Nurses Might Persuade Patients to Use Wearable Devices

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Wearable devicesNurses and others in the medical profession are eager to see wearable technologies become a vital part of their jobs and their lives — not to mention the lives of their patients — and there is already a tantalizing variety of gizmos to crave.

Yet market forces don’t seem to be favoring an onslaught of medical devices despite the impact they might have, especially for those afflicted with chronic life-threatening noncommunicable ailments such as cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.

Health care providers and insurers are constrained by budgets and regulations. Capitalists are skeptical that investing in wearables will give them a suitable return on investment. And consumers are not uniformly enthusiastic. In fact, their recalcitrance may be inhibiting adoption of health care-related wearables more than any other element.

Medical community backs adopting devices

There is plenty of enthusiasm in the medical ranks for devices to promote asthma and diabetes management, smoking cessation, and breast health. There’s even a consumable pill on the way that can track many of a patient’s vitals, and there are now tattoos said to do the same. There are also applications that make nurses’ jobs easier or help a hospital track incoming patients in the wake of accidents and disasters.

“Digitally enabled care is no longer (merely) nice to have. It’s fundamental for delivering high quality care,” a leader in health information technology, Daniel Garrett, told Forbes magazine in 2014.

Most of the body-related consumer products have turned up, however, in the fitness community, with tracking of pulse and respiration rates and the like becoming popular enough to attract comment and conjecture about medical applications, although without much commercial follow-up.

“Developers continue flocking to a saturated market filled with hipster pet rocks, devices that gather reams of largely superficial information for young people whose health isn’t in question, or at risk,” writer J.C. Herz lamented in Wired near the end of 2014.It’s a shame because the people who could most benefit from this technology — the old, the chronically ill, the poor — are being ignored. …There is a very real — and potentially lucrative — potential to shake up the health care system and frack the $2 trillion annual cost of chronic disease.”

A year after Herz made those allegations, some analyses indicated interest in health care application is picking up steam, although the public’s enthusiasm for wearables is still in doubt.

Mobile apps from hospitals

About two-thirds of the 100 largest hospitals in the United States have mobile apps for consumers, and nearly 40 percent of those have developed apps for their patients, according to a report issued by the research consulting firm Accenture during the first week of 2016.

Research Now Group surveyed 500 health care professionals in 2014 and found:

  • 46 percent planned to start using mobile apps in their practices by 2020
  • 86 percent said the apps would improve their overviews of patients’ conditions
  • 72 percent said patients would take more responsibility for their own health if they possessed the right app

Which apps do patients want?

But what are the right apps? That’s the quandary for health care providers whose desire for new products is offset by stagnant technology budgets.

The biggest quandary is that the would-be customers are a bit hazy about what they want from wearables, not to mention their wariness of cybersecurity issues.

The Accenture report said patients’ fickleness could cost each of the app-happy large hospitals it surveyed $100 million a year.

The problem is that only 2 percent of the patients at those large hospitals were using the apps, mostly because only 11 percent of the hospitals fulfilled the patients’ three most-desired functions: access to medical records, appointment scheduling, and prescription refill requests. Accenture found that 7 percent of patients switched health care providers as a direct consequence of their dissatisfaction with the devices.

Will patients use wearables?

The public’s apathy and outright antipathy weren’t a shock to the wearables industry.

PricewaterhouseCoopers’ Health Research Initiative (HRI) reported in 2014 that more than half of all purchasers of wearables weren’t using them every day as prescribed, and that 10 percent had stopped using them altogether.

So someone will have to bridge a gap between what people think they want and what they really need, and nurses are the likely conduits. Perhaps no one is better suited than nurses to steer patients toward more optimizing use of medical devices, and there is hope on that front, says Herz.

“So who’s made a long-term commitment to measuring and tracking their health? People with two or more chronic diseases,” Herz asserted. “People with chronic diseases don’t suddenly decide that they’re over it and the novelty has worn off. Tracking and measuring — the quantified self — is what keeps them out of the hospital.”

She cited a Pew Foundation survey that found 45 percent of U.S. adults are afflicted with at least one chronic condition. “While only 19 percent of people with no chronic conditions track their health indicators, 40 percent of adults with one chronic condition do so, and 62 percent of adults with two chronic conditions do so.”

Cost-effective for patients with chronic conditions

So nurses could be telling patients how their devices can keep them out of the hospital.

Herz says the money is there to help them and those costs will be offset. “If you took all the fitness bracelets and smart watches sold in 2014 and multiplied that retail number by six, it still wouldn’t match the $6.3 billion U.S. market for blood glucose test strips.”

Some on the financial side of the equation concur that the economics ultimately favor a concentration on wearables for the chronically ill.

One criterion: “Is there actionable data that really affects the health care system and the costs that are associated with it?” asks Sean MacLeod of Stratos, which Forbes described as an incubator of health care technology for new-product innovation. When it comes to wearables for the chronically ill, MacLeod says the answer is yes.

“What about the diabetics, what about people with epilepsy, what about those with chronic mental illness? And those without resources that get trapped within the health care reimbursement cycle and don’t get predictive and preventable care on a regular basis that helps them through avoiding a worsening of a chronic disease. …

“The big promise here,” explains MacLeod, “is that by implementing these devices in a meaningful way to truly address chronic or preventative medicine — that will be the way you will likely have a large impact on the cost structures of the system.”

Demand for wearables remains a challenge

So, wearables facilitators clearly see health care as their primary potential market despite the current ennui of the potential customers.

“Can our innovators rise to the challenge of an aging, chronically ill society whose medical costs are swamping our economy?” Herz asks. “It’s a slow-moving market, so until the consumers of these actionable data devices actually demand it, there is little likelihood that the system will change, because of the lack of momentum due to inertia of payers, reimbursement systems and the cost structure that currently exist.”

Someone will have to convince those chronically ill consumers, and nurses are on the front lines. Although about one-fourth of the U.S. population has owned wearables, the devices still seem irrelevant to the people who need them most.

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