Hawley Montgomery-Downs, PhD, an associate professor of psychology at West Virginia University, and Florence Comite, MD, endocrinologist at Comite Center for Precision Medicine in New York City, give their views on additional challenges that the healthcare industry must address before wearable data can be integrated into EHRs successfully.
1. Can physicians draw immediate conclusions from the data?
Many physicians fear that they’ll be inundated with wearable data without any way to analyze it, says Montgomery-Downs. Comite agrees that this is a valid concern; however, if the data is valuable, she says physicians will find a way to integrate it into their practice.
2. Should wearables be subject to scrutiny by the Food and Drug Administration (FDA)?
Not necessarily, says Montgomery-Downs. However, she says consumers and physicians need to be more informed about what these devices can—and cannot—do. “We emphatically need to demand a completely objective evaluation from an unbiased third-party laboratory before we make decisions about whether we use the data,” she says.
3. What about liability related to real-time data?
Will physicians be liable for reviewing all wearable data as it flows into the EHR? What if physicians don’t notice data (e.g., elevated heart rates) that signal a life-threatening event? Will EHR technology be able to alert physicians to meaningful data anomalies upon which they can act immediately?
4. What happens when there’s a privacy or security breach?
Breaches of protected health information happen frequently, but when the EHR includes wearable data, these breaches may be more complicated and intrusive.
5. Will consumer device fatigue add to data inaccuracies?
More than 33% of individuals stopped using their wearable after six months, according to a 2014 research study by Endeavor Partners. What happens when data collection suddenly ceases or there are large gaps in time? Data inconsistency may make it difficult for physicians to draw accurate conclusions, says Montgomery-Downs.
Wouldn’t it be great to prevent anything from ever emerging and detecting it years before someone gets physically ill or expresses symptoms? I think this is the future of medicine
– Florence Comite, MD
Seeing the bigger picture
Other countries also struggle with these same questions, says Comite. “I think doctors around the world tend to be the same … I’m not sure they’re ready for it,” she adds, referring to the integration of wearable data into the EHR.
Still, the question of whether to integrate wearable data is one that needs a clear answer given the continued consumer adoption of these devices worldwide. In both Australia and England, for example, 55% of individuals own a wearable device, according to PwC. In Singapore, the numbers are even higher at 60%.
In the United States, physicians may find themselves faced with reviewing wearable data in the EHR sooner than they think. Value-based payment reform incentivizes providers to render high-quality care that yields positive outcomes. The 21st Century Cures Act enacted in December 2016 also promotes personalized healthcare.
Wearable data supports both of these and other initiatives to improve health and wellness, says Comite. “Wouldn’t it be great to prevent anything from ever emerging and detecting it years before someone gets physically ill or expresses symptoms? I think this is the future of medicine.”