A new report published in the Journal of the American Medical Association throws a wet blanket on the wearable craze, saying such devices won't help improve health outcomes until they get the patient engagement dilemma figured out.
And that doesn't seem to be happening yet.
Written by Mitesh S. Patel, MD, David A. Asch, MD, and Kevin G. Volpp, MD, all of the Philadelphia VA Medical Center at the University of Pennsylvania, the report – published in JAMA on January 8 – says wearable devices aren't the drivers of health behavior change that everyone wants, but they could become facilitators. And that will only happen when they're designed to appeal to the common consumer and maintain engagement over time.
"If wearable devices are to be part of the solution, they either need to create enduring new habits, turning external motivations into internal ones (which is difficult), or they need to sustain their external motivation (which is also difficult)," the authors noted.
The report cites four gaps between perception and reality:
1. A person must be motivated to want a device and be able to afford it. That's difficult when most devices cost hundreds of dollars, the authors said. And that may be why such devices currently appeal to those who need them the least – early adopters of technology, the young and physically fit, and the wealthy. The study suggested finding new ways of making the devices affordable, such as having payers or employers helping with reimbursement.
2. After acquiring a device, a user needs to remember to wear it and recharge it. This is a challenge, the authors argued, when you’re targeting an audience that isn't that motivated in the first place. The problem is compounded by devices that require the user to take extra steps to transfer data to a smartphone or computer where it can be viewed and acted on. The study suggested developing devices that automatically transfer data to smartphones without any effort by the user.
3. Devices must be able to accurately track targeted behaviors. The authors wrote that devices measuring sleep patterns, heart rate and other biological data haven't been tested enough to prove that the data is valid. On the other hand, wearable devices could be used in conjunction with home-based medical devices to improve health behaviors, such as reminding the wearer to take medications.
4. The information collected by wearable devices must be presented back to the user in a manner that is understood, motivates action and convinces the user to keep wearing that device. This is where the disconnect is most noticeable. Studies have shown that more than half of those who purchase a wearable device stop using it after a period of time, possibly as soon as six months. The devices themselves aren't sustaining change, so it's up to other sources – particularly employers or social networks – to motivate users to continue. That may come from competition, peer support or reward programs.
"Successful use and potential health benefits related to these devices depend more on the design of the engagement strategies than on the features of their technology," the report concluded. "Ultimately, it is the engagement strategies – the combinations of individual encouragement, social competition and collaboration, and effective feedback loops – that connect with human behavior."
