For scientists and researchers who are developing new treatments for disease, Data is power. For patients, Data can mean empowerment. Devices that track health indicators are readily available. These devices can track heart rate, blood pressure, blood sugar and even respiratory rate and body temperature.
This week in the Wall Street Journal, the medical applications of the fitbit device are explored. The fitbit is a basic pedometer that tracks movement, steps taken, calories consumed and (in certain models) sleep habits. This device is commercially available for around 100 dollars and was initially embraced by serious athletes in order to improve performance. Now, according to researchers, these devices may be able to impact health outcomes–both inside and outside of the hospital or healthcare setting. These impacts may forever change how physicians and healthcare systems think about managing chronic disease.
As I have mentioned in previous blogs,I firmly believe that smartphone applications for medicine are going to be a part of mainstream medical practice in the coming years. Providers will prescribe apps just as they do pharmaceuticals. In the case of the fitbit device and others like it, data obtained from physiologic monitoring can be used to assess physical fitness and progress towards obtaining specific health goals. In several recent studies, researchers at Massachusetts General Hospital in Boston, have found that the fitbit users who have diabetes are more likely to have better control of their blood sugars and achieve weight loss related goals better than those who do not use the device. Many patients with type 2 diabetes can better control their blood sugars through reduction in BMI (body mass index) and the data provided from the fitbit device seems to have a positive correlation with weight loss in this particular patient sample. In the hospital setting, researchers at the Mayo clinic found that in post-operative cardiac surgery patients, the fitbit was able to identify patients that needed more physical therapy intervention–by tracking movement in the early post-operative days. It is likely that by identifying and intervening early in patients who are not progressing after surgery we will be able to prevent many common complications such as deep vein thrombosis (DVT), pneumonia and other morbidities associated with lack of activity after surgery.
At this point, the FDA has no immediate plan for regulation as long as they are not specifically created to treat a particular medical condition or disease process–however, I do expect regulators to act on all types of biomedical data collection devices within the next 5 years. According to the WSJ, the health monitoring device industry is projected to exceed 5 billion dollars in 2016–largely due to our focus on patient engagement and prevention. Concerns have been raised as to the security of data and as to the reliability of the data generated by these devices. As with most new medical innovations, there is still much work to be done. We must create secure servers where patient’s data can be safely deposited (and HIPAA compliant) and easily accessed by their healthcare providers in order to provide necessary changes to care. In addition, the patient must be able to access their own data in order to assess progress, adjust goals and optimize their lifestyle changes in order to produce better health outcomes. Additional concerns have been raised around the legal implications of a large repository of medical and physiologic data—are physicians responsible for every reading and every piece of data in the repository? Will there be frivolous lawsuits initiated by ambulance chasers (or fitbit chasers) in the future?
I contend that more data is better. Data provides me with the power to make better decisions for my patients. Data provides my patients with real, meaningful feedback. When we are sick, we often feel as though we have lost the ability to determine our own destiny and lose any semblance of control. Data allows patients with chronic illness to actually regain some sense of control—and achieve ownership of their disease with the power to invoke change.