The Apple Watch 'future of health' on your wrist is likely still years away, say doctors

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in Apple Watch
Apple's vision of the Apple Watch being "the future of health" may be years off due to slow acceptance from the medical community and the focus on gathering -- but not making use -- of data.

An Apple Watch's blood oxygen mode
An Apple Watch's blood oxygen mode


In a new piece by The Financial Times, a number of doctors and others in the medical field have detailed the difficulties in incorporating the Apple Watch into the daily care of patients. Some said that a future where the Apple Watch actually improves user health on a larger scale is still a ways off.

While the Apple Watch and similar devices can collect many useful data points -- which, in some cases, can be clinical grade -- most doctors aren't using it. For example, clinical psychologist Michael Breus says that 99.9% of medical professionals aren't onboard yet.

"The problem is, that is not accepted by the medical community and it won't be for quite some time," said Dr. Steven LeBoeuf, co-founder of biometrics firm Valencell. "The [FDA] would have to approve it and then doctors have to accept it, and then they need to get reimbursed for it. That's a long process. It's not as straightforward as one would think."

Another problem is what to do with the data that the Apple Watch collects. Virta Health CEO Sami Inkinen says that just giving people data without personalized care recommendations isn't enough to improve health.

"It's like selling someone a scale: it's not very hard to tell people what percentage they are overweight," said Inkinen. "But how do we actually change behaviour and drive results, like getting your blood sugar down, getting you off the medication and getting your weight down? For me, that is completely missing from the Apple Watch."

Additionally, research indicates that many Apple Watch users already identify as healthy and fit, so it's likely that the device's target market doesn't include the people for whom the Apple Watch could bring the most benefits.

However, some doctors are hopeful that the Apple Watch could be used for both patient care and research purposes. According to the CDC, chronic diseases were the "leading driver" of America's $3.8 trillion in healthcare costs. They're also generally preventable by exercise, diet, and early detection.

Shruthi Mahalingaiah, a researcher at Harvard, has been using various generations of the Apple Watch to track the ovulation cycle of 70,000 women in a large study.

Dr. Richard Milani, a vice-chair of cardiology as Ochsner Health, has been using data-collecting devices to monitor data points from thousands of patents and use AI to predict outcomes like which people are more likely to fall.

However, Milani acknowledged that "normal doctors are not doing all this."

Apple, for its part, has been making progress toward a health and wellness goal. It's partnered with companies like Johnson & Johnson and medical institutions on large-scale studies.

The company added that it is "still early in our journey in health." It added that it's "invigorated by stories of customers whose lives have been improved -- and in their own words, saved -- by the technology we design and build."

Read on AppleInsider

Comments

  • Reply 1 of 15
    "The problem is, that is not accepted by the medical community and it won't be for quite some time," said Dr. Steven LeBoeuf, co-founder of biometrics firm Valencell. "The [FDA] would have to approve it and then doctors have to accept it, and then they need to get reimbursed for it. That's a long process. It's not as straightforward as one would think."

    The FDA gave their stamp of approval for the ECG feature arguably a much more advanced feature than the other features used on the watch. I’m confused. Does this Dr. Steven LeBoeuf know this or did he assume that is wasn’t already approved 🤨
    williamlondonjas99
  • Reply 2 of 15
    applguyapplguy Posts: 230member
    The future is closer today than yesterday. 10 years ago who would have imagined a watch doing an ECG. I look forward to what tomorrow brings. 
    jas99
  • Reply 3 of 15
    Continuous Blood sugar monitoring will be a major mover to improve health. The ability to closely keep track of your blood sugar throughout the day and knowing what the effect of eating, fasting, exercise will allow people to better manage this illness. Today we must continuously prick our fingers a painful and annoying exercise that isn’t always possible for many. Health insurance only pays the costs for those with the most severe symptoms and this makes continuous monitoring devices unavailable to most. Diabetes is a pervasive illness among the US. Population and growing. Including this within the Apple watch will  make a huge impact.
    jas99
  • Reply 4 of 15
    damankas said:
    "The problem is, that is not accepted by the medical community and it won't be for quite some time," said Dr. Steven LeBoeuf, co-founder of biometrics firm Valencell. "The [FDA] would have to approve it and then doctors have to accept it, and then they need to get reimbursed for it. That's a long process. It's not as straightforward as one would think."

    The FDA gave their stamp of approval for the ECG feature arguably a much more advanced feature than the other features used on the watch. I’m confused. Does this Dr. Steven LeBoeuf know this or did he assume that is wasn’t already approved 🤨
    That confusion is because👨‍⚕️won’t explain us the difference between a health device and a health indicative device.
    There’s little or no urgency for approval of  devices by Medical Authorisation Authorities around the globe.
    The medical world considers self-medication a pretty bad idea - as it would deny their own medical expertise and come at cost of the significance of themselves
    jas99
  • Reply 5 of 15
    GeorgeBMacGeorgeBMac Posts: 11,421member
    damankas said:
    "The problem is, that is not accepted by the medical community and it won't be for quite some time," said Dr. Steven LeBoeuf, co-founder of biometrics firm Valencell. "The [FDA] would have to approve it and then doctors have to accept it, and then they need to get reimbursed for it. That's a long process. It's not as straightforward as one would think."

    The FDA gave their stamp of approval for the ECG feature arguably a much more advanced feature than the other features used on the watch. I’m confused. Does this Dr. Steven LeBoeuf know this or did he assume that is wasn’t already approved ߤ覬t;/span>

    No, he is correct.  FDA approval only means Apple can sell it, not that a doctor needs to accept it.
    The scenario would be: 

    Patient:  Hello? I need to see the doctor because my Apple Watch said I have A-Fib.
    Secretary:   OK, we can give you an appointment (2 weeks or more away of course!)
    Doctor:  (2 weeks later) I see!  Well, make an appointment with a lab to have an EKG done.  We'll let you know what it says

    A patient reporting "My watch said...." would be taken no differently than the same patient saying "My arm hurts..."   Each is simply a patient report to be evaluated.

    As for the Apple Watch, no physician will ever take it as the final word.   They have no way of validating the results because there are too many variables.

    -----------------------------------------------------
    But, the Apple Watch is already making one big difference in medicine:  A-Fib has historically only been diagnosed when a patient complains of things like shortness of breath or a physician notices an irregular heartbeat.   As Dr. Reifell of the Apple Watch based Heartline Study points out:
    " Since the turn of the century, we've used ECG to diagnose A-Fib.  Given the sporadic nature of A-Fib, using ECGs when a patient presents with an irregular pulse is almost diagnosis by coincidence.   Now we can bring ECGs to the patient with implanted and wearable devices like pacemakers, insertable monitors, and the Apple Watch"

    At the very least, the Apple Watch can trigger a closer look by a physician who could order a Holter Monitor where data is conflicting.

    edited January 2022 JWSCdewmeStrangeDays
  • Reply 6 of 15
    GeorgeBMacGeorgeBMac Posts: 11,421member
    As the article points out (if you read it closely enough):  There are two things going on here:
    1)  The physician is a medical person concerned with medical treatments of medical conditions.
    2)  The Apple Watch is primarily concerned with promoting the person's health through lifestyle.

    The two are at odds with each other:
    It was been estimated that 80% of the many trillions of dollars we spend on health care each year go to treat so called "Age Related Chronic Diseases" such as heart disease, diabetes, cancer, arthritis, dementia, etc.   But, it has has been shown that 80% of those diseases could be eliminated or mitigated with a healthy lifestyle.

    Physicians focus on medical treatments.   They work in a "Disease Management" system.
    The Apple Watch can help put most of them out of business by reducing or eliminating their most profitable diseases.
    JWSCjas99
  • Reply 7 of 15
    GeorgeBMacGeorgeBMac Posts: 11,421member
    Where the Apple Watch can mostly revolutionize medicine is not in direct treatment of diagnosis -- but in research.

    Most of the chronic "Age Related" diseases that eat up most of our healthcare resources can be mitigated, prevented and even reversed with healthy lifestyles.  But, a main obstacle to studying healthy lifestyles and their impact has been the ability to gather data.

    The research community casts a suspicious eye towards the self report and recall of patients: 
    -- How many hours did you exercise over the past month?
    -- What was you average heart rate as a percentage of its max?

    The Apple Watch can and does eliminate that problem.   Researchers are now able to gather reliable, objective data free of error cheaply, quickly and effectively.  Apple's research project makes it possible for researchers to gather direct information from the Apple Watch.  They know if you exercised and for how long, how often and at what intensity.

    Apple themselves is backing such a study.  It's their "Heartline Study" which gathers patient health data from the Health App and relates it to whether they develop A-Fib -- or not.
    There is also the "heart and movement" study going on -- and others....
    JWSC
  • Reply 8 of 15
    JinTechJinTech Posts: 966member
    The last time I was at Kaiser, the nurse asked me, and I am not joking "what is that on your wrist?" She was probably in her late 40's too.
    jas99
  • Reply 9 of 15
    GeorgeBMacGeorgeBMac Posts: 11,421member
    JinTech said:
    The last time I was at Kaiser, the nurse asked me, and I am not joking "what is that on your wrist?" She was probably in her late 40's too.

    My experience has been the opposite.   I had nerve problem in my shoulder and saw a bunch of physicians, nurses, and PTs.  It seemed like everyone of them was wearing an Apple Watch!

    One advantage, if nothing else, is their water resistance -- since health care people do a lot of handwashing.  They can use the alcohol based antiseptic too -- but that can really dry out the skin when it gets used multiple times a day.
    edited January 2022 jas99
  • Reply 10 of 15
    damankas said:
    "The problem is, that is not accepted by the medical community and it won't be for quite some time," said Dr. Steven LeBoeuf, co-founder of biometrics firm Valencell. "The [FDA] would have to approve it and then doctors have to accept it, and then they need to get reimbursed for it. That's a long process. It's not as straightforward as one would think."

    The FDA gave their stamp of approval for the ECG feature arguably a much more advanced feature than the other features used on the watch. I’m confused. Does this Dr. Steven LeBoeuf know this or did he assume that is wasn’t already approved ߤ覬t;/span>
    No, he is correct.  FDA approval only means Apple can sell it, not that a doctor needs to accept it.
    The scenario would be: 

    Patient:  Hello? I need to see the doctor because my Apple Watch said I have A-Fib.
    Secretary:   OK, we can give you an appointment (2 weeks or more away of course!)
    Doctor:  (2 weeks later) I see!  Well, make an appointment with a lab to have an EKG done.  We'll let you know what it says

    A patient reporting "My watch said...." would be taken no differently than the same patient saying "My arm hurts..."   Each is simply a patient report to be evaluated.

    As for the Apple Watch, no physician will ever take it as the final word.   They have no way of validating the results because there are too many variables.

    -----------------------------------------------------
    But, the Apple Watch is already making one big difference in medicine:  A-Fib has historically only been diagnosed when a patient complains of things like shortness of breath or a physician notices an irregular heartbeat.   As Dr. Reifell of the Apple Watch based Heartline Study points out:
    " Since the turn of the century, we've used ECG to diagnose A-Fib.  Given the sporadic nature of A-Fib, using ECGs when a patient presents with an irregular pulse is almost diagnosis by coincidence.   Now we can bring ECGs to the patient with implanted and wearable devices like pacemakers, insertable monitors, and the Apple Watch"

    At the very least, the Apple Watch can trigger a closer look by a physician who could order a Holter Monitor where data is conflicting.
    A friend of mine has minor arritmias (and is also an hypochondriac). Has been advised to look less to his watch, by example.

    I have lung issues and I use blood oxygen app, share data also when I’m visited, add some value.

    health is a complicated topic (for those unhealthy) and healthcare is even more complicated. 

    Progress is fast (by example in cancer, now the probability of living happily after is 1/2 while in the seventies was around 1/3 -if I’m not wrong).  But if you (or someone close to you) is the one on the wrong side of the statistic perception can change.

    As a conclusion: I am a little skeptical on the overall boost that one single tool  can provide (today)
    edited January 2022
  • Reply 11 of 15
    jimh2jimh2 Posts: 453member
    Medical monitoring device makers are setting up lines of defense to prevent being overtaken. Many laws exist to make it near impossible to enter these markets. Some companies probably see it as a long term risk when it is really a near term risk. 

    Much like BlackBerry and others they will drag their feet and be eclipsed. Companies making single use devices will be eclipsed by things like the Apple Watch that have their functionality built in along with a lot of other stuff. 

    These industries have close to zero competition because the entry point is costly. Apple and others have the bank to poach the key employees at these legacy companies as well as the software engineers with far more capability than those at device companies. 
    jas99
  • Reply 12 of 15
    GeorgeBMacGeorgeBMac Posts: 11,421member
    jimh2 said:
    Medical monitoring device makers are setting up lines of defense to prevent being overtaken. Many laws exist to make it near impossible to enter these markets. Some companies probably see it as a long term risk when it is really a near term risk. 

    Much like BlackBerry and others they will drag their feet and be eclipsed. Companies making single use devices will be eclipsed by things like the Apple Watch that have their functionality built in along with a lot of other stuff. 

    These industries have close to zero competition because the entry point is costly. Apple and others have the bank to poach the key employees at these legacy companies as well as the software engineers with far more capability than those at device companies. 

    Yes, that is true.
    But do not underestimate that healthcare industry.  It isn't JUST the manufacturers.  It is a coalition of insurance companies, physicians, healthcare organizations (like hospitals),etc. -- all backed up by the federal government and its agencies (mostly the FDA).

    That collusion chased the snake oil salesmen out of medicine.
    But it also created a powerful monopoly that has, so far, defeated all efforts to fix its very broken system.  A system that charges far and away the highest prices in the world for some very mediocre care.

    That may be why Apple is approaching this are with such extreme caution.
    jas99muthuk_vanalingam
  • Reply 13 of 15
    Another problem is what to do with the data that the Apple Watch collects. Virta Health CEO Sami Inkinen says that just giving people data without personalized care recommendations isn't enough to improve health.

    "It's like selling someone a scale: it's not very hard to tell people what percentage they are overweight," said Inkinen. "But how do we actually change behaviour and drive results, like getting your blood sugar down, getting you off the medication and getting your weight down? For me, that is completely missing from the Apple Watch."

    So Inkinen expects the Apple Watch to actually interpret all the data and recommend medication and diets individually to every user? 
  • Reply 14 of 15
    StrangeDaysStrangeDays Posts: 12,325member
    Ochsner Health quoted in the story is my PCP clinic here in New Orleans. They incorporated the HealthKit medical records integration, which is pretty nifty for tracking and trending labs over time. 
    williamlondon
  • Reply 15 of 15
    GeorgeBMacGeorgeBMac Posts: 11,421member
    Ochsner Health quoted in the story is my PCP clinic here in New Orleans. They incorporated the HealthKit medical records integration, which is pretty nifty for tracking and trending labs over time. 

    I stopped importing medical records when I saw how bad they were ("Garbage in - Garbage out).   For instance, This past summer I just had a shoulder problem and got 4 different diagnosis from different doctors:
    --  Arthritis
    --  Partially torn rotator cuff
    --  Moderately closed C5 foramen
    -- Brachial Plexus Neuritis

    At least 3 of the 4 are wrong.  But they still show on my medical records as a medical problem.  Essentially, its a form of disinformation and I don't want to spread it around anymore than necessary.  For instance, when I started physical therapy the therapist saw the "Partially torn rotator cuff" and refused provide effective therapy that would help fix the real problem -- the effects of Brachial Plexus Neuritis.
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