How Wearable Tech is Disrupting Medicine

The wearable tech market is booming. Experts predict that shipments of wearable devices will exceed 400 million in 2026, leaping 73% from last year. By then, 1.3 billion people will own a smartwatch or fitness tracker, doubling global ownership today. But to what extent can smartwatches, smart rings, and other wearable devices use the data they capture to transform healthcare more broadly?

I listened to a great podcast the other day produced by Economist Impact, titled “New Foundations: How Wearable Tech is Disrupting Medicine”. The episode is only a 23-minute listen, but I’ve summarized the most interesting takeaways below, along with my thoughts about the future of wearables and potential challenges to mass adoption from a VC’s perspective.

Image by Blocks Fletcher via Unsplash

“Datasets that wearables provide are gold mines for powerful insights“ — Tom Hale, CEO of Oura Health

Now that nearly 1 in 4 U.S. adults own a wearable device or activity tracker (approximately twice that of 2015), society is gaining access to a whole new wealth of information. “This amount of data and duration of data collection hasn’t been possible before,” said Tom Hale, CEO of Oura Health, on the New Foundations podcast.

We’re essentially witnessing the largest study of its kind, without a formal sponsor. These insights can yield a degree of greater understanding around sickness and disease as well as give doctors the ability to create more personalized diagnoses from troves of patient data and predictive algorithms.

For the first time, a person’s treatment plan does not need to be based on sweeping assumptions about their cohort, age, or demographics, but rather can be determined by the amalgamation of choices they’ve made throughout their day/life, and their individual propensity to improve those metrics over time. This could come to life in the form of getting better sleep, exercising more regularly, or drinking less alcohol to improve a wearable’s “readiness score”, which ultimately translates to a lower chance of developing chronic conditions.

With the advent of wearables, people can now tangibly see the benefits of changing their behavior through scores, charts, and badges.

But collecting data as a preventative health measure doesn’t stop with the person using the device.

The more people take actions in response to different health metrics, the more scientists can prove (or disprove) that those actions have an impact on certain conditions or disease states for the broader population. Again, we’re talking about the largest unofficial study of its kind. More than a billion people.

Strengthening the subjective voice of an individual through objective wearable data may one day allow doctors to prescribe interventions based on linkages between a patient’s inputs. For example, the subjective feelings of grogginess or stress can be analyzed alongside objective metrics such as heart rate variability or REM sleep. Linking subjective and objective data provides a sixth sense, so to speak, which can be a powerful tool for both individuals and the larger population, when extrapolated.

Screenshot taken from https://ouraring.com/

The market for even smarter smart devices

Beyond basic health insights gleaned from metrics such as steps, calories, glucose intake, or resting heart rate, companies are now figuring out how to measure and treat previously amorphous conditions such as anxiety and depression as well as gauge the likelihood of pre-term births, through wearables.

Apollo Neuro’s stress-relieving technology has been tested across thousands of users both in-clinic and in the real world through six clinical trials, with nine more currently underway. This is only one example of a company making headway in the mental health wearables space. Other businesses exist and many more are soon to follow suit.

In addition, earlier this month (Nov. 2022), WHOOP announced that it had identified a novel pregnancy digital biomarker to screen for premature births. Building off of this research, the company has launched a new pregnancy feature, the Pregnancy Coach, which provides pregnant members with a new view of their HRV and RHR trends contextualized by the week of their pregnancy, as well as pregnancy-specific coaching.

The current market size for these devices is about $116 billion, with a CAGR of 18% from 2021 to 2026. The market size will soon reach $265 billion.

Increasingly smarter wearables will have a positive impact on screening and prevention as well as treating patients in a more acute state, suggests Alexandre Tavazzi, head of the CIO Office and Macro Research at Pictet Wealth Management. Tavazzi elaborates:

“With more than 20% of GDP spent towards healthcare in the U.S., there’s significant room for cost savings by better treating diseases and by improving screening and prevention.”

According to a 2019 study published in JAMA, inefficiencies in the U.S. health care system amount to more than $760 billion per year. Being able to prevent diseases by helping people live a healthier life and receive more effective treatment can have a direct impact on these cost savings, which will eventually be of interest to payers and employers (if not already).

A future with mass adoption of wearables

Imagine a future where a patient’s relationship with their doctor, health system, or insurer, is based on their wearable’s data history compared to that of the average person’s. This reality isn’t too far-fetched. Health entities may one-day leverage algorithms to make predictions about a person’s propensity to respond to certain medications or treatment plans based on models trained by millions of other people’s data and results.

Now imagine a future where doctors and scientists have access to decades of wearables data and where the general public has adopted biotracking technology in mass. In this hypothetical reality, data leveraged through wearables can improve public health outcomes by alerting people to potential sickness in real-time, prior to suffering from its ailments.

Duke University’s Big Ideas Lab has been conducting research on infection detection from wearables even before the COVID-19 pandemic began. Through this work, they discovered early markers of influenza, rhinovirus infection, and RSV (respiratory syncytial virus) by looking at temperature patterns collected from devices.

Jesselyn Dunn, Assistant Professor of Biomedical Engineering at Duke University and Big Ideas Lab, elaborates on this research in the New Foundations podcast.

“So, when COVID unraveled in China, it became sort of obvious that the technologies we had been developing as these early indicators of infection could be very useful in this new emerging disease.”

Duke University had ~7600 people enroll in the study and recently had their research findings accepted for publication.

Dunn further explained that indicators of these digital biomarkers usually go awry before a person is presenting noticeable symptoms, suggesting that preventative measures can be taken to stop the spread of viruses or even shorten the duration of illnesses with the help of wearables.

“…We can see that somebody is coming down with an infection before they themselves know that they’re sick. And the implications of that are huge.”

Photo by Atypeek Dgn via Pexels

Achieving the never-been-done-before

As the podcast goes on, Leo Wolansky, director of Data Strategy and Products for the Pandemic Prevention Institute at the Rockefeller Foundation, continues to paint the picture of a prevention-focused future made possible by wearables.

“What we’re trying to accomplish at the Pandemic Prevention Institute is unlock data that can be shared widely to ultimately raise the alarm around either (1) a new threat or (2) a change in an existing threat.”

During the pandemic, the detection of COVID-19 was made possible for Oura Ring users (and NBA players) by monitoring temperature patterns over time. Imagine that use case in mass. “Cycling troves of information through models that identify when there are anomalies in population health is our ultimate goal,” Wolansky said.

The Pandemic Prevention Institute wants to eventually get to the point where it is able to detect outbreaks before they happen and alert the public of this threat, without requiring people to physically go to a healthcare facility and be diagnosed.

Photo by may sam on Unsplash

Challenges to adoption: data biases & privacy issues

While the above trends may sound probable and promising, deriving predictions around population health can’t be possible if only fitness junkies and tech-forward adopters are using these tools. For a predictive future of this kind to reach fruition, we need to continue collecting data and improving adoption. From an investor’s perspective, this can only be possible once the devices become more affordable, more discrete, and more incentive-driven, to encourage the general public to buy and use them regularly.

The threat of data biases

Since fitness junkies and health-connoisseurs continue to be the primary owners of wearable tech at present, one potential issue on my mind is the biases being generated due to the demographic makeup of such adopters.

Today, the people most likely to report using wearable devices are white, affluent individuals with a college or graduate-level education (AHH > $75,000). By design, many of these users are already generally health-conscious, able to afford preventative care, and willing/able to take preventative actions to improve their health (e.g. have the financial means to join a gym, have access to healthy foods, or have the ability to dedicate more time to sleep and meditation).

If we want to one day create a future in which wearables allow doctors to improve health outcomes and predict and prevent disease at scale, we need to make sure the data collected is representative of the wider population. Only then can we say anything definitive about population health, let alone attempt to improve it.

Challenges to creating this tech equality will be multi-fold, but will likely revolve around the cost of wearable devices as well as the level of savvy necessary to be able to operate them, so as not to prohibit adoption by less affluent or older demographics.

Looming privacy questions

In addition to fair representation of population groups, monitoring people at all times to capture large amounts of intimate data will likely raise privacy concerns for many. Of course, there are great benefits to such innovation, but people will want to know how their data is being used, who has access to it, and what that means for their future selves (e.g., Will payers one day be able to hike insurance premiums if they notice members sleeping less or being more sedentary? Will patients be granted control of this data with the ability to send and rescind access in a user-friendly way? Will new privacy laws need to be created to protect users? And how long will it take before all of this becomes mainstream?).

Put simply: How should the balance be struck between innovation/medical benefits against privacy?

After listening to the New Foundations podcast, it’s clear that experts don’t yet have answers to these questions, but it’s certainly on their minds.

My take

As an investor who is deeply passionate about the future of health, and someone who geeks out about the idea of self-actualizing predictions based on my unique biomarkers, the insights that wearables can bring are both exciting and fascinating, to say the least.

That said, I also know people who have intentionally opted not to own a wearable device or activity tracker because of the metrics-focused obsession they can cause (similar to owning a scale or counting calories). For this reason, I worry about mass adoption of wearables among the young female demographic, or anyone generally struggling with body dismorphia issues.

Regardless of our desire to own wearables for fitness purposes or our willingness to share data with government organizations such as the CDC for alerts on future virus outbreaks, wearables will inevitably create a better living experience for people over time. The simple act of letting someone know that they might be coming down with a cold and should try to take it easy or to use contraception next time they have sex because they’re in a fertile “time of the month” are all features rooted in today’s reality — and that alone is pretty cool.

If you own a wearable device or activity tracker, I’d love to hear your thoughts. What’s your take on data collection and privacy issues? If you don’t— why haven’t you hopped on the biotracking trend? Drop a comment to keep the conversation going. I’d love to hear from you.

This article does not reflect Swiftarc Ventures’ plans to invest in the wearable technology space nor do I have a professional affiliation with any of the companies or people mentioned above. All opinions and views expressed are my own and are current as of the date of this writing. My content is for informational purposes only, and does not constitute or imply endorsement of any third party’s products or services, nor should it be considered investment advice.

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Jess Schram

Health & Wellness Investor @Swiftarc Ventures, formerly at 14W and Lerer Hippeau. All thoughts are my own.