Wearable biometric monitoring comes of age

Wearable fitness technology is exploding. Today’s opportunities for biometric monitoring may surprise you, but what’s coming in the future could change how we practice health care.

In 2012, the U.S. Food and Drug Administration (FDA) approved a cellphone case which, for $200, turns your iPhone into an EKG monitor. This year, earbuds are emerging as the cutting edge of biometric sensors, because they maintain constant skin contact for best measurement.

ra2studio/iStock/Thinkstock

Innovative new earbuds allow you to listen to music while monitoring your heart rate, as well as distance, cadence, speed, and calories burned in your workout. Furthermore, a small preliminary study at Duke University revealed that these earbuds can be used to accurately estimate total energy expenditure (TEE) and maximum oxygen consumption (VO2max).

Valencell is the clear leader in earbud innovation, but others will soon follow. Apple recently filed a patent application for its version of an earbud biometric sensor that measures temperature, heart rate, and perspiration levels. There is even an existing Apple patent for technology that picks up your telemetry as a “cardiac signal” that identifies you by measuring and remembering features of your waveform, such as the P-wave.

Why is wearable monitoring technology exploding right now? Sensors are becoming much cheaper, and the ubiquity and Wi-Fi connectivity of mobile devices is making them even more affordable. Now, instead of building in lighted screens and the larger batteries required to operate them, these monitoring devices just need to connect to the phone or tablet you already have. This lowers cost and increases functionality.

Also, the federal mandate around Electronic Health Records-Meaningful Use (EHR-MU) has begun to require that all patients have the ability to view, download, and transmit personal health data. Although this level of data portability for patients is still being developed, EHR-MU has lead to the creation of secure patient-data portals and mobile apps, such as Microsoft’s HealthVault, which is opening up huge opportunities for synergizing data between providers and the health-fitness apps and devices that patients already use. Meanwhile, the app market continues to experience exponential growth overall, especially in the “health and fitness” and “medical” categories (see comparison below).

Number of apps, by operating system, as of 17 June 2014.

Note: For each operating system, more apps are available for smartphones than for tablets. (Adapted from "AppBrain stats," "The mobile revolution is here," and "App store metrics."

Apple recently announced a promising innovation to collect and unify all of this information. This soon-to-come service, called “HealthKit,” will collect all your health data from apps, wearable fitness technology, even health care providers. Full details will not be revealed until their new operating system upgrade, iOS 8, is released this fall. Already, Android has announced its own “Google Fit,” also a health data aggregator service.

This continuing wave of innovation will change how we collect and use biometric data in the very near future. Instead of collecting a one-time snapshot of data collected on infrequent trips to a clinical setting, new technology allows frequent, even continuous monitoring, of people as they live their lives. More and more, patient-generated health data (PGHD) is being entered into the EHR through secure portals, increasingly through new apps and biometric devices. At a recent American Medical Informatics Association conference, the keynote speaker suggested that, “within 5 years, the majority of clinically relevant data … will be collected outside of clinical settings.”

With these innovations, opportunities for improved care include: 1) increased and more frequent patient data; 2) lower cost and increased availability of biometric monitoring equipment; and 3) increased involvement of patients in their own care.

There are also concerns. They include: 1) overwhelming providers with huge amounts of data; 2) loss of data security and privacy when transferring patient data from a HIPAA-secure portal to retail apps and mobile devices; and 3) possibility of compromised accuracy in collection of data.

What do you think of these new trends in biometric monitoring? I invite you to share your thoughts below.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.