As a researcher at Harvard, Shruthi Mahalingaiah used Apple watches to follow the ovulation cycles of 70,000 women for more than two years in an unprecedentedly large study. But as a doctor, she complains that she’s stuck with “dinosaur technology”.
The iPhone maker calls the Apple Watch the “ultimate device for a healthy life”, but it’s not yet something Mahalingaiah can use with her patients because there was not enough innovation to validate and include the data. not.
“How we practice is sometimes decades behind scientific discovery,” she said. “We have the personal monitoring and we have this whole medical-industrial complex – but how are they going to talk to each other?”
Mahalingaiah’s problem finding ways to integrate Apple’s technology into day-to-day care is partly why the Apple Watch, launched in 2015 and worn around the wrists of more than 100 million people, has largely failed to promise to “keep the future of health. your pulse ”.
Tim Cook, the company’s CEO, has repeatedly said Apple’s biggest contribution to the world will be in “health and wellness” and the Apple Watch is the most visible part of that strategy, with its range of sensors that can measure blood oxygen levels. follow movement, sleep and heart rate and take an electrocardiogram.
When Apple introduced the ECG feature in 2018, Dr. Richard Milani, vice president of cardiology at Ochsner Health, predicted it would “reverse the tide” for how patients can be monitored and treated.
He said he remembered colleagues who ran up to me and said, “I can make a diagnosis of this and not even have to do another test because it’s clinical grade!”
He felt optimistic about how dealing with patients with chronic heart conditions would simply move “two or three office visits a year” to a more holistic approach, involving constant monitoring of symptoms.
Milani said his team is now able to monitor data points of thousands of patients and then use artificial intelligence to predict things like who are likely to fall in the next year – the main cause of hip fractures, brain injury and a host of other problems for humans. 65 and older.
But he admits that “normal doctors do not do it all”.
Michael Breus, a clinical psychologist known as “the sleep doctor”, also believes portable items such as the Apple Watch could disrupt the traditional “passive doctor-patient relationship”. But he said “99.9 percent of doctors” are not on board.
The potential for data to improve preventative medicine is enormous. The U.S. Centers for Disease Control and Prevention says chronic diseases are the “leading driver” of America’s $ 3.8 billion in healthcare costs, and are “often” preventable through exercise, diet and early detection.
“If all you had from people was accurate heartbeat and accurate activity context throughout the day for someone’s full life, you can model whether they have hypertension, or they have diabetes – all that,” says Dr. Steven LeBoeuf, co-founder from Valencell, a manufacturer of biometric sensors.
“The problem is that it is not accepted by the medical community and it will not be for some time,” he added. “The [Food and Drug Administration] will have to approve it and then doctors have to accept it, and then they have to be compensated for it. It’s a long process. It is not as simple as one might think. ”
Apple has tried to make some progress, for example with Johnson & Johnson, the pharmaceutical group, to study how its watch can reduce the risk of stroke. It has also worked with university researchers such as Mahalingaiah to design mass studies. And it has partnered with hospitals to look at how clinical communication can be digitized.
But critics have said Apple’s efforts do not live up to its promise. Sami Inkinen, CEO of Virta Health, a telemedicine clinic focused on type 2 diabetes, said it was not enough to give people more information.
“It’s like selling someone a scale: it’s not very difficult to tell people what percentage they are overweight,” Inkinen said. “But how do we actually change behavior and drive our results, such as lowering your blood sugar, getting you off the medication and losing your weight? For me, the Apple Watch is completely missing. ”
A research report published in May confirmed what others found: “portable devices lag behind their potential”, with “little evidence” that they “bring about sustained behavior change”.
Apple said its focus was on giving customers tools to monitor their health and that it was working with developers in the medical field to promote more personalized patient care. It pointed to a new “share” feature that allows users to share their data with their family, caregivers or doctors.
“And while we are still early in our journey in health, we are strengthened by stories of customers whose lives have been improved – and in their own words, saved – by the technology we design and build,” it said.
Neil Cybart, an analyst at Above Avalon, said breaking into healthcare was likely moved away “from some of Apple’s core competencies”.
“They’re really good at coming up with a device that captures this data, but (less focused on it) trying to get these big networks to embrace it and that their workflow is centered around Apple Watch,” he added.
Meanwhile, most Apple Watch buyers already identify as fit and healthy, according to research at Forrester, which suggests that the device is unlikely to be on the wrists of those who need it most from a health perspective.
“The concern is that people who need it the most may have the least access. Even distribution is critical, ”says Dr Seth Martin, a cardiologist at Johns Hopkins Hospital. He said Apple is more focused on adding new features to the device than helping doctors integrate it into their practice. John Hopkins lends Apple watches to patients so they can use their application, he added.
Carolina Milanesi, analyst at Creative Strategies, suggested that despite its focus on health, Apple was fortunate enough to sell the watch as a lifestyle accessory for the iPhone and is unlikely to dig deeper into medical wearables.
“If they were really interested in making a difference in health, they would open the clock to work with Android,” Milanesi said. “But they do not.”