and help improve patient outcomes. Metrics such as resting heart rate are important to gauge cardiovascular health and can indicate early signs of illness or health issues. During the COVID-19 pandemic, the Food and Drug Administration allowed non-invasive devices to send information to their healthcare providers to disclose exposure to contagious infections. Remote patient monitoring can help reduce the spread of COVID-19 and other infectious diseases and may keep chronically ill people out of the hospital.

Another important use case for healthcare wearables in telehealth is through its impact on patient engagement and experience. Over three-quarters of those who track their health say it changes their behavior at least moderately. Why is this important? The Centers for Disease Control and Prevention (CDC) has found "a growing body of evidence" that patient engagement can have better health outcomes.

The use of wearables as part of a connected healthcare approach, such as the hospital-at-home model, has been linked to an expansion of interest in home health technology and a sense of greater control by patients in their own healthcare. By using connected health technology, a patient can be monitored. Connected healthcare has been linked with reduced hospital admissions. It provides more options for both the consumer and provider to manage chronic conditions. 

Research conducted by the National Library of Medicine (NLM) has shown the following with regard to telehealth adoption:

• Approximately 17% of all respondents reported using telehealth because of the pandemic.
• The weighted percentage is higher than this for racial and ethnic minority groups. At 23%, Black respondents have the highest weighted percentage reporting telehealth use.

This is not to say telehealth has been historically distributed equally. According to the Institute for Healthcare Improvement (IHI), "Nearly one third of rural Americans lack access to high-speed broadband services, and the gap in access extends beyond rural America along economic and racial lines."

For example, the IHI article cites that, “Lower-income individuals may have more difficulty taking time off work, finding childcare, or accessing transportation to travel to a health care facility. Older patients and those with disabilities may face mobility constraints. Providers must address barriers as well as realize opportunities for using telemedicine to decrease, rather than increase, health inequities.”

Additionally, understanding community-specific factors, like in this study of California residents with limited English proficiency, shows the acceptance of new care delivery technologies could help inform telehealth implementation among diverse populations.

The American Medical Association (AMA) is one of many entities helping to close the digital divide in regard to access to telehealth services. An AMA 2021 policy was created to help ensure that minority communities, individuals residing in underserved rural and urban areas, older adults, and individuals with disabilities can reap the benefits and promise of telehealth.

Healthcare providers hoping telehealth may help address digital equity concerns are unlikely to see immediate benefit from the use of wearables given one survey found those who use them tend to be white, tech-savvy, have some college education, and are more affluent than the average U.S. household—many making at least $75,000 per year.

Other issues of concern for these devices include cyber security. Wearables come with distinct hardware, software and network security risks. As they collect and transfer data between devices and systems, the data could potentially be compromised if the network is not completely secure. Security researchers recently identified 33 vulnerabilities in the most commonly used protocol for transferring data from wearable devices used for remote patient monitoring. This raises the potential for ransomware and man-in-the-middle attacks.

The impact of wearables on data privacy requirements is another challenge for healthcare providers. A survey conducted by Arlington Research found 52% of telehealth providers experienced patients’ refusing a virtual visit citing mistrust in technology or concerns about privacy and data safety. In the same survey 81% of healthcare providers expressed concerns about how patient data will be used and shared from telehealth sessions. The growing healthcare wearables market also brings new complications for HIPAA compliance.

Other concerns raised about healthcare wearables include:

• doubts from some clinicians about the reliability of the accuracy of the data
• whether some health benefits from wearables are due to a combination of the Fogg Behavior Model (people are inspired to make a change by their ability to do so, their motivation and by being prompted to) and the Hawthorne Effect (people only change behavior when they know they are being watched).