Health

Guess what? Doctors don’t care about your Fitbit data

Image Credit: Shutterstock

In theory, health wearables could make a real difference by providing a way to monitor at-risk people, like diabetics. They might be a great way to monitor poorer people who often never touch the health care system until it becomes an emergency.

Also, the Affordable Care Act (ACA) is introducing millions more people into an already taxed healthcare system, and wearables could be a powerful tool to monitor those new members, catching illnesses before they turn into clinic visits.

Those are pretty ideas, but health wearables, at least so far, have very little to do with real health care issues, the ones that are costing the U.S. billions to treat every year. For the most part, health wearables are worn by the “wealthy and well.”

There is no connection between wearables and the population health management that healthcare reform emphasizes. By the end of 2019 experts expect that about half of the healthcare services delivered will be paid for based on their quality and the health outcomes they create.

The consumer health platforms being built by Google (Google Fit), Apple (Health Kit), and Samsung (SAMI), we’re told, will act as cloud repositories for health and biometrics data collected by wearable devices. They’re also supposed to foster sharing of health data sets by device, app, and analytics players.

At Apple and Samsung’s announcements the companies also trotted out doctors and from big-name hospitals, suggesting that these platforms might act as a conduit through which consumer-generated health data might make its way into real, clinical systems within the healthcare system. Furthering the suggestion is the fact that Apple and Samsung say they are working directly with Epic, the dominant electronic health record company in the U.S.

If the healthcare system could make good use of this data, the thinking goes, doctors might be able to keep in touch with patients while they’re well, and keep them well, instead of coming in contact with them only when they get sick.

But sources in the medical devices, digital health, and healthcare industries say that most doctors have little time for, or interest in, using wellness data collected by wearable devices. They don’t want to spend money on additional (and unproven clinical systems), and most of all, they don’t want to worry about keeping the data private.

“It’s just one more data set they have to deal with, and they’re already wrestling with lots of data every day,” one source told me. A doctor might be interested in knowing whether or not a patient wears a Fitbit or a Jawbone wearable to count steps, and even encourage the habit, but they do not want to receive a constant flow of biometrics data from patients.

“Doctors would love to be excited about wearables — they’re gadget guys at heart — but their day-to-day is spent battling 30 year old fax machines to get your last lab report.” says Jeff Tangney, CEO of Doximity, which makes a social communication platform for clinicians. “For a busy doctor, the ability to use email would save more lives than a Fitbit.”

Another source told me that hospital administrators don’t want the data coming into clinical systems because it’s a liability. If the data fell into the wrong hands it could expose the hospital to privacy violations under HIPAA laws.

“Or what if an ambulance chaser (FitBit chaser!) claims we should have taken action for a patient who stopped walking daily?” our source asks.

Then there’s the issue of the quality of the data coming from consumer wearables. Many of the wearables that will plug into the big health platforms will not be clinical grade. “Doctor’s do care about the reliability of the sampling and the quality of data,” says medical technology expert Jim Bloedau, “. . . although there’s little proof that consumer devices and self-measurements meet a clinically acceptable threshold.”

In order for the data from your Fuelband to matter clinically, it would have to flow securely in to the electronic health record used the clinic and/or hospital. And in the cases of Apple’s and Samsung’s platforms that means the Epic electronic health record.

Epic has proven to be very pragmatic and non-progressive when it comes to data sharing. The company has built a highly functional electronic health record (EHR) product, both for clinics and hospitals, but it has never been big on sharing data with other EHR systems. At one time, Epic built a product that would allow its health provider customers to share clinical data with other health facilities that used a competing EHR product. They named it “Epic Elsewhere,” which speaks loudly of the company’s closed, proprietary approach to building software.

MyChart

Above: A screen from Epic’s MyChart app.

So is Epic really a company that’s likely to work hard to collect consumer biometrics data, crunch it, and display it in the EHR in a way that doctors can easily understand and use? It’s easy to find people in the industry who have serious doubts.

Because Apple and Samsung have been completely silent about their consumer health platforms this summer, we have no idea what Epic’s real role in the whole thing is. To its credit, Epic has developed a well-used and well-respected app called MyChart used by patients to view parts of their patient record. The company might be developing an EHR module that contains secure health and wellness data taken from Apple’s or Samsung’s consumer health data platforms.

But I’m guessing that if Epic does enable doctors and other practitioners to use the data in a compelling way, smart money says it will be a conservative effort, and slow to arrive.

One of the marquee hospitals Apple has partnered with on Health Kit is Mayo Clinics. Mayo’s marketing medical director, Dr. John Wald, told VentureBeat at the Apple Health Kit launch that doctors will have good reasons to access the data from Apple’s Health Kit. “If it makes life easier for the physician by helping to keep patients healthy they’ll want to use it,” he said.

I’ve no doubt he’s right, but that’s a pretty big “if”.


HealthBeat — VentureBeat’s breakthrough health tech event — is returning on Oct 27-28 in San Francisco. This year’s theme is “The patient journey: Connections, data, and innovation.” We’re putting long-established giants of the health care world on stage with CEOs of the nation's most disruptive health tech companies to share insights, analyze trends, and showcase breakthrough products. Purchase your tickets now!
105 comments
Dr. Tom Giannulli
Dr. Tom Giannulli

I think the data will be very useful if 'prescribed' by the provider, with the intent to gain insight into a problem under managment.  Thus flooding the provider with data that has no real value with respect to clinical decision making will hurt the adoption of such tech.  Wearables are useful tools for monitoring but are not well positioned or manged as screening tools. 

Wayne Caswell
Wayne Caswell

“Most Doctors” – I suppose that means those docs pressured to see more & more patients and who now spend less than 10 minutes per visit. I understand their reluctance, but there are others who do embrace remote sensor monitoring.

Who? Start with concierge clinics and functional medicine specialists who promote health & prevention as the core part of their service. The problem is that “most doctors” aren’t trained in prevention or the three pillars of health: nutrition, exercise & sleep. Instead, from day-1 in medical school, they learn about symptoms and diagnosing & treating illness. They don’t profit from prevention and instead lose money from it. That’s the fee-for-service model. 

thinkschools
thinkschools

Healthcare, and other regulated industries have hard time figuring out what to do with consumer tech. Wish we had more @Dropbox types.

She_Sugar
She_Sugar

@StevenBarley Not true of continuous glucose monitor results - when the pt. shares that data to make effective changes.

heyAdamCrouch
heyAdamCrouch

Don't expect docs to stare at your daily step counts and look for trends. Software should interpret health wearable data and serve alerts

pedpsychdoc
pedpsychdoc

@VentureBeat Everyone should use a home digital blood pressure monitor and record their readings daily. They're cheap too.

TheEnvisionist
TheEnvisionist

@VentureBeat Interesting point. Eventually doctors will integrate into this kind of system. Esp. the business minded ones.

Jeff Durso
Jeff Durso

Many of my friends (and myself) now walk between 30 - 50+ miles per week because of FitBit trackers. Not sure I'd classify that as useless...

Josh Umbehr
Josh Umbehr

@Unesco Telemedicine who says this is a task for physicians?  As a physician, we are best pain to interpret this data, we just need better software to collect the data for us.

Josh Umbehr
Josh Umbehr

@PuroSportique @VentureBeat @InnervationFit I do not think it is a question about accepting the change, it is about getting a software system and payment model to make it meaningful for patients and physicians alike

Josh Umbehr
Josh Umbehr

@getOverSite @VentureBeat I disagree, typos or not, that does not affect how physicians interpret vital signs and health metrics that can be obtained from fit bit devices and other consumer health devices/apps

Josh Umbehr
Josh Umbehr

@Wayne Caswell well said.  In our concierge /direct primary care practice we built an EMR that integrates bit bit and other device data directly into our patients charts in a seamless fashion for doctors to interpret.


Yes the fee-for-service model is of limited value in medicine, I think a membership style system benefits the doctors and the patients more effectively.


Direct primary care (memberships) is to fee-for-service, as Netflix is to Blockbuster

Josh Umbehr
Josh Umbehr

@jeet_mahal @scientre @SkipFleshman @VentureBeat what?  That is making sense of course we know what to do with this kind of data.  Trying to lose weight?  Walk more, proof that you are walking more comes from your fit bit.


We have integrated wireless scales, wireless blood pressure costs, and iOS compatible glucometer's directly into our EMR, www.atlas.md

Josh Umbehr
Josh Umbehr

@thinkschools @Dropbox I could not agree more, I think there is a direct correlation between governmental regulation and decreased innovation.


Look to direct primary care models that are free from the majority of burdensome/unnecessary regulation, this is where true innovation is happening as we speak.

Josh Umbehr
Josh Umbehr

@vivekjain11 @VentureBeat I do not think it is just fitness bands, but wireless blood pressure cuffs, wireless scales, smart phone compatible glucometer's, healthcare apps, etc.

Josh Umbehr
Josh Umbehr

@She_Sugar @StevenBarley exactly, you could even decrease the need for A1c's if home glucometer's integrated directly with the physicians EMR, like we have done with www.atlas.md

Josh Umbehr
Josh Umbehr

@heyAdamCrouch exactly, computers are excellent at the task of collecting and organizing the data.  Physicians can then interpret and communicate with the patients based on the data.

Josh Umbehr
Josh Umbehr

@lmsergio @jborton1641 @VentureBeat if mint.com can monitor my financial data and alert me to trends, warnings, make suggestions… Then physicians should expect the same from the EMR's.

Josh Umbehr
Josh Umbehr

@pedpsychdoc @VentureBeat and we control blood pressures effectively, we drastically decrease the risk of heart disease and stroke, so why not make it as easy as a home device that seamlessly integrates with your physician?  Because HIPAA says we cannot?  I think that is a bad reason to avoid innovation.

Josh Umbehr
Josh Umbehr

@vgul @ARJalali @amcunningham ugh!  Why are physicians always waiting to improve patient care until there is a CPT code or ICD-9 code to tell them how to do it?!  So frustrating…

Josh Umbehr
Josh Umbehr

@TheEnvisionist @VentureBeat we already have integrated it into our EMR and we did not stop fit bits, we can agree with most consumer wristbands, blood pressure cuffs, wireless scales, glucometer's, and some healthcare apps.


The future is here now.

Josh Umbehr
Josh Umbehr

And with the amazing data on health benefits from walking, physicians like myself should be making this a key focus.  But as the saying goes if you cannot track it you cannot manage it. Or, what gets measured gets done.

Josh Umbehr
Josh Umbehr

@sajclarke @startuphealth @VentureBeat that platform is already here, we built it for our own practice and our patients are benefiting from integration with fit bits and other devices.

Josh Umbehr
Josh Umbehr

@datachick @heycorey why does everything go to paraprofessionals?  As a physician, I want to be the one managing my patients healthcare, that is why I went into this profession.

heycorey
heycorey

@datachick I was thinking Clinical statistician as job title. Incumbents, once again, missing the big picture about change.

datachick
datachick

@heycorey I know my own doctor doesn't even want to see my exercise graphs or BP measurements.

datachick
datachick

@heycorey Those people, too. But I could see health pros who focus on preventative could use results of analysis.

fqure
fqure

@mHealthInsight @3GDoctor Agree N.A. culture needs to shift. The more data, the options available to make a decision, has not sunk in

amcunningham
amcunningham

@vgul so you think evidence for QOF is as bizarre as cream and lemon together in tea?

vgul
vgul

@amcunningham it shouldn't be but until reformed that is exactly how it was. There was no justification & nobody cares