Advice to doctors: Use Fitbit, or lose a link to patients

From the mHealthNews archive
By Eric Wicklund

I am now one of the estimated 15 percent of America with a Fitbit. I've yet to master the intricacies of the wrist-worn health and wellness monitor, though I am getting used to checking the dashboards on my iPhone each day for activity and sleep data.

Interestingly enough, on days when I hop on my bicycle for a ride, my step count increases dramatically, and I hit a whole bunch of activity goals. This is great, though I'm not sure how riding a bike can be compared to taking a walk.

Therein lies the problem that consumer-facing wearables have in crossing over to the healthcare market. What doctor is going to trust a Fitbit or similar device in giving accurate information that can be used in a clinical manner?

That's the dilemma faced by Amy Gelfand, a pediatric neurologist at the University of California, San Francisco, who wants to use Fitbits in a 24/7 study of sleep patterns in children with episodic migraines. As reported in BuzzFeed, Gelfand likes the Fitbits because they're relatively inexpensive, easy to use and discreet. But she worries that the data she'll get from them won't be reliable enough to draw accurate conclusions.

“I have a heebie-jeebie factor about somebody using them in their science,” adds Hawley Montgomery-Downs, an associate professor of psychology at West Virginia University whose studies have found inaccuracies in Fitbit’s sleep-tracking abilities, in the BuzzFeed story. “They don’t vary by a couple minutes or a couple percentage points. They vary  and as a scientist I don’t use this word lightly – very dramatically.”

That Fitbit and other wearables like it can provide health-related benefits is evident. According to a recent survey by Healthline, 80 percent of Fitbit users say the device keeps them motivated to exercise and track their activity, while almost half feel the device helps them better understand how active they are and a quarter are motivated enough to increase their activity.

To be fair, Fitbit, which recently went public, has stated quite clearly that its activity trackers aren't to be used for clinical purposes. But that's not stopping some companies from using the devices. According to BuzzFeed, Biogen is using Fitbits to track mobility in multiple sclerosis patients, while Medidata is using both the Fitbit and the Garmin Vivofit in its own health tracking studies. Another player in the market, Misfit Wearables, is reportedly involved in about a dozen health research projects.

That has some people concerned.

“If you’re doing a research study where the goal of the study is to get people to increase energy expenditure, it’s a great tool to help motivate people,” Patty Freedson, a kinesiology professor at the University of Massachusetts-Amherst who's studying Fitbit's ability to neasure calories burned, told BuzzFeed. “But I’m not certain about precision and accuracy enough to use it as the outcome measure, to say, ‘Yes, this person’s activity level increased by 42 percent.’”

“Consumers should stop paying for these things until they can be shown compelling evidence that they are rigorously evaluated and dependable,” added Montgomery-Downs.

Not so fast.

The challenge facing healthcare these days is to make it engaging to consumers and providers, not one or the other. Obviously, wearables like Fitbit are popular, so healthcare has to find a way to tap into that popularity and use it to enhance clinical outcomes. Instead of finding a way to capture traditional vital signs from a wearable, how about creating new data points that appeal to both sides?

It's true these consumer-facing wearables aren't accurate enough to track certain physiological conditions just yet – that's the domain of the more complex, provider-facing wearables. But if they've captured the attention of a public that hasn't been keen on tracking health and exercise in the past, there's some value there. Find a way to use it.

Related articles: 

Are providers finally finding value in wearables?

Want to improve patient engagement? Start with the basics 

Wearables: fad or fixture?