In recent years, digital health innovations—from electronic records management to telehealth services—have transformed hospital operations at every step of the delivery process. The next wave of excitement leverages technologies that many of us interact with every day: wearable consumer devices.
Wearable devices for our wrists and heads are transforming healthcare in the home, in the hospital, and everywhere in between. Smartwatches are making it easier than ever for care teams to communicate with each other and monitor patients with chronic conditions, and they’re offering healthcare providers an unprecedented amount of data that they can use to evaluate health practices and offer more accurate diagnoses. Similarly, VR headsets are creating new opportunities to train doctors, improve the patient experience, and treat medical conditions. Together, these devices open a range of new possibilities for a healthcare network seeking more innovative care and deeper patient and staff engagement.
To start, smartwatches are providing medical practitioners and hospital staff with valuable, hands-free tools to improve the efficiency of care. Smartphone-based clinical coordination tools such as Tiger Text have demonstrated that improved clinical communications can lead to improved coordination of care. Nonclinical team members, such as those who clean the rooms and transport patients within the hospital, need the same type of coordinated efforts. Notably, nonclinical staff activities are often task-oriented, in which speed and completeness of the job are hallmarks of good performance. The smartwatch is an ideal form factor for documenting task-oriented activities for either clinical or nonclinical staff.
The potential impact of improving the speed and completeness of tasks with the use of the smartwatch may include the following:
- increasing the availability of beds,
- expediting patient throughput,
- decreasing patient wait times,
- reducing emergency room congestion,
- improving patient satisfaction scores, and
- reducing length of stay.
Smartwatches are also helping care teams monitor patients with chronic conditions and seniors outside of a clinical setting. However, there have been a few technical challenges in deploying smartwatches for patient care. Some examples are as follows:
- Cost: Smartwatches have traditionally been tethered to a smartphone, which means that patients either need to purchase or already have a specific smartphone in order to use the smartwatch.
- Lack of access to the raw data from the smartwatch: Data is preprocessed and formatted in a specific manner, which decreases the capability of developers and healthcare organizations to apply advanced analytics on the data sets.
- Lack of mobile device management (MDM) capabilities: Devices that are purchased by healthcare organizations for their patients or members need to be “locked down” to prevent individuals from modifying the applications. Also, healthcare organizations need the ability to push updates and patches to the smartwatches to ensure that adjustments in protocols are applied uniformly across all patients.
- Lack of data security on the smartwatches: With the growing threat of cyberattacks and malware, healthcare organizations and patients need to ensure that data on the smartwatches is protected.
The good news is that recent advancements in smartwatch technology have allowed us to address these issues and create new use cases. A good example is the Samsung Gear S3 smartwatch, which is available as an “untethered” 4G LTE device. The user can make a phone call directly from the watch. This smartwatch is also enterprise-ready so it can be managed by MDM, the raw data is accessible via APIs, and the data is secured on the Samsung Knox mobile platform. Samsung Knox has received the “most strong” rating for security among mobile platforms for the past two years from Gartner.
The capability to deploy smartwatches in an enterprise setting without the requirement of the individual to carry a smartphone has created new clinical opportunities. A Colorado healthcare organization is deploying smartwatches to seniors and those with autism. They are collecting biometric data, pushing medication reminders, using global positioning satellite technology to provide geofencing (which alerts family and caregivers if the individual goes beyond the pre-defined boundaries), and enabling seniors to send emergency calls with three pushes of a side button on the smartwatch.
But smartwatches are not the only wearable devices that are changing the practice of care. Virtual reality (VR) headsets are proving to be a highly effective therapeutic tool for managing pain, stress, and anxiety in a variety of clinical settings. At Cedars-Sinai Medical Center in Los Angeles, clinicians have demonstrated that VR therapy can reduce pain by 24% in hospitalized patients as compared with control subjects. The VR therapy typically lasts 10 to 20 minutes and consists of a calming and/or engaging immersive video. VR therapy has been shown to be effective with children and adults with conditions ranging from medical to surgical to obstetric. In many cases, patients have demonstrated reduced narcotic usage. Other studies have shown that pain relief can last anywhere from two to 48 hours after the VR therapy, which means that VR therapy can and should be considered a primary or adjunct treatment option. Samsung and Cedars-Sinai are currently conducting a prospective randomized controlled trial to evaluate the impact of VR therapy on pain and narcotic usage in hospitalized patients.
Another area of promise involves the use of VR to address macular degeneration. In macular degeneration, the individual has a blind spot in the middle of the visual field that continues to enlarge as the disease progresses. While wearing the VR headset, the blind spot is essentially removed.
The way it works is that the camera on the phone captures the imagery in real time. Artificial intelligence then processes the image and super-imposes the processed image over the blind spot. The functional result is that the patient is able to see.
However, the one example of VR that is perhaps the most remarkable involves the use of VR to treat patients with spinal cord injury. In a study of eight patients who had chronic (three to 13 years) and complete paralysis due to spinal cord injury, all patients had neurologic improvement, with four of the eight patients (50%) upgrading their functional status to partial paralysis after a 12-month treatment program that involved VR, visual-tactile feedback, and a robotic exoskeleton.
The interesting thing about these use cases involving the smartwatch and virtual reality headsets is that neither of these devices are medical devices, per se. However, the clinical benefits when applying these consumer devices can be profound and far-reaching. We often use the term “consumerism of healthcare” to reflect the changing environment in which consumer expectations dictate how care should be delivered. We may want to consider expanding the definition to include the emerging category of consumer devices being used to treat medical conditions.
So, the next time you see someone playing a game in virtual reality or running with a smartwatch, remember, you’re not just looking at the newest consumer technology. You’re looking at a powerful, state-of-the-art device that can provide clinical and economic benefits. Smartwatches and VR headsets are reducing costs, increasing engagement, and improving outcomes—helping doctors to provide higher quality care and enabling patients to lead happier, healthier, and longer lives.
