This Week in Health Tech

Wearables and Healthcare

January 14, 2020 Vik Patel and Jimmy Kim Season 1 Episode 5
This Week in Health Tech
Wearables and Healthcare
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This Week in Health Tech
Wearables and Healthcare
Jan 14, 2020 Season 1 Episode 5
Vik Patel and Jimmy Kim

In this episode of This Week in Health Tech, Vik and Jimmy discuss the growing trend of wearables in healthcare. 
They discuss the challenge of providers trusting wearable data and transferring wearable meaningful data to providers without overwhelming clinical staff. 
We also discuss how will wearables help employers and insurers, but there is a legitimate concern for privacy.

Support the show (http://www.thisweekinhealthtech.com/)

Show Notes Transcript

In this episode of This Week in Health Tech, Vik and Jimmy discuss the growing trend of wearables in healthcare. 
They discuss the challenge of providers trusting wearable data and transferring wearable meaningful data to providers without overwhelming clinical staff. 
We also discuss how will wearables help employers and insurers, but there is a legitimate concern for privacy.

Support the show (http://www.thisweekinhealthtech.com/)

Speaker 1:

[inaudible]

Speaker 2:

welcome to another episode of this week in health tech where we cover the latest news and trends in the health tech industry. My name is Jimmy cam and of course I'm always accompanied by my cohost, Vic Patel , Vic Patel , what's going on brother? I can tell you what's going on.

Speaker 1:

I'm really, really sore. You can't be sewing yet. How's that for a start?

Speaker 3:

I mean that that puts a new, a new line into to to delayed onset muscle soreness. I mean it's, it's pretty, it's pretty early for the soreness to kick in already, man . It's only been a couple of hours .

Speaker 1:

Let's, I want to tell our listeners we just worked out, so Jimmy, if you haven't listened to our first episode, I mentioned that not only Jimmy is a professional podcast producer and a host, but he's also a professional trainer, fitness coach. Extraordinary as what I was calling. Oh amazing. Amazing coach. But I am sore and I think I'll definitely be sore probably tomorrow or and more the day after

Speaker 3:

a hundred percent man. That's called that Dom syndrome, the Toms, delayed onset muscle soreness and a look. Can I, can I, can I, can I put in a little bit of a shameless plug in here? Is that okay if I do that? Um , as Vic mentioned, I am a fitness coach and I actually do host another podcast as part of my company's called the remix my fitness podcast , which can be found on iTunes, Spotify, all those good networks, wherever you like to listen to your podcasts . I would also like to say that this podcast is sponsored by Tito inc, which is a trusted tech partner for healthcare organizations. And for more information, please visit Tito inc com. That's T I D O inc com and we're also sponsored by host my podcast.com where professional podcasts are made like this one. So Vic , tell us like, Oh one on one. I give you the introduction of what we're talking about today.

Speaker 1:

Well I think it actually fits in really good. The way I started this podcast, we are talking about variables today. So in the class as we were working out, I'm not going to name any names, but Jordan, no NAS , but Jordan, he has a new Apple watch. I saw that today. I was really surprised because I never have seen any wearables on him ever. Right.

Speaker 3:

Generally even in the class , in our classes in general, I find that most of us have , most of you guys don't

Speaker 1:

anything period. I used to, but we do a lot of, we do a lot of weight lifting and you know, sometimes it kinda gets in the way. But I do, I would like to air my Apple watch as much as I can because it does track everything really well and I want to see what my heart rate is in certain, you know, in different exercises. But I asked him, I was , you know, I was asking Jordan about why suddenly the Apple watch, I mean one of the reasons Jordan is wearing the new Apple watch because he just wants to keep track of his heartbreak, right. As we, as we work out and , and that's probably the most common use. All Fitbit's off Apple watches that I know of and I mean that's as well, right? That step count is huge. Step count is huge, but it's the devices how mature so much, right? We started out with simple device variables that we're tracking our steps and we were running and now you know , it's gotten to the point where it's not just menu , we're actually doing an activity. It'll also track your sleep, how many times you are turning in your sleep and you know how many times you were in deep sleep. It was kind of funny though that we were going to record our variables and you know, somebody in our, in our class instead only had a new ,

Speaker 3:

yeah. Well you know, as we talked about this like a couple episodes go and you were asking me about like apps and what kinds of things that I use and you know, I wasn't ever like a big proponent of it, but I actually, I don't know if you consider this a wearable, but many, many years ago, maybe about 10 years ago, I purchased a, a polar watch. Are you familiar with polar at all? Thick, no idea. So polar watches, they're their primary function is to record heart rate. That is, that's that's what they're , they give you a little, a little strap that you wear around your chest at the time and you where you wear , you wear a watch and it tells you the time. It gives you a stopwatch, but then the other function is it tells you what your, what your current heart rate is, what your max threshold here, what your max threshold was and then what you could set like the low point and the high points and things like that. That was my, would you consider that a wearable at the time, like maybe it was like 10 10 12 years ago or you , you are you, do you consider wearables like it has to, has to, has to give you like all this other information.

Speaker 1:

No, I mean that, that now that you said it was about 10 years ago, it makes much more sense because I was a little worried about this company. If they had this variable today, you had to strap on all these things, but it goes Apple.

Speaker 3:

I think it makes more sense though. Like I mean we can get into the details a little bit of more, but um, I'm, I'm not like I, I know how that the G I know how they're getting the heart rate on are on the device. I know how they're measuring that. But I always found having to strap something around my chest, close to my heart, and then the watch telling me what, what my heart rate was. I always felt that was like a little bit more accurate. But I mean I could be wrong. I haven't worn a wearable since that point.

Speaker 1:

Well that, so today in Apple watch, the new one that came out in Apple series four , it'll , it can actually do an ECG. Right? And so people with cardiac problems for example, or if you think you have certain kinds of heart issues, it's pretty cool. Right on there on your wrist you can measure your or see your ECG. Now, I don't know if the physicians actually trusted and I think there has been lot of, there have been many vocal physicians who are coming out against this, you know, it's not going to be an accurate as a device used in a hospital or a clinic. However, the underlying idea of how an ECG is done using the electric current

Speaker 4:

man

Speaker 1:

according to Apple, according to all their research, it is pretty close to, or it is pretty accurate. Right. And but having access to all to the ECG now. Okay, so that's great. But what's the next step? Do you stand that data to your physician if it's abnormal or do you just Oh , you know, right. I mean, so that's the other thing. You have access to it, but it would be nice if you could actually send that data automatically back to your GP. If I can just point this out, I noticed that you're wearing something on your wrist. What are you wearing on your [inaudible] ? Is that a wearable [inaudible] was that a considered like a, you can raise your heart rate and all that stuff? Yeah, I'm reading the Apple watch series three so I don't have the machine that Vic , you can have a serious I need to upgrade. Is that what you're saying? Okay, so how can, can I, can I prod you a little bit? It was that, is that okay about ? About, about the wall is proud of me. So why , why are you asking? I don't know . I felt like being being nice today. So you had that watch for how long now? I had this for a year now. For a year. Now you've, I'm sure you've gotten used like the , the heart rate monitor and the steps and perhaps like the sleep measured , it measures your sleep. Have you, have you seen like your stats in regards to that? But I can tell you one thing. So the first six months I wanted pretty much every day. I don't know if it's a novelty wore off is the right reason, but I'll be honest, I don't read it every day. Right. I would like to just because when I do wear it for the full week, the stats that I get out really good and you can compare from week to week in terms of okay, this is how many times I exercised and this, these are the number of steps that I had last week. So I, I feel like I want to beat the stats from last week. You're competitive with yourself? Yeah, I want to be a better me every week and, but anyways, sorry, I didn't mean to answer in such a long way. What were you,

Speaker 3:

well I guess I guess what I'm asking is like kind of kind of leading to this point. So the same with you. This the same reason for me. When I had the one , I had that polar watch, I had it on for about three to six months. I can't really remember. And then I always kind of knew what my heart rate felt like and then to the point where I didn't feel like I needed the watch at all because it was every time I looked down, I guess like one 40 beats per minute. And I look down, it's like one 41 42 or when I second it's like pumping out of my chest. I'm like, okay, bet you it's like one 75 and I looked down it's one 75 so I imagine it's probably perhaps the same with you . You, you go to your workouts or you take the number of steps that you would normally take on a Monday, Tuesday, Wednesday. You generally sleep around the same time. All those things. I also want to know when you see the stats, does that automatically get sent to some sort of spreadsheet or some, some you would need to log into another app or something like that? Or is it, do you see it right off your phone? Oh, sorry. Write off your watch. It's in the way .

Speaker 1:

Watch. But it's obviously way easier to see the stats on my iPhone. And by the way, you're showing your age there. It's uh , does it go into a spreadsheet or,

Speaker 3:

Hey, you know what, today, what I was, what I was trading, somebody asked me, how old are you? And I said I'm 37 and they're like, Holy crap, you're 37 years old. I would have no idea. So eat that van , eat that .

Speaker 1:

Anyways, I see or logic about this whole strapping on a belt on your chest and then what you are seeing is, I don't know if I need a device that's always tracking me, but my reason for tracking all the time it's because it actually, it actually keeps track of stats even when you are not working out. So for example, if you wanted to know what your resting heart rate is that it is, right and what's your heart rate is men you are sleeping there it is. And if you are working out and if you want to compare all the way from your resting heart rate to your heart rate when you're actually doing some exercise, you are doing cardio and you want to, you want to compare from the least to the maximum. It's a really good way to do ham . All those, that information right in front of you.

Speaker 3:

[inaudible] well, I was also asking because you know, whether it comes in a spreadsheet or whether you need to go into an app, because you know, in terms of let's say, thinking about if I was a patient and I was seeing a doctor on a regular basis or, or another health professional, would I just show them my phone and be like, here, here are my stats, this is how I'm sleeping, this is, this is what my Kellogg and caloric output is. Um, so I wanted to know like in terms of the ease of use of being able to share that information with somebody else. And

Speaker 1:

that's the key. So that's the challenge. That's the next challenge. And you know, as more and more people have variables. So one of the things I was looking into, some of the numbers and the install base for the variables is going to surpass 120 million by 2023 just in us. And that's just, you're saying 120 million people are potentially wearing wearables in the United States alone by 2023 so in three years, that's crazy. Right? So it's a huge number. And for all these people who have variables, the question that you just asked about, okay, so how do I show this information to my physician? And so if you are showing them the phone that's a little bit awkward. First of all, I mean, you're showing your phone and then suddenly there's a text message from saying , you know , it's , I dunno , it's not, it's not the most easiest way, right. And most of the time is the physicians will heal, will obviously be nice and or she , they'll glance at your phone and say, okay, yeah, no , it looks fine. But the better way would be to actually transfer that data from your phone automatically wirelessly into the physician's EHR. So in their clinic or in the hospital, you send this data and, but what's going to happen is there's going to be so much data coming out of these devices that the physicians are, they're not gonna know what to do with it, right? Like it's just, it's just too much information. It's too much information. They already don't have time now. They're not going to sort through all this data coming from your phone about how you're sleeping, how many times you are walking and and running and you know, how's your heart rate. But one of the reason, and , and this may happen in us and Canada before it happens in other places, is because the way physicians are getting reimbursed is changing a little bit, right? So right today, most of the time they are getting paid based on treating a condition. So if something's wrong, you go to the clinic, you go to the hospital, they take care of you, and then they send you home. Hopefully you are better. It's about keeping people healthy. It's about the positive outcomes. So it's if I keep, if I keep Jimmy healthy and out of the hospital, I'm going to get paid more than if I'm your physician and you end up in the hospital every three to six months, I'm actually going to make less. So with this payment reform, the variables might actually be the key because if I can get the, if I'm a doctor and if all my patients have variables or most of, let's say 80% of them have variables, right? And if I'm getting this data automatically and somehow if it can flag just the critical points for me, then that would make my job a lot easier in keeping all my patients healthier and out of the hospital and I , I'll make more money. So that's where, that's where it's going to next. Because all these time , I mean we spent so much money on people ending up in the hospital and let me give you a number there. So in U S hospital, readmissions cost about 26 billion. I mean that's just for Medicare patients and do, I mean do you know what, what a readmission is? No, please. I was down those, my very next question. So if you are admitted in a hospital, right, for a certain condition, and let's say you had chest pain, so you were in the hospital for chest pain and then you know, you , you were admitted for a couple of days, they took care of you, they made you better, and you go home. Now within a week you're again having chest pains or certain conditions that you feel like, Oh, I need to go back to ER, I need to go back to the hospital. That's when it's called the readmission because you ended up back in the hospital within a week. And that's costing us a lot of money, right? So, and that's what I think variables can help because if I go home or let's say, you know, Jimmy, let's just pick on you again. Okay? So easy target. So you at home and now one of the things that the doctor told you was, Hey, make sure you walk at least so many steps a day, right? 10,000 steps a day. Or let's start with 7,000 make it easy on you. Now the variable is tracking it, but after the first two days the doctor notices and this is the data going back to him. Right. And he noticed his own , he's not walking any like he's only doing 3000 steps. Okay. So his activity has decreased already and , and I need to make sure that he keeps that up. Otherwise he's going to end up back in the hospital. So you see what I mean? Like I think maybe that's what variables can help us a little bit. No, I definitely see what you mean. And like, like you, you and I would not work , we're not doctors, but if you could give us like uh , what are, what are some of the stats do you think would be useful that currently that we have available to us in the wearables that would be useful or they could

Speaker 3:

potentially be useful

Speaker 1:

just being in healthcare and , and , and just seeing the data that would help a physician and you know, what's available in the variables. I think the heart rate, it's probably a very crucial data element that can DEC because if , if you are constantly at a certain rate, which is outside of the normal range that tells them that something's going on here. [inaudible]

Speaker 3:

like that resting heart rate. Like I , I use that resting heart rate a lot. Um, and that's something that I was helping Jordan track today. I mean we were working out so he wasn't at his resting heart rate today, but I was constantly asking like after a heavy set or a heavy lift and like what's your heart rate out right now? Where, where did it go? How high did it go in ? How fast did it come back down? Because for me, that's a good indication of how, how healthy you are and when we can get to when we get to get back to lifting. So I think that that's a really great point where you, we can perhaps like the wearables can send like what the median heart rate is, what your median resting heart rate is when you wake up in the morning, which is, which is usually the lowest at the lowest point of what our heart rate is. Um, and if you send that to the doctor or your health, your , your health practitioner, they could see that. I , I think that's a great, a great , uh, a great indicator.

Speaker 1:

Yeah. And it, it can be, you know, I mean the new, the way you see all this data, it's not just numbers. I mean it's done beautifully in a graph. So you know, just at a glance you can easily see what's going on. So you don't have to like read all these numbers and then figure out, Oh no, his, his heart rate's always out of range. But, so that, so that's one of the things that I think would definitely help physicians, but it has to be done where it's not information overload, otherwise it defeats the purpose. The physicians are not going to take a look at that data. It has to be done very smartly. It has to be kinda condensed. Right. And if it can be done in a way where they don't have to like sort through a lot of numbers, then that's even better.

Speaker 3:

And in terms of wearables where, where are we right now? Where are we at? Are we at the where at point of wearables where we only wear it on our wrists . Are there other wearables that are available or other wearables that are out there that um, health practitioners are preferring

Speaker 1:

patients to use? Yeah, I think there's, there's some new ones that are more like a patch. So, and , and again, you know, those patches may keep track off your blood pressure for example.

Speaker 3:

That's a big one. Blood pressure cause clearly currently the these watches, right? Or these wearables right now they don't measure blood pressure yet.

Speaker 1:

No they don't. And so think a lot of those biosensors is probably, you know, those are the next set of variables that we will see more and more where a lot of them could be a patch. And maybe in the near future is, is an embedded device, a wearable . I'm a huge fan of that. I can rate, you know, the all variable is tracking pretty much all everything that's going on in your body.

Speaker 3:

Uh , you know, aside from the embeddable stuff, we have the, we have the patches, we have the, we have the watches. I mean that, that's all well and good and we want to , we want to see these things now being used by the healthcare professionals. How far do you think we are from, from the health care professionals using these actively? You said you said this apprehension, I guess first and all I , you know, I forgot to ask this. What , what is their apprehension? Is there apprehension that they, it's not as accurate or if it's not as accurate, like really not accurate to their standards?

Speaker 1:

Well, I think there were, there was a group of physicians that had actually, they came out against the whole ECG. That's, that's in the Apple watch. Um, and I think they had a bunch of reasons which I probably would not do justice and explaining what the reasons were in not trusting the ECG done on the Apple watch. However, your question about, you know, are we there where actually physicians will use this data? I think they will use that data as long as we are not just bombarding them with all this data every day that's coming through and it's not making any sense. Right? It has to make sense for them and it has to be easy to use. The other thing actually, not just physicians, but think about if you are a big company with a lot of employees, one of your biggest cost is health insurance, right? And if you have healthier employees, hopefully the insurance costs can go down. So more and more companies are actually giving away variables for free. I mean they are giving away Fitbit's, I don't think Apple watches are being given away for free yet. So that's the other trend that we are going to see where more and more companies will take advantage of the variables to make sure that it's keeping their employees healthier. And in turn it's helping them keep their insurance

Speaker 3:

less . You know, I've actually seen that this, this is very example that you just mentioned. One of the companies that I do work for, they did a little pilot project where they hired a, they hired a physician and they got a portion of a portion of their company members to where Fitbit's , and then they would measure things like their steps , um , how much activity that they were getting in their sleep, things like that. This was on a , on a volunteer on volunteer basis. And what they were using with that data was like, how can we now help these individuals , uh , who need the help , uh , get the help that they need. Uh, whether there's more physical activity or help them get better sleep and how can we help the employees that are already doing the things that they're already doing? How can we help them keep motivated so they don't stop? And what can we learn from, from their activities. So this was, I didn't know too much about it. I don't, I only from the, the couple of employees that I spoke to who only know all of a sudden I was, I saw, I saw a bunch of them wearing Fitbit's and some of my classes and I was like, what is that all about? And you know, they told me about it. So , um, I guess this, I guess this is your right, you'd use this as like a, you know, a way to offset the cost. I worked , didn't think about it that way. Um, I just thought, Oh, you know, there , there's some sort of project that this company was doing that's smart

Speaker 1:

right now. How many people have volunteered? That would be nice to know. I mean, on a percentage basis and maybe that data would tell them something, you know, once they track. But, so that's a whole, another thing about tracking your employees, you with the wearables, because now if you think about it, so health data and privacy, you know,

Speaker 3:

it's huge, right ? My favorite topic and we'll put the Luna oil that , so what do you think about the whole, I mean, did you volunteer? No, no, I didn't volunteer. I'm not, I'm not part of this. I'm not a part of this company. I'm just a contractor there . Oh yeah. You know, but it was, it was when I was seeing people come in and work out, you know, all of a sudden people that weren't wearing wearables last week, half the class is now wearing wearables. I'm like, well , what's going on over here? Like did everyone just happen to get like a splurge and Fitbit's and they were all wearing Fitbit's and um, they , they told me about this project. I don't know the results of it. They were very like, they had to keep it quite hush, hush with , with, with , amongst whoever was running this, I'm going to call it experiment, but they , they told me the , they told me the reasons and uh, I would have loved to know what they got out of it because I know since then the , they don't do it anymore. So, I don't know if it was like a one off, like let's do this for like three months or six months or so. Um, and

Speaker 1:

yeah , someone figured it out. Oh, we shouldn't be tracking all everyone's health.

Speaker 3:

Well, I'll tell you, I w I , I wouldn't volunteer for that. You know, for me, I'm on my end because it's just if I'm at a company, I'm there . I'm supposed to be there from like nine to five or like 10 to six, whatever, whatever the regular hours are now for a company. But after that and before that, like it's kinda , that's my business. Why, why, why would I want them to know that I'm up past

Speaker 1:

a certain point? Yeah. And where do you stop? I mean once you start tracking certain things, then what's the next step?

Speaker 5:

[inaudible]

Speaker 1:

so yeah, I mean I think that's definitely going to be one of the topics where maybe there'll be some kind of, even a government policy that may actually prevent companies from, from tracking the variables that they're giving away for free. I mean if you are like I think, I think it's good if companies are giving away variables for their employees. However, the data is should only go back to the physicians, right, to the caretakers and not, I mean the company should have no access to it because again, then you know, the privacy of individuals is at risk. And then could you make a , could you make a decision I in terms of, Oh, we have all these healthier individuals that will promote them, make sure they're happy, stay in the company and the ones that are not healthy and may actually cause our insurance to go up. Let's somehow, you know, gradually kind of show them the door. I don't know, I'm just, and that's just basically a basing and on just their pure health and not on, let's say you know, you , you know a lot of people who are workaholics, who may not live the healthiest lifestyle, but they're fantastic employees, right? They , they work hard, they're dedicated, they're, they're loyal to their company is just perhaps they don't live the healthiest lifestyle because of those things. You, you, you ask those people because of that too, right? Like you know, those, those, those are the, those are the pros and cons. Those are the tough questions. Yeah. Yeah. And the other, the other aspect of the variables that could benefit is the insurers. So if I'm an insurance company and if I give you a free wearable so that it would hopefully motivate you to stay healthy and, and work out often. But again, I think we will run into this whole conundrum of, okay, if the insurance company is tracking my health, would they up my premium if, if I'm, if my held is, you know, if I'm not staying healthy and if I'm not working out often as I should. That's another tough question to think about. Yeah, I mean there's all these pros and cons to it, right? Like it's pro we get all this information and not only do we get this information, cause I think a lot of us have, and it's kind of like, well okay, I walk 10,000 steps or my sleep is off, so what? But then we can forward it to a health professional and they could probably look at it and be like, okay , uh, you know what, Vick , you need to start sleeping better and perhaps you should try X, Y, and Z. But then we have the cons of like, well, how much information is too much information? Who should

Speaker 3:

have this information to begin with? Right? It's this like vicious circle that we're always going into.

Speaker 1:

Purpose of the variables was to kind of take your own health into your own hands. Right? I mean it's, it's the whole thing of you were talking about in the very, very beginning where I wanted to compete with myself and check my stats from last week. I think that's, that's huge because now you are taking care of yourself, you're taking care of your health and here's an amazing tool that would actually help you to do that. But once we, once we started sharing that data over there , you know, again, some of the pros and cons that we just talked about. I think the biggest thing though, the healthcare providers, so he find him if I'm a physician, if I'm a clinic or if I'm a hospital, I think with the whole , uh , value based payment reform that's coming and , and it's, it's definitely beneficial for them to figure out, okay, how are we going to integrate with the wearables that are out there and how are we going to allow our patients to send that data and meaningful data right back into the EHR. And so I think, I feel like there's definitely going to be an increase in terms of the integration between the variables and the hospital, the HRS and the clinic EHR .

Speaker 3:

I hear you on that. And you know, I don't want to get into like a trend or maybe I do, I don't know, but of making like multiple parts of these episodes. But I would love to get, I would love to get like a doctor on here and we can start asking them these, perhaps these questions and kinda hear, hear what they have to say about wearables and whether it's something that they , that suits them. Like, what do you think? Do you think that'd be a good episode to have?

Speaker 1:

So maybe that's a great idea, Jimmy. You know, we should, in part two I feel like we are, we are, we're going to have part two for every topic, but

Speaker 3:

I think it only makes sense because how fast are things changing in, in this world of health tech I think is ever, ever changing. And um, you know, the , you hear from the professionals that are going to use there who are going to potentially use it. Um, I, I think it would only make sense. And you know, every episode we only hit the tip of the iceberg and we're just, we're just chipping away at all this information and, and I think the more professionals that we get on here , um, and you know, we be , we get a lot more educated from, and I know, I know, I definitely do. I think we can call it a wrap for this episode over here today. Yeah, I'm getting sore and getting progressively sore. I hear you on that one. Do me a favor. If you listen to this episode, don't forget, hit that subscribe button. In fact, smash that subscribe button. Hit us up in the comments field us, know what you want to hear about whether you think wearables are good, where whether you think wearables are bad for for us, let us know. Me and Vick , we will. We would love to know those things as always because I'm , I'm kind one on one or you have the last [inaudible] you have the last words before we wrap up to wrap up this episode.

Speaker 1:

Thank you Jimmy. One of the things I hope listeners get out of this episode is that the number of variables is going to increase exponentially over the next few years. And what I would suggest, what I would recommend to healthcare providers is that be ready for this, right? I mean if you make it easy for your patient population to use the variables in keeping them healthy and making sure that this information, the critical information gets to the right providers in the right time, then it's going to, it's going to make their job easier as well. So yeah, variables is something that I would definitely pay attention to if I'm a healthcare provider.

Speaker 3:

So you hear , you heard it there.

Speaker 2:

That's the final words from Victor itself . My name is Jimmy Kim, and that's a wrap for another episode of this week in health tech. Good night. You heard it. Good night.