Viewpoints

As technological innovations expand, the opportunities for healthcare are limitless. In the last five years, smartphones and Bluetooth technology have opened the door for a number of new patient intelligence tools, often referred to as consumer intelligence tools. The most popular patient intelligence tools are, undoubtedly, fitness trackers or wearables. Other innovations with healthcare implications include phone-enabled body thermometers, Bluetooth blood pressure monitors, and digital weight scales. The increasing use of patient intelligence tools shifts some responsibility from physicians and providers to patients. When used properly, these tools can help to improve healthcare outcomes.

Wearable devices are gaining traction, with one in 10 Americans now owning a fitness tracker. The devices are equally popular among genders, with 54 percent of fitness tracker owners being female, according to a report published by The NPD Group in January. Based on a study of 5,000 individuals over the age of 18, the report says that wearables are popular among all age groups, as shown in the chart on page 40. With a variety of manufacturers that include Fitbit, Garmin, Jawbone, Misfit, and dozens of others, prices for the devices have dropped, making them accessible to a large portion of the population. The increased utilization of fitness trackers suggests that the U.S. population is becoming more concerned with fitness and activity levels. Along with promoting a more active lifestyle and better diet, the devices are also able to monitor sleeping patterns. Fitness trackers promote proactive healthcare and wellness. New software platforms, such as higi, are beginning to integrate fitness tracker data with body metrics measured at retail pharmacy locations. This allows weight, body fat percentage, blood pressure, and pulse to be loaded to a user’s profile and integrated with his or her activity log. This provides a more complete profile of the user’s health.

  PC Magazine recently reviewed many of the popular fitness trackers and compared the features of each. This information may be helpful when counseling patients or discussing wearables. The comparison chart can be found at: 
http://www.pcmag.com/article2/0,2817,2404445,00.asp

A Number of Options

While not medically approved for diagnosing sleep apnea or delayed sleep-phase syndrome (DSPS), fitness trackers have allowed many users to recognize that they experience disturbed sleep, prompting them to seek medical attention. This can be extremely helpful in prompting awareness of sleep disorders, if used properly. The sleep-tracking feature can also be useful for monitoring how different habits (e.g. taking decongestants, eating before bed, consuming alcohol) affect sleep patterns, better engaging patients in their own healthcare. When used properly, fitness trackers provide a trove of useful and actionable information that could change the way we view healthcare.

While fitness trackers promote proactive health, healthcare providers can use many new patient intelligence tools in treatment. Obvious value can be seen in new phone-enabled wireless thermometers. Raiing, a Beijing-based firm, is piloting one such thermometer at Boston’s Partners HealthCare. Approved as a 510(k) medical device, Raiing’s iThermonitor peels and sticks to a patient’s armpit and can transmit temperature readings every four seconds via Bluetooth technology, allowing for remote monitoring. Many wireless thermometer devices are battery operated and reusable, and can store up to 72 hours of readings. While this patient intelligence tool may be excessive for the layperson, it can provide peace of mind for many new parents with toddlers. Along with use for the public, the healthcare-specific implications are unquestionable. With early detection of infection being vital in the treatment of cancer, constant temperature readings can aid in pediatric cancer care by catching infections and starting early treatment. The manufacturer also notes potential value in treating transplant patients and as a fertility thermometer in women attempting to get pregnant.

   
Thanks to increased consumer uptake of fitness trackers and Bluetooth technology, pharmacy is in a position to offer a service to counsel patients, especially those who may suffer from data overload.   

With Bluetooth technology also came wireless-syncing weight scales. For patients trying to lose or gain weight, these scales can make tracking their progress simpler. Most of these devices provide more than weight monitoring and allow for body fat and hydration level monitoring. The wireless scales easily sync with a cell phone app to make monitoring less intrusive. While this has obvious implications for dieters, it could also be used to monitor weight for various disease states. Imagine patients with congestive heart failure who are told to monitor their weight to ensure that they are not retaining fluids. While the patients may not be technology savvy, having a Bluetooth-enabled scale could allow the patients’ family or friends to monitor their weight remotely and intervene if they notice a drastic weight change indicating fluid retention. As this technology progresses, the benefits and uses will expand.

Along with digital thermometers and scales, Bluetooth-enabled blood pressure cuffs are now available. These home blood pressure monitors allow patients to track readings on their smartphones, and many store 120 readings or more. By tracking their readings, patients can better identify high blood pressure triggers, whether from stress, caffeine, or lack of sleep. Many of these monitors also detect irregular heartbeats, so that patients are prompted to seek medical attention when necessary. When patients can monitor blood pressure from home and send the results to their physicians, will we see a decrease in physician office visits? Or will we see an increase in doctor visits as patients become alarmists and needlessly worry over an occasional high rating? With new technology, we must also provide patient education to ensure the results are responded to appropriately.

Physicians and pharmacists should be vigilant about counseling patients on these new devices when the opportunity presents itself. Some patients may suffer from information overload, and become overwhelmed by the sheer volume of data. They may “freeze” and panic from not knowing how the devices work.

Physicians and pharmacists should also be vigilant about counseling patients on these new devices when the opportunity presents itself. Some patients may suffer from information overload, and become overwhelmed by the sheer volume of data. They may “freeze” and panic from not knowing how the devices work. Others can become obsessed with the numbers, frantically jumping out of bed and running around their house at 11:50 p.m. to reach their 10,000 steps for the day. While all of this data can be used for good, it is important for patients not to get fixated on their numbers. Physicians can use this data to help guide patient care, but the data is not the be-all and end-all. As with all good things, moderation is key.

While many patient intelligence tools exist to improve patient care, the medical profession is often slow to change and adapt. Despite the widespread use of many of these applications and devices, it may take some time before they are integrated into formalized patient care. However, as individuals adopt and use these tools, it is inevitable that medical professionals will be required to address patient questions about various technological products. Now is the time to become familiar with and better understand these emerging technologies so that we can appropriately respond to patient inquiries and provide insight, direction, and referral information, when required. Implementing patient intelligence tools into healthcare may be slow, but their use can help improve preventative care and expand treatment options. CT


Ann Johnson, Pharm.D. is a consultant at Pharmacy Healthcare Solutions, Inc., which provides consulting solutions to pharmaceutical manufacturers, PBMs, retail pharmacy chains, and software companies on strategic business and marketing issues. The author can be reached at ajohnson@phsirx.com.