How wearable devices can help Ireland get into better shape

Amongst the most striking findings of the EY Ireland Consumer Health Survey 2023 was the willingness of people in Ireland to embrace a digitally enabled health service. The majority of respondents indicated that they would be willing to share health information captured by a wearable device with clinicians.

This enthusiasm for sharing data from wearables presents clear impetus for the Irish healthcare system to provide digital-first models of care that can integrate the associated data asset. However, progress in this direction has been slow to date. Dr. Mary Coghlan, Partner, Data, Analytics and AI at EY Ireland looks at the potential benefits that wearables can bring both to patients and the healthcare service and what needs to be done to realise them.

Q. To what degree has the Irish healthcare sector embraced and integrated wearable devices?

A. The end consumers of wearable technology are way ahead of the healthcare system. People are using smart watches to record health information like VO2 max, resting heart rates and many other health and wellness related variables. They are utilising this data to understand and improve health and for lifestyle guidance. However, this vast source of data is currently untapped by the healthcare system. The linkage of the data from the individual to the system is a key challenge.

Q. How can patient outcomes be improved with the use of wearables?

A. People can wear a 24-hour blood pressure monitor to guide treatment of hypertension. However, as the device doesn’t “speak” directly to health ICT infrastructure, the data generated cannot be leveraged in real time. Examples of “siloed” devices include types of blood pressure and blood glucose monitors. Patient outcomes could clearly be improved if, for example, their data was continuously available in a primary care centre.

To bring this a stage further, data from personal wearable devices could be collected and analysed at population level. This could be a key asset to guide population-based planning of health services and, critically, population health management. Population analysis could enable risk stratification according to specific lifestyle factors and “give advice” based on an individual’s data-driven wellbeing profile.

In extreme cases, wearable devices could be life savers if enabled to detect and alert critical incidents to appropriate clinical services.

Q. What are the challenges to the integration of personal wearable technology in the patient journey?

A. There are technological, infrastructural and governance challenges. The technologies exist, but the challenge lies in how they are deployed in an integrated way that protects patients’ privacy and rights.

It is technically straightforward to make the data available to GPs for example. The issue then is what can be done with the data when it arrives. GPs, other clinicians and services need to be provided and upskilled with relevant analytics tools to optimise usage.

Health services are complex. Management of that complexity is required before technology can be put in place to enable sharing the data across the ecosystem. Easier use bases for the data should be deployed in the first instance to make progress. Progress is sometimes inhibited by a degree of conflation of the challenges of data privacy, governance and accessibility.

On the other hand, progress can be accelerated by incentivising the use of patient data for better health outcomes – and this approach helps healthcare systems to innovate.

We do not yet possess the ICT infrastructure to collect, store, use and distribute the data at population and system levels. However, this infrastructure is available to us for the future and the wearable tech potential is just another reason to pursue it.

Q. What use cases could there be for wearables in the short term?

A. Sláintecare, our national health strategy, is focused on delivering the right care, in the right place, at the right time. This is often in our homes where wearable technology can have a key role to play.

Having a wearable device connected to a primary care centre or other clinical setting allows people to have their health monitored remotely and for proactive intervention on an as needs basis. Virtual hospital wards are based on this principle.

Additionally, wearables can enable younger adults to take responsibility for their own health in very meaningful ways that will yield massive benefits in the long term. Personalised lifestyle advice or clinical interventions can be generated by indicators picked up by a device at a very early stage.

These uses cases apply at the individual level. However, the real money shot would be the ability to gather the data at a population level and use that to manage and improve overall population health. This can be invaluable for chronic disease prevention and management for example.

Q. How will generative AI (GenAI) expand the frontiers of wearable devices and of personalised healthcare?

A. We are only in the foothills when it comes to the adoption of GenAI. While AI has been deployed in areas such as mammography for some time, GenAI has the potential to drive utility and outcomes to the next level. And wearable technology can be integral to this.

Data beyond pure diagnostics (for example, lifestyle risk factors) can be incorporated into algorithms and expanded to drive greater clinical insight.

GenAI can potentially detect and explore new and more complex patterns in the outputs from wearables that can be applied to a range of different scenarios to see if there’s a correlation between them and incidences of disease in the wider population. And this makes it a very powerful prognostic tool. We can move the dial on clinical fundamentals such as diagnosis, screening and prognosis to a level that can have a profound impact on the health expectations and experience of our population.