By Dr Aiden Hannah, Deloitte Centre for Health Solutions

Real-world data (RWD) is central to healthcare’s transition into more personalised, proactive, preventative, and predictive (4P) models of care. Smartphones and wearable technologies gather vast quantities of RWD that can help to better predict, diagnose, understand and treat disease. Deloitte’s Digital Consumer Trends Survey has tracked global digital consumer preferences and behavioural changes across the history of smart devices since 2010. This year, 4,160 UK citizens aged 16-75 years were surveyed between April and May 2022, with several questions focused on health measurement, principally via smart watches and fitness bands. This week’s blog presents our analysis of the health focused findings and explores the potential for data collected on smart devices to be integrated with health data to improve individual and population health outcomes.

Two in five adults now have a wearable device

Over 40 per cent of respondents now have access to a wearable device. This year, smart watch adoption reached 25 per cent. Fitness band adoption fell to 21 per cent in 2022 from 25 per cent the prior year, suggesting that some former band users want greater functionality and have upgraded to a watch (see Figure 1).

Figure 1. Which, if any, of the following devices do you own or have ready access to?

Furthermore, the majority of 25–34-year-olds (57 per cent) now own a smart wearable. While ownership among 65–75-year-olds is far lower, daily usage in this group is the highest of all age categories (see Figure 2). This level of ownership and use of smart devices, therefore, spreads across all generational groups.

Figure 2. Ownership and daily usage of smart wearables by age category

Higher levels of ownership correlate with higher social grade and salary. Indeed, there are many tech-related inequities and access to smart health devices is yet another example. This inequity is an important consideration as we move into a future of health where patients are empowered, proactive participants in their health and the lines between patient and consumer are blurred. As highlighted in our 2020 report Digital transformation: Shaping the future of European healthcare, digitalisation of healthcare should be deployed with the aim of reducing health inequalities and promoting equity of access, not exacerbating these issues. There are many groups of society at risk of digital exclusion, including those on lower incomes, with low levels of formal education, with certain disabilities and older age groups. For digital’s health potential to be exploited fully, challenges in digital skills, connectivity (having fast and reliable internet access) and accessibility (including financial barriers and usability) need to be tackled.¹

Health data collection and appetite for data sharing

Users of smart devices monitor a wide variety of health parameters, with the number of steps the most tracked (47 per cent), see Figure 3. This is likely due to step counting being a common functionality of even the simplest devices, often being passively and continuously monitored. Although basic, this measure has been shown to motivate a significant increase in daily step-count, which can provide numerous physical and mental health benefits.²

Figure 3. Health parameters monitored by survey respondents on your devices such as smartphones, smart watches and fitness bands

However, by monitoring more sophisticated parameters such as blood pressure and blood oxygen levels, more targeted health information is gained that can encourage individuals to adhere to a healthier lifestyle and manage their health conditions more effectively. Additional data, such as knowing where people have walked, and mapping this to pollution levels in those areas, would also be valuable to collect from a public health perspective.

Quantifying these health parameters can be valuable to individuals, but may have greater benefit when shared with medical professionals to enable deeper insight into the patient’s condition when making a diagnosis, or paired with population outcomes to train advanced algorithms that provide predictive health insights. Importantly, 72 per cent of survey respondents who monitor health data on personal devices would be comfortable giving their doctor access to their data (see Figure 4).

Figure 4. Comfort level of respondents in giving their doctor access to their health data

This high level of agreement highlights the significant potential for consumer devices to become valuable diagnostic tools, enabling healthcare systems to gain new real-world insights that improve understanding and treatment of disease. However, those who monitor health data on personal devices are already much more engaged with their health and seeking healthy behaviours than others in the population. The willingness of these other individuals to share personal device data with medical professionals would likely vary, with the convenience of sharing, potential benefits, and comfort levels around revealing potentially unhealthy behaviours, being important factors.

Connecting consumer data to healthcare data

The COVID-19 pandemic highlighted the changing role of patients in healthcare, with many patients transitioning from being passive recipients of care to empowered consumers. Consumer technology companies, their products and established digital infrastructure played an important role in this shift. Currently, however, consumer health data sits independently of healthcare data, with no secure infrastructure to support their integration, preventing the true potential of such data from being unlocked.

Connecting consumer device data to healthcare data has the potential to radically transform diagnosis and how, when and where healthcare is provided. While clinicians have historically relied on self-reported or ‘snapshot’ data to understand health parameters such as episodic readings of heart rhythms, breathlessness and activity levels, consumer wearables (and smartphones) provide a unique opportunity to provide clinicians with continuous, longitudinal datapoints collected in a real-world environment.

Despite a clear willingness for some consumers to share their data, including with health insurance companies, the benefits of sharing data with healthcare must be clearly articulated and data privacy concerns addressed. Moreover, successfully linking personal monitoring data to electronic health data is an area of ongoing research. For example, the British Heart Foundation (BHF) Data Science Centre, is conducting research on improving cardiovascular diagnosis and healthcare.³ Its work ultimately aims to create a ‘population scale wearables dataset linked to NHS records’, the aim being to optimise the value of wearable datasets by linking them to clinical outcomes.⁴ However, as recognised by the BHF Data Science Centre, there are currently several challenges to achieving this integration.⁵ These include:

• maintaining trust and transparency around data sharing, including appropriate consent practices, establishment of data ownership and robust data security
• ensuring data is accurate, valid, representative of population diversity, and accepted by medical professionals
• overcoming digital infrastructure obstacles such as interoperability (both between consumer devices and health records) and healthcare system digital maturity.

Furthermore, significant public criticism of previous data sharing projects has resulted in them being postponed or cancelled.⁶ Overcoming these challenges will therefore both require and support new ways of working between patients, clinicians and consumer technology companies, with trust and the implementation of appropriate data governance frameworks critical. In addition to the numerous challenges to data sharing that exist between health and care organisations themselves (discussed in a previous blog Integrated Care Systems: achieving an integrated future through shared data); legal, regulatory and ethical challenges also apply when third-party consumer organisations share personal data for medical purposes. These need to be addressed as a matter of urgency. Solutions require the involvement of multiple organisations across the private and public sectors, in combination with input from the public and device users to ensure a patient-centric approach to data-sharing is developed.

Conclusions

The increasing adoption and use of consumer wearable devices to monitor health parameters, coupled with consumers’ willingness to share their data with healthcare providers, presents a significant opportunity to improve health outcomes. While pairing consumer data with health records presents several challenges and will require improvements to the IT infrastructure, clinicians’ mindsets and digital inclusion, by prioritising trust and transparency and increasing digital literacy, there is an opportunity to harness this valuable data to greatly improve understanding, diagnosis and treatment of health conditions.

Aiden Hannah, Research Analyst

Aiden has a background in physics and biomedical engineering, and a strong technical knowledge of diagnostics and digital healthcare. Most recently working as an academic researcher, he undertook a range of multidisciplinary projects involving close collaborations between MedTech companies and clinicians; supporting the development of novel biosensors and low-cost diagnostics, including clinical trial design and conduct. Aiden has focused on the health technology investment pipeline and the medical device regulatory processes as part of his doctorate industry placements.

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¹ https://www.hdruk.ac.uk/helping-with-health-data/bhf-data-science-centre/

² https://zenodo.org/record/5827260#.YvoMp_jMI2x

³ https://zenodo.org/record/5827260#.YvoMp_jMI2x

⁴ https://www.theguardian.com/society/2021/aug/22/nhs-data-grab-on-hold-as-millions-opt-out

⁵ https://zenodo.org/record/5827260#.YvoMp_jMI2x

⁶ https://www.theguardian.com/society/2021/aug/22/nhs-data-grab-on-hold-as-millions-opt-out