On average, people visit their doctors once a year during which time they have their height, weight, blood pressure, temperature, and heart rate measured. These vital signs are measured using equipment that meets the "gold standard," measurements that are the best available under "reasonable conditions". This once a year measurement in your doctor's office uses equipment that can produce the most valid, reliable, and repeatable measurement. However, were you running late to your medical appointment, perhaps had a cup of coffee recently, or maybe you're having an "off day" due to stress at home or work. While the gold standard measurement you provided at the once a year visit with your doctor is valid, does it really represent your overall health?
Consider what your doctor may be thinking based on one set of vital signs? Sure, they may have you relax for 20-30 minutes and take a second set of vitals to compare numbers. Hopefully you relaxed a bit but, you noticed the numbers and you're probably taking long deep breathes between your provider's questions to get that blood pressure and heart rate down closer to normal before the second set of measurements. You could wait 3 hours and the numbers may not change much. You're in a waiting room thinking about relaxing. This is not exactly the best place to capture health data under "reasonable conditions". In fact, there's actually a name for this phenomenon, white coat syndrome or white coat hypertension. It is the term for when you get a high blood pressure reading in a doctor’s office and a normal reading at home. The anxiety of being around doctors in white coats can make your blood pressure rise. Most people don’t need treatment if their blood pressure is normal at home.
Instead of one or two valid, but likely non-representative measures of your true health, we measure some of your vital signs 350,400 times per year using the smartwatch on your wrist. Assuming you wear a smartwatch 16 hours a day and values are measured once a minute, these objective data points will provide a true representation of your health and develop your baseline from which deviations can be detected. The Apple Watch, and other devices, have the potential to increase the frequency and accessibility of vital sign measurements from your real-world environment. Why may this be a better way to measure health? Let's consider the following:
- Continuous Monitoring: Unlike sporadic doctor's visits, wearables offer nearly continuous monitoring of many vital signs and can longitudinally track data in real-time, providing a more comprehensive picture of your health over an extended period. This is especially useful for detecting irregularities or trends that might not be apparent during infrequent visits to the doctor.
- 24/7 Accessibility: Wearables can be worn throughout the day and night, allowing them to collect data during various activities, sleep, and rest. This constant data collection helps in capturing changes in vital signs that might occur during different times and situations.
- Immediate Feedback: Wearables often provide immediate feedback to the user, alerting them to any unusual changes in vital signs. This can prompt individuals to take timely actions, such as seeking medical attention if their heart rate or blood pressure goes beyond safe limits.
- Early Detection: By continuously monitoring vital signs, wearables can aid in the early detection of health issues. For instance, sudden spikes in heart rate or blood pressure could be indicative of underlying problems, allowing users to consult a doctor before the issue becomes more severe.
- Long-Term Trends: Wearables accumulate data over time, enabling users and healthcare professionals to identify long-term trends in vital signs. This information is valuable for managing chronic conditions or tracking improvements resulting from lifestyle changes or medical interventions.
- Data Accessibility: Wearables usually sync with smartphone apps or cloud-based platforms, allowing users to store and share their vital sign data with healthcare providers. Doctors can remotely monitor these data and make more informed decisions during virtual appointments or in between visits. Users of wearable devices may also opt-in to sharing their data to support research to detect diseases, validate interventions, or predict infections.
- Reduced Burden on Healthcare System: With more frequent monitoring and self-management facilitated by wearables, individuals may experience fewer unnecessary doctor's visits, freeing up medical resources for more critical cases and help to lower healthcare costs.
- Personalized Insights: Wearables often provide personalized insights based on the collected data. They might suggest lifestyle modifications, exercise routines, or stress management techniques to improve overall health and stabilize vital signs. Amissa Health, based in Charlotte, NC, uses longitudinal data from people at risk of dementia to longitudinally measure health and behaviors to discover digital biomarkers for early cognitive impairment and the validation of low-cost modifiable behaviors to delay the onset of Alzheimer's and related dementias.
- Integration with Telemedicine: Wearable data can be easily integrated into telemedicine platforms, allowing healthcare providers to assess a patient's health remotely and provide recommendations without requiring an in-person visit. Medical providers can reach larger populations including individuals that have been historically underserved or live in rural communities. The use of a monthly remote patient monitoring technology platform, which is often reimbursed by Current Procedural Terminology codes 99453, 99454, 99457, 99458 and 99091, enables providers to improve situational awareness on patients while generating revenue for their clinic or healthcare system.
- Awareness: Wearables can make individuals more aware of their behaviors and how they impact their vital signs. This increased awareness can lead to healthier lifestyle choices and better self-management of health conditions.
It's important to note that while wearables offer numerous advantages in terms of increased vital sign measurements, they are not a replacement for professional medical advice and diagnosis. They can complement healthcare by providing additional data and insights, but any concerning changes in vital signs should still be discussed with a qualified healthcare provider.
