Wearable tech.
It’s pretty exciting stuff!

If you were born in the 90’s or before, you’ll likely remember dreaming about the kinds of technologies the future might bring, most certainly starting your sentence with “will we ever…” or “imagine if…”.

Today, it’s less a matter of ‘if’ and more ‘when’. Our hopes and expectations are wide open, and with innovation moving at breakneck speed, we can envisage endless possibilities to our future that feel both real and likely. Just look at Neuralink’s Blindsight, a brain-chip implant that has been granted “breakthrough device” designation by the FDA and heading into human clinical trials. Not only does it promise those with optic nerve damage to regain their sight, but those born with a defect of the nerve to be able to see for the first time!

The endless possibilities in our future can make us giddy with excitement, which is compounded by a plethora of articles from both conventional and social media, that will have us believe that a seamless transition into a human-machine cyborg world is just over the horizon.

But is patient engagement
with wearable tech guaranteed?

Wearable tech in healthcare already incorporates a wide range of applications, including monitoring ECG, blood oxygen levels, blood pressure and blood glucose. These are of course quite different from bio-integrated technology such as Neuralink, yet the narrative tends to cluster wearables as a group, potentially leading to unrealistic expectations on how useful these technologies will be to HCPs in the short to medium term.   

Current wearable tech suffers from several barriers. Reliability is one of them; e.g. inconsistency in results and/or connectivity issues. Data privacy concerns are another; i.e. the ever-lingering threat of a major data breach of users’ biometric information. But possibly the single greatest barrier to the use of these technologies is users’

long-term loss of
engagement and interest.

We see this time and again with consumer products, where the initial spark ignited by a clever new piece of kit or app inevitably wanes. How many of the smartphone apps you have downloaded have been collecting virtual dust on your phone? And if you are a smart watch user (which, on the balance of probability, you are), how many times have you checked your sleep cycle or your heart rates in the past month? And there it is.

Of course, users whose running or cycling is an integral part of their identity, will continue to regularly monitor their activities for long periods of time, aided by social platforms where they can share and celebrate their accomplishments. But not the rest of us.

We expect that engagement with wearable tech in healthcare wanes even faster than in lifestyle applications. Look no further than adherence with life-saving treatments in chronic diseases such as high blood pressure or high cholesterol. Speak to any pharmaceutical manufacturer or physician, and they’ll tell you: adherence is the bane of their lives.

In a recent study, we at B+C spoke to Chris from the UK, a diabetic patient who has lived with the condition for many years and is well versed in the causes and prognosis of his condition. He's been prescribed an SGLT-2 and understands the protective benefits the treatment provides. And yet, he is a self-confessed intermittent complier… “I know it’s important, I know it’s prolonging my life but sometimes I just have enough of it all. I’m getting a bit older now and I want a break. It’s a constant reminder that I’m ill, and in any case, I feel fine and I have no symptoms”.

Now imagine asking patients to keep wearing a wristband that’s looking out for an MI that MIGHT happen. Or might not. Oh, but the device needs to come off in the shower, and it needs to be charged every week.

Good luck with that.

It’s true that non-intrusive gadgets, which better integrate into the body and require no active participation from the patient are likely to fare better. Neurolink, and NFC chips are good examples. 

But, even with full NICE/FDA approval of in-body and on-body tech, we can reasonably expect late adopters to be a sizeable segment of the market. They’ll say they want it… just not quite yet. In the meantime, more conventional, but more effective wearable approaches will be needed.

Looking to the
consumer sector
for inspiration

We know that telling patients that something will save their life is not enough to keep them interested! Healthcare providers and tech developers would therefore do well to learn from the consumer sector, particularly from app developers who have come up with tried-and-tested measures to secure long-term use and commitment from their users. 

App developers have used several tools to make their technology ‘sticky’ or even addictive. Many of these could also be suitable in the wearable health tech sector:

Personalisation – wherever possible, the wearable should leverage user data to personalise usage and experience. Feedback on the metrics measured and what this means for THEM will be critical.

Push notifications and alerts – well-timed notifications to bring the user back to the wearable kit. This can, and should also be tied in with the personalisation aspect where the patient is actively notified of a reading and its relevance to their potential condition. In addition, progress updates on milestones such as period of usage and how this improves the effectiveness of keeping the patient safe, would serve well here.

Social features and community engagement – allow users to opt into data sharing functions and engage with peers sharing experiences and knowledge. Receiving feedback from others with the same condition or the same gear can add to the ‘stickiness’ of the equipment.

Gamification – provide game-like elements to increase engagement, such as a points system or rewards on reaching milestones. These could be extended to incentives and commitment loyalty programs. I know what you’re thinking: who’s going to pay for all this? For instance, cost savings made by the health service from the preventative impact of monitoring could be reinvested back into the system.

Bottom line

Until the bio-integrated (in-body and on-body) tech we fantasise about comes to fruition, so that patients can forget about the devices they are using, wearable tech is here to stay. And, if wearables are to stay relevant and have a tangible health benefit, they will need to ensure maximum patient engagement.