The first time I heard the term “wearables,” I immediately pictured Tony Stark gearing up in his Iron Man suit and bringing his closest friend J.A.R.V.I.S. (Just a Rather Very Intelligent System) online, embedded within his headpiece. Obviously, we don’t live in a time with flying suits and technology that displays holograms based on our thoughts, but technology has advanced tremendously over the last 10 to 15 years. Think back to when all your watch did was tell time and your glasses just corrected your vision. Now, there are watches that tell us to take a walk because we’ve been sedentary too long, and then count the number of steps we took, and glasses that manage our schedules and take pictures.Wearable devices are hitting the market for everything from glucose monitors to medical-grade adapters that attach to a smartphone and provide an EKG.
WHAT IS IT? HOW IS IT BENEFICIAL?
Wearable technology encompasses a variety of electronic devices that can either be worn on clothing or as an accessory.1 They include smart technology that connects to other devices (a smartphone) or networks (the cloud) and have the capability to track a particular action – or the lack of action.2 Some of these items are still quite controversial, but consider how much easier healthcare could be if there was a way to securely automate the process of collecting data provided by wearables. How much time could it save pharmacists and physicians if they could gather data prior to an appointment and receive an accurate, up-to-date picture of their patients’ health? Accurate is the operative word here. I don’t know about you, but if I’m seeing a doctor because I’m exhausted due to lack of sleep, and I haven’t tracked my sleep data, it might feel like it’s been months since I’ve had a really good night’s rest, when really it’s only been a few weeks. It can be difficult to provide an accurate representation of health problems if patients haven’t been taking notes or tracking their activities. The idea of making wearable data available to patient care teams is one that I don’t anticipate many objections to, especially if it can be done securely. As you can imagine, the applications of wearable technology are plentiful, but utilizing them comes with a fair share of technological challenges.
Recent steps in technological advancement lay the groundwork for sharing wearable data by allowing patients to input information into their (personal) electronic health records (PHRs). Many EHR systems already include this functionality. Patients can opt to use an electronic chart via a link provided by their doctors and set up an account where they can log everything from fluctuations in weight and over-the-counter medications to medication reactions.
Application Programming Interfaces (APIs) are tools that facilitate the provision of this data by managing the exchange of information between systems.3 As more software systems begin using APIs, the need for industry standards to allow healthcare information to be exchanged has become increasingly important. Think of it like this: software used by nutritionists or dietitians has its own set of data that practitioners can record, which is different from what primary care physicians and pharmacists capture in their software. Standards allow the codified information that is similar across all systems (e.g., allergies, medications) to be shared in a way that the receiving software can systematically process and interpret. Then, it presents the remainder of the provider-specific information to the end user in a simplified, meaningful way.
Now that many health systems, doctor’s offices, clinics and hospitals have implemented EHRs, the new goal for the healthcare industry is to make those systems interoperable across the entire health spectrum. Currently, wearables do not easily send or share data with pharmacy or physician software systems. Additionally, wearable devices do not always use the same criteria used in healthcare, further reinforcing the need for standardization. There are some intermediary systems available that allow patients to upload wearable data to a cloud-based system that deciphers and displays the information within the EHR. These intermediaries have “pilots already starting to determine how patient generated health data can be best delivered to caregivers and researchers to assist in improving outcomes.”4
WHY SHARE? HOW DO WE SHARE?
The focus is no longer to count the number of patients seen or prescriptions filled. The overall healthcare industry is shifting towards value-based care. Payers are becoming increasingly interested in models that promise to reduce healthcare costs while also improving patient outcomes. Physicians are realizing that pharmacists can fill a critical gap that they aren’t equipped to manage. The combined data of all parties involved in healthcare paints a much clearer picture of what’s going on. Why not use data from patients and their devices to further enhance and understand their overall health, especially if it has the potential (spoiler alert) to influence payment reform and change the way pharmacies are reimbursed?
As wearables progress and manufacturers provide new products to assist consumers with their health and wellbeing, the devices will become more popular and more affordable. As healthcare technology advances and securing the exchange of data becomes easier, more and more healthcare and software systems will jump on board. And as all healthcare providers begin to collaborate and work as a team to provide the best comprehensive care for patients, pharmacy benefit managers and payers will notice and want in on the cost savings.
One day, the healthcare industry could have its very own J.A.R.V.I.H.S. (Just a Rather Very Intelligent Healthcare System), but the evolution of technology is not going to wait on slow adopters to participate. As one data-enthusiast said, “I’ve seen a lot more progress when groups of provider organizations and technology developers get together and say, ‘We’re going to go at the quickest pace we can, regardless of whether the whole market travels at the same speed.’”5 Healthcare providers and their software systems must be prepared to step out of their comfort zones and get connected! So, as the expert in wearables, Tony Stark, would say, “Sometimes you gotta run before you can walk.”6
Now, take a deep breath, press your index finger on the button of healthcare, and suit up as you prepare for an interoperability skydive. Just be sure you have your jetpack and rocket boosters ready!
1 Wearable Technology. Investopedia. n.d. Web. 13 Oct. 2017. www.investopedia.com/terms/w/wearable-technology.asp
2 Smart device. Wikipedia. Sept. 2017. Web. 13 Oct. 2017. https://en.wikipedia.org/wiki/Smart_device
3-5 O’Dowd, Elizabeth. Why Application Programming Interfaces Are Key for Healthcare. n.d. Web. 16 Oct. 2017. https://hitinfrastructure.com/features/why-application-programming-interfaces-are-key-for-healthcare#
6 Iron Man. Dir. Jon Favreau. Per. Robert Downey Jr. Paramount Pictures. 2008. Film.