By Matt Schur from the AMT Pulse.
Welcome to the wearable revolution.
These devices, which began largely as consumer wellness trackers, are now shifting toward clinical and medical applications that have the potential to, for the first time, greatly improve care and patient outcomes.
Roughly one in three Americans use wearables to track their health today, according to a Health Information National Trends survey. Among those users, nearly 80% are willing to share their data with a healthcare provider to improve their health monitoring and management. The overall market is expected to quadruple in value from 2023 to 2029, reaching $169 billion a year, according to Daedal Research.
The progress has the potential to shape the future of healthcare, boosting everything from patient engagement and monitoring to the management of some of the most notoriously difficult-to-treat diseases.
Today’s Wearable Climate
As modern as wearables may feel, the technology dates back hundreds of years, including to Leonardo da Vinci’s conceptualization of one of the first pedometers in the 1500s. Innovation naturally continued, with major progress in the 19th and 20th centuries, which saw the rise of hearing aids, wristwatches and heart monitors.
The ecosystem now is vast, spanning smartwatches, fitness trackers, smart rings, biosensing patches, smart clothing and even exoskeletons. These devices rely on embedded sensors—such as accelerometers, optical heart rate monitors and electrodermal activity sensors—to continuously collect physiological data. Many devices connect to smartphones or cloud platforms, where algorithms interpret the data.
Wellness still dominates the space, with many people using devices for tracking physical activity and sleep. Some consumeroriented devices have gone a step further in recent years, allowing users to track heart rate variability and blood oxygen levels or detect irregular heart rhythms. More advanced wearables—which are bleeding into medicalgrade device territory—are coming to market, too, such as smart shirts that can measure electrocardiogram data and next-generation continuous glucose monitors that remain implanted for more than a year and are minimally or noninvasive.
As much as these devices have advanced, “Most of them are not meant to diagnose or even perform medical-grade monitoring,” says Angela McIntyre, Executive Director of the Stanford Wearable Electronics (eWEAR) Initiative. “They can give an indication of your health.”
Accordingly, the data gathered from these devices can be complicated, says Jeannie Bailey, PhD, Associate Professor of Orthopedic Surgery and Director of Physical Function and Biomechanics Research Core at the University of California, San Francisco. Dr. Bailey is part of a team developing wearable technology to help monitor patients’ biomechanical recovery from surgery.
The data from certain devices, such as step counters, can vary widely, making them not particularly reliable or predictive of health. However, “We are getting more sophisticated metrics for walking biomechanics, like asymmetry or stability, and it would be useful to have that data for understanding patients,” Dr. Bailey says.
As such, the medical usefulness can be noisy and hard to parse. “Clinicians probably don’t see the direct potential of how to use these devices to make medical decisions now, but if we do more rigorous research, their clinical utility will likely expand,” Dr. Bailey says.
Tech Challenges
As wearables become more prominent, they raise important questions beyond clinical reliability, including around data use, regulations, privacy, user anxieties and more.
For instance, people are finding consumer sleepwear technology informative. While wearables can help enforce and suggest better sleep habits, it can also be a source of stress. “The leading cause of insomnia is fear of not being able to sleep,” says Rosalind Picard, PhD, Professor of Media Arts and Sciences; Grover M. Hermann Professor in Health Sciences and Technology; and Director of the Affective Computing Research Group at the MIT Media Lab. “When people use these devices, it’s important they have a healthy perspective about it.”
If you’re the type of person who might get so stressed about your sleep data that it affects your sleep, then you need a strategy to cope with that information or potentially not use the device, Dr. Picard says. Researchers also recommend focusing on long-term data rather than small samples of just one night or one week of activity.
Among the biggest challenges is privacy, including around how data is collected, stored and used. “Electronic health records do a pretty good job of protecting privacy right now,” McIntyre says. “Incorporating wearable data into those standards would be helpful.”
It’s not just the devices that pose a challenge. Device manufacturers might work with third-party vendors to analyze or store data as well, potentially creating additional opportunities for information misuse.
At the same time, researchers, including Dr. Bailey, point out that some of the information being shared is innocuous compared to what else is being tracked these days. As Dr. Bailey says, a watch might track metrics such as steps taken and heart rate. But smartphones collect vastly more information.
“The wearable data being collected doesn’t tell much about you as an individual,” Dr. Bailey adds. “It tells us what your day-to-day is like, but not where you’re doing it or who you are. I feel the risks associated with this type of activity data are relatively small.”
Another major wearable hurdle is U.S. Food and Drug Administration (FDA) approval, something consumers should monitor. “The language can sound the same on the surface, but what’s underneath can be very different in some cases,” Dr. Picard says. “FDA-exempt does not mean that the FDA has given it a thumbs-up. FDA cleared is like FDA-approved. Many people think it’s weaker than the approved version. But for devices, that’s as strong as approval gets.”
Part of the reason it’s important to pay attention to the approval is that the process is thorough, typically requiring large-scale studies and tests, Dr. Picard says. She adds that people should also pay attention to FDA clearance for the indication that needs to be tracked. “For example, there are a lot of consumer products that claim to offer FDA-cleared electrocardiogram information,” Dr. Picard says. “While that indication might be FDA-approved, their pulse rate, heart rate and the rest of their cardiac parameters are not cleared.”
Lastly, funding, especially for research, remains a major challenge. As Dr. Bailey highlights, a lot of the funding pouring into the space is coming from the commercial side and industry partnerships. While that is helpful and important for getting products into the world, this dynamic places too much emphasis on product value over outcomes, she says. “They’re not financially incentivized to improve patient outcomes; they’re incentivized to sell products,” Dr. Bailey says. “For us to understand the clinical impact of these devices, we need more federal funding for research. We need that funding to elevate this work.”
Shaping the Future
As wearable technology continues to evolve, its impact on healthcare is expected to extend far beyond basic tracking and into core areas of improving care. The following five emerging applications highlight how wearables could lead to a larger role in clinical care, patient engagement and healthcare system efficiency.
1 - Patients taking ownership of their own health
The biggest potential impact of wearables is patients engaging with their health, giving them information that goes beyond how they think they feel or how they recall their symptoms, Dr. Bailey says. “I think people can look at their performance over time, and it motivates them to do more,” Dr. Bailey says. A UCLA Health study, for instance, found that people using wearable devices increased their average step count by 1,300 steps per day.
Wearable data can be broken into daily or even hourly goals, with devices tracking performance over time and providing immediate feedback through apps and alerts. Users can also see patterns emerge, such as how activity levels change throughout the week or how sleep impacts energy and performance, helping users make more informed health decisions and reinforcing positive behaviors. Over time, this engagement has the potential to break down existing healthcare barriers by making health management more accessible and personalized, encouraging greater participation moving forward, Dr. Picard says.
Wearables also help translate abstract health concepts into tangible feedback. For instance, instead of being told to increase activity, users can see exactly how many steps they’re taking, how their heart rate responds to exercise or how sleep quality changes over time.
2 - Patient monitoring between visits
Wearable technology is beginning to close one of the most persistent gaps in healthcare: the lack of visibility into patients’ daily lives outside the clinic.
Traditionally, providers have had to rely on patient self reporting and intermittent check-ins, which can be inconsistent or incomplete. Did the patient take their medication? What does it really mean when a patient reports being active or eating healthily? More challenging yet: What is their pain like?
Continuous data from wearables offers a more objective, real world view of patient behavior and health over time. “We want to quantify measures about our patients,” Dr. Bailey says. “I think wearables are going to be a little bit of a proxy for accountability.”
Let’s say you just had knee surgery. The doctors want to know about the pain and how recovery is going. When they ask questions about mobility and walking ease, a patient may
downplay or misremember their activity levels.
Wearable technology, meanwhile, can offer a clearer, more objective picture of what patients are actually doing—not just how they perceive they’re doing—by tracking daily movement and activity patterns. This data can reveal trends over time, such as periods of increased activity followed by days of reduced movement, helping clinicians better understand recovery progress and potential setbacks. “Wearable data is opening the door to removing the disconnect between patients’ perceived function and their actual function,” Dr. Bailey says.
3 - Employee training
Wearable technology is also already improving how healthcare professionals are trained and supported in their work by integrating digital guidance and feedback into training and real-world environments.
That includes augmented reality (AR), where digital information overlays what people see. Surgeons, for instance, are using AR goggles to overlay digital imaging, such as from MRIs or CT scans, during procedures, which can improve precision, boost efficiency, reduce errors and more.
“It will become possible to train lab technicians doing their work, like analyzing blood and tissue, by having them wear augmented reality glasses,” McIntyre says. “A teacher using a camera in their glasses could capture what they’re doing, and then AI would assist to help codify those steps in the process.”
Students and trainees can then wear the same goggles and follow the training steps via the recorded AR session. “Being able to train people with AR and smart AI agents can help make the workflow a little easier,” McIntyre says.
Over time, these systems could reduce training time, improve consistency and minimize human error—efforts that may help the healthcare industry address its growing workforce shortage.
4 - Improving diagnostics and vaccinations
One of the most exciting potential developments, according to McIntyre, is the development of Band-Aid-style smart patches. Unlike rings or watches, these wearables adhere directly to the skin thanks to advances in biosensors and stretchable electronics. “Smart patches for heart monitoring are available, and smart patches for monitoring a range of biochemicals are early in development and proof-of-concept in the lab, but it could be transformational,” McIntyre says.
They could eventually enable continuous monitoring of physiological signals and biochemical markers, helping detect everything from hydration levels and vital signs to hormone fluctuations in real time.
“Microneedle patches will be capable of monitoring interstitial fluid and different compounds or hormones in your blood to be able to see if those are present or not,” McIntyre says. “They could perhaps change the way vaccines are administered, with people potentially receiving a patch in the mail to put on their skin.”
If successful, this approach could significantly improve vaccination rates by making administration more convenient and less invasive, particularly for populations with limited access to healthcare facilities.
5 - Helping difficult-to-treat conditions
Dr. Picard is part of a team developing wearable technology to help manage Parkinson’s disease. “It’s a little more sophisticated than just movement information—it can tell the difference between Parkinson’s tremors and non-Parkinson’s tremor-like movements, and when you’re changing from a period of bradykinesia to dyskinesia,” Dr. Picard says.
Bradykinesia refers to slowed movement caused by the disease, while dyskinesia involves involuntary, erratic movement triggered by the medication used to treat the disease. Both are unwanted states, which patients call “off time.” Getting the medication dosing and its timing right is tricky, and when it happens, it allows the patient to have “on time” when they function with normal movements, Dr. Picard says. Patients can shift between “on time” and “off time” due to many factors, including exercise, diet and sleep. Getting medication optimized so patients stay most of the day in “on time” has been like trying to keep a car in the lane while somebody covers the driver’s eyes, she adds.
Wearable technology is now uncovering the eyes—helping the doctor and patient see the patterns of on-time and off-time and their triggers, Dr. Picard says. This allows caregivers to adjust medication more precisely, enabling the patient to live their life more normally. “Now, they can see the data change, and then you can change the medication. With the wearable technology, people are ending up with much more ‘on time,’ leading to significant improvements for caregivers and patients.”
Wearable technology is improving other neurological conditions, including epilepsy, where devices can monitor and summon help if someone is having a seizure. “Wearables are bringing dramatic improvements in the lives of epilepsy patients and helping save lives,” Dr. Picard says. “Every patient and every doctor should learn about this technology and see if it is right for their needs.”