In one of the opening sessions of the 22^nd Population Health Colloquium, Kapil Parakh, MD, PhD, Medical Lead, Fitbit, Google, Washington, DC, discussed emerging trends in digital health and how new tools can improve outcomes and impact population health.

Dr Parakh, who is also a practicing cardiologist at the VA Medical Center, began by explaining that he sees wearables and digital health as leading edge as the approach to health care delivery shifts from volume to value.

“Value-based care aims to meet the health care challenges of an aging America, where chronic conditions such as diabetes and hypertension are on the rise,” shared Dr Parakh. “It’s often difficult for providers, health systems, and payers to engage patients in their health on an ongoing basis. But now, wearables can help bridge the gap.”

It is estimated that 72 million American adults will own a consumer wearable by 2024, such as a Fitbit, Apple Watch, step tracker, or something similar.  

“Wearables make the invisible visible,” Dr Parakh explained. He continued while guidelines tell us that reducing sedentary time is beneficial to heart health and all sort of other health benefits, it isn’t the most inspiring messaging to patients. Wearables present the opportunity to set goals, like walking 10,000 steps in a day, which produces real outcomes, is trackable, and more engaging for a patient than attempting to make lifestyle changes.

Dr Parakh summarized 8 main benefits of wearable technology that can help “leverage subsequent data insights to support population health and value-based care” which included the following: connecting the dots for providers, promote healthy lifestyle, facilitate disease management, support patients, increase patient engagement, detect disease, leverage data insights, and support health care workers

Bridging the Gap

“As a cardiologist, I'll see somebody maybe a couple times a year if they are sick—maybe once a quarter,” Dr Parakh said. “There is a lot that happens in between. For example, if any of us have been to a dentist, you might floss the week before and after you'll see them. Most of my patients will start working out the week before and after they see me and then forget about it until the next time they show up.”

Wearable technology bridges the gap and provides insight from those gap periods which in turn, can be shared and used to promote a healthier lifestyle.

For the aging population, wearables offer insight to providers between clinic visits. Data from Fitbit demonstrates that more than 50% of wearable owners believe the data collected by their device can be beneficial to their doctors and more than 70% of older adults are using these technologies already.

Earlier Detection, Better Monitoring

Wearable and digital tools like smartphone apps are becoming increasingly population across the health care industry. FDA-cleared features on smartphones can even detect atrial fibrillation which might have otherwise gone unseen due to the time between appointments.

Apart from simply reminding people of appointments or serving as reminder applications, wearables and smart phone technology have capabilities to support rehabilitation and enhance quality of life, Dr Parakh emphasized.

“One of the bigger challenges with cardiac rehabilitation is the delivery of the intervention,” he said, which was made all the more difficult during COVID-19 because patients weren’t able to visit a clinic or office and track their heart activity.

Dr Parakh shared his experience with a cardiologist in Ireland who was forced to create a virtual program for their patients during the pandemic and used digital wearables to track patient progress. “What they showed was that not only was this equivalent to in-person monitoring, but more people were more engaged. People felt like they were connected to the hospital.”

More studies are being conducted based on devices abilities to detect atrial fibrillation. Fitbit, Samsung, and Apple products have ways of detecting abnormalities which can be especially helpful for patients who might be at risk of cardiac events or even stroke.

Dr Parakh noted that if health plans or providers were able to provide cheap wearables, especially to at risk patients, from a population health perspective, there is an opportunity to reduce health inequities and make an impact on outcomes.

Improving Support for Health Care Workers

“The complex challenges that health care workers face are way more than what a wearable can fix,” noted Dr Parakh. “If you are 3 people leading the work of 5, you don't need resilience, you need more help. But it is often the case that we are in a profession that is very self-sacrificing and helping others.”

Though wearables cannot solve all the challenges health care workers face, especially in a post-pandemic world, Dr Parakh cited several studies which demonstrated the wearables improved feelings of overall wellness among emergency medicine residents.

“There was a trial—a pilot in the Orlando VA—where the nurses reported positive effects of the devices and it was interesting because they found they were paying more attention to their wellbeing [because of the wearables] and so they living a healthier lifestyle,” said Dr Parakh.

Overall, Dr Parakh concluded implementing these digital tools, using the data collected from them, and conducting programs related to them can positively impact populations across the health care delivery spectrum.