Wearables - just for Christmas?
Speaking at the 12th Annual Connected Health Symposium in Boston last Friday, Dr. Ezekiel Emmanuel delivered a somewhat surprising verdict on digital health. "I think you can forget about wearables for the masses", said the vice provost for global initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, going against much popular assumption, and challenging one of the biggest investment theses in the market at present.
According to Dr. Emmanuel, wearables target the wrong audience. At present, over 60% of healthcare spending is spent on around 10% of the population those who are older, have chronic conditions, and are usually at the lower end of the socio-economic scale. What these people need are "invisible devices that stay behind the scenes". By contrast, those who invest in wearable healthcare technology such as fitbits, jawbones and apple watch apps, are typically young, fit and wealthy. As such, he believes investment in fitness gadgets like these will have very little impact in terms of improving the general healthcare landscape or the experience of those who need care most.
Also speaking at the Symposium, Dr. Robert Pearl, CEO of the Permanente Medical Group at Kaiser Permanente, said that though wearables might make nice Christmas gifts, they serve little medical purpose. More important, he said, and more valuable to the industry, would be video.
Wearables are fun fitness aids and there are special purpose wireless patches being developed that will be valuable in a certain number of clinical contexts.
But we agree with Drs Pearl and Emmanuel: the vulnerable of society need most care and account for the vast majority of health and social care spending. The elderly, young and mentally ill need passive, continuous, non-contact monitoring not gadgets.
It's with exactly this belief that we at Oxehealth have been developing our own video vital-signs monitoring software. The Oxecam turns ordinary digital video cameras into health monitors, able to remotely track and record the vital signs of subjects from a distance of several metres.
Wearables can irritate skin, be damaged in the normal course of daily life, run out of batteries, be unhygienic, are bulky and may not be to a patient's taste. Crucially, they require the patient to remember to use them. Remote, passive monitoring by a camera sensor is much easier to successfully integrate into daily life. And that means cameras can truly take hospital care into the home – the "big space" in future healthcare, as Dr Emmanuel emphasised.
Cameras aren't only a better solution for the elderly and children in hospital and home settings: they are uniquely suited to mental health environments. Our own technology is being trialled in secure rooms at Broadmoor Psychiatric Hospital and inside police custody cells, environments where the risks of self-harm posed by the small parts of wearables render them unusuable.
Contactless technology, and video in particular, offers a huge range of potential applications and scope to protect and care for the most vulnerable and in need in our society. Though the "technohype" around wearables may be misplaced, digital and connected health could have a significant impact on delivery and quality of healthcare, and help build better solutions for the future not just for Christmas.