COMMENTARY

What Is the Current Value of Fitness Trackers?

Gregory R. Weidner, MD

Disclosures

May 19, 2016

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Hi. I'm Dr Greg Weidner from Carolinas HealthCare System. This is the second episode in this Medscape series focused on digital health and patient engagement. Today we are going to talk about wearable fitness trackers—what should practicing physicians know and do with respect to this growing trend in personal digital health?

Let's start with a quick overview of the trend. In the United States, the fitness-wearable market grew by an average of 500% year-over-year between 2010 and 2014. The global wearables market is projected to reach $19 billion by 2018. Most of us have experienced this growth firsthand as our patients, friends, and family show off their Fitbits®, Apple watches, Jawbones®, or Garmin trackers. In addition to these devices, the market is seeing companies like Under Armour and Walgreens build entire ecosystems around connected health as central to their brand identity and consumer-engagement strategies.

Despite the continuing market growth, adoption of fitness trackers is still a concern. Surveys by Rock Health and others suggest that more than half of these devices end up in a drawer within a year of purchase, so it might be tempting to dismiss the fitness tracker trend as a fad, or one that has more relevance to retail sales than to health improvement. Let's go a little deeper on that question to see where opportunities might lie for physicians and patients.

WebMD presented results of a survey at the Healthcare Information and Management Systems Society 2016 Conference & Exhibition, which looked at patient perspectives on wearable devices for health, with a companion clinician survey. They surveyed 2600 WebMD users and 195 clinicians, and found some interesting patterns and preferences by generation. The age groups least likely to use wearables were millennials (born in the early 1980s to early 2000s) and the so-called Silent Generation (those born before 1942). The hesitation in these two groups was for different reasons. For the younger group it was about cost, but for the older generation it was because "A doctor hasn't recommended it." Only 31% of physicians said they recommended wearables to patients. Of those who did, the biggest benefit cited (67%) was "motivating patients to follow a treatment plan." Concerns identified by doctors were cost, difficulty of use, dataflow, and integration.

A number of questions will need to be addressed long-term about the data from personal trackers and other growing sources of patient-generated data, like remote diagnostics and mobile apps. There are other considerations, including privacy, security, interoperability, accountability, and response expectations. Who on the practice or health system side is going to monitor and process all of this patient-generated data? How will the data be integrated into existing systems and workflows? Some progressive health systems are building patient-generated data into their technology and patient engagement strategies, but that's not a reality for the huge majority of physicians.

Where does all of this leave patients and their doctors? I think the answer is to partner in ways that leverage the popularity and usability of these devices alongside the clinical context and expertise provided by physicians and their teams.

We know that physical activity and a nonsedentary lifestyle are important for general health and for management of many costly chronic conditions (like hypertension, diabetes, dyslipidemia, and obesity). A systematic review of published studies in the Journal of the American Medical Association[1] concluded that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure. Popular activity trackers add important design elements to the basic pedometer, which makes the experience more personal, social, and mobile, as well as providing game mechanics, data visualization, and insights to drive engagement and behavioral change.

In our experience, patients respond well to the use of an activity tracker (whether it is a simple pedometer or the fanciest digital tracker). It can elevate the conversation about activity and exercise and helps patients take ownership of their health. Patients routinely tell us that their trackers keep them aware of their activity levels and provide motivation to keep them active. Many tell us that it makes physical activity fun. After all, exercise and activity happen outside the doctor's office. Our patients call that life.

The immediate value of the data from fitness wearables is to provide actionable insights to patients and to engage them in healthy behavioral changes. If physicians use that approach, then the why and how of leveraging these devices becomes much clearer. Here are some high-level pointers that we have learned through our work to help you support your patients in using wearable fitness trackers toward better health:

Make it simple: Provide basic information to help patients select a device that suits their goals and budgets. Consider financial constraints as well as health and digital literacy.

Make it personal: It is often helpful to establish a baseline by having patients wear a pedometer or tracker for a week or two without changing their usual activity. Then help them select a step or activity goal and make a plan for improvement.

Make it social: Encourage patients to connect with friends and family for accountability, support, and fun. Most of the commercial connected trackers have companion apps or software that make this easy to do and engaging.

Leverage your team: Encourage members of your practice staff to use a fitness tracker and to make it part of regular conversations with patients, so that levels of measured activity become a part of your practice's culture of health.

Make it meaningful: Follow up with patients about their efforts and successes, and connect the dots to help them understand how their activity has affected their health.

We have listed some informative links in the text below this video.

What's your experience with fitness wearables in practice? What advice would you add? [Readers: Tell us in the comments section.]

Thanks for watching, and we wish you and your patients the best of health.

Health tracker information:

Business and Market review of fitness tracker wearables market

WebMD Wearable Fitness Tracker Survey Summary

A Meta-Analysis of Pedometer-Based Walking Interventions and Weight Loss

Wellocracy Blog: Feedback Loops and Why They Work

PC Mag: The Best Fitness Trackers for 2016

Use of Wearable Activity Trackers (Fitbit) in Clinical Trials

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