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Wearing it well: the healthcare potential of wearable technology

For pharma the possibilities presented by wearable technology could be enormous

Innovation update

There is a feeling that 2014 could signal the start of the widespread adoption of wearable technology that will – according to some – make us all leaner, fitter and hopefully less likely to develop chronic diseases.

Of course, many people are already using their smartphones as a loose form of wearable technology to carry out health enhancing activities such as monitoring their calorie intake and boosting their fitness levels.

There is a plethora of personal trainer apps available, and many runners use the GPS functionality built into many smartphones to monitor their routes and running speeds with apps like RunKeeper. Some apps – notably the popular Zombies, Run with more than 800,000 users – have also introduced a gaming element to encourage people to stick with their training schedules.

Meanwhile, additional functionality is constantly being introduced such as the M7 co-processor in the recently-launched iPhone 5S that functions as a built-in pedometer.

Increasingly however developers are envisaging a series of interlinked devices – some wearable – that will allow users to keep track of their fitness and health goals via the cloud.

Despite the hype surrounding smartwatches such as Samsung’s Gear 2 and the Pebble – and some very optimistic market forecasts – sales have been somewhat lacklustre to date, and a recent survey by NPD found only one in five consumers in the US were interested in buying one. The subcategory of smartphone-linked fitness bands seems to be performing rather better, however, with sales developing fairly well for the likes of Nike’s FuelBand, Jawbone’s Up and Fitbit, although Nike has said it intends to exit the hardware market and concentrate on fitness apps.
Fitbit meanwhile hit a setback earlier this year when a skin rash issue forced a recall, but retail outlets such as RadioShack in the US have reported encouraging uptake for the device along with the fitness band category in general.

“Digital fitness is still a relatively small category, but one that is certainly expanding along with the growth in all forms of wearable technology products,” said the company’s chief executive Joe Magnucca. That ties in with market research from Canalys, which predicts that there will be 8 million fitness bands sold in 2014, rising to 23 million next year and 45 million-plus by 2017, representing a global market of around $25bn.

Smartphone giants get in on the act
Samsung laid down something of a marker in the health and fitness segment with the launch earlier this year of its Gear Fit device, which added a lot more smartphone-like functionality to the platform compared to the first-generation devices.

It has however (like some of its peers) been somewhat let down by a lack of GPS and automation in its fitness apps. That means users have to tell the device when they start walking or running, if they want to check their heart rate or let it know they are falling asleep. As a result, it kind of breaks the cardinal rule of successful technology, which is to fit as seamlessly as possible into users’ daily routines.

The sector is moving along at great speed, however, and with Google’s health data service Google Fit recently launched and Apple promising its own variant HealthKit will be available for iOS 8 in the autumn there are no signs of a slowdown.

Both systems promise to act as fitness and health tracking systems, collecting data from fitness tracker devices and health-related apps but details are few and far between at the moment.

Google and Apple are already announcing partnerships with app developers such as RunKeeper, as well as wearable companies like Fitbit and crowd-funded start-up Misfit, whose Shine movement tracker has been featured on Apple’s recent TV advertising campaign.

The big problem for companies targeting the consumer end of the market is how to stop these devices gathering dust in a drawer after the initial techno thrill wears off, perhaps lying alongside other health-targeted platforms like the Wii Fit.

They key to solving that problem will be to improve the accuracy of sensors, as well as their integration into a network of devices so that the data can be collected and interpreted automatically, with a minimum of effort on behalf of the user.

From fitness to health
The market for fitness technology is clearly moving, but what about health? Here too, there are some interesting portents to repot. Amazon recently launched a dedicated wearable technology store with a Fitness & Wellness category but also a section called Healthcare Devices which features blood pressure monitors, pulse oximeters, sleep and mood trackers and posture sensors.

Ultimately, wearable devices could include sensors and software to measure a broad range of physiological parameters, including heart rate, blood pressure and oxygen levels, body mass index, and potentially even complex measures such as stress or blood sugar levels.

Apple, Google and Samsung are all rumoured to be researching ways to give wearable devices such as smart watches the ability to check blood sugar and help diabetics manage their condition. For example, Google has just signed a deal with Novartis for its contact lenses that measure glucose levels in tears.

Achieving that goal would give it a beachhead in a diagnostics market currently valued at more than $10bn a year and – potentially – have a massively disruptive effect on the businesses of current diagnostics players such as Johnson & Johnson and Medtronic.

Samsung’s Simband a game changer?
All this is still fairly speculative, but once again things are developing quickly. Samsung has just unveiled a prototype system called Simband – that combines what the company claims is the first open-platform sensor module with a smartwatch it describes as a “modular reference platform for wearable health sensors”. The device links with Sami, a cloud-based data repository and the company is planning to have a beta version of the system in place by the end of the year.

At the moment, the prototype collects heart rate, heart rate variability, and skin temperature data, and Samsung is working with technology partners to develop sensors for other variables such as oxygen and carbon dioxide levels.

It has deliberately chosen open-source software and hardware to make it as easy as possible for developers to work with the platform and offered the sweetener of a $50m fund – dubbed the Digital Health Challenge – to encourage them to get on board.

At the unveiling of the Simband and Sami health platform in May, Samsung chief strategy officer Young Sohn said that understanding our physical well-being better through technology is the “single greatest opportunity of our generation”.

It is not yet clear how any of the new integrated fitness and health platforms will handle privacy issues, particularly as newer and more sophisticated sensor technology is developed.

From consumer to patient
For the pharmaceutical industry, the possibilities presented by wearable technology are clearly enormous. Imagine being able to record such a wealth of data in real-time from patients in clinical or post-marketing trials for example, although it seems likely that privacy issues will have to be addressed. Meanwhile, for healthcare systems the promise of keeping patients out of hospital via remote monitoring and providing timely health and lifestyle advice and feedback is a major draw.

One example of the latter approach is Playtabase’s home automation system Reemo, which allows the user to control just about any networked device using simple gestures. While targeted at the consumer market in the first instance, the potential applications in allowing elderly, infirm and disabled people to maintain their independence are interesting.

Moreover, regulators are certainly waking up to the idea. The US FDA approved two motion-tracking wristwatch-like devices earlier this year – CamNtech’s MotionWatch and Pro-Diary – for use in clinical trials. Meanwhile, it is likely only a matter of time before a wearable could follow the footsteps of mobile apps such as WellDoc’s BlueStar diabetes management programme and become a reimbursable item.

Of course, the sector will only really gain momentum when the technology appeals to patients on a consumer level, so it is driven from the user up, rather than from the healthcare system down.

Some observers have sounded a note of caution however, suggesting that access to wearable technology could eventually evolve healthcare towards a two-tier healthcare system. The digitally-literate could use the technology to demonstrate a commitment to health – securing preferential access to new medicines and enjoying favourable insurance rates – while others miss out.

It remains to be seen whether wearable technology goes mainstream, let alone has a fundamental impact on society in the way that the internet and mobile devices have, although the early signs are good.

Pharma has been talking for years about moving away from a product-oriented business model to one more closely focused on serving the needs of patients – perhaps wearables could become a pillar of that new approach.

Phil Taylor
is a freelance journalist specialising in the pharmaceutical industry
6th August 2014
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