By Urvi Shah, senior manager, Deloitte Consulting LLP
In the last decade the functionality and accessibility of wearables has steadily increased. As a direct result so too has the capacity for wearables to collect continuous data on a variety of health measures. But despite increasing adoption amongst consumers, there are barriers to making effective use of these rich data sources across health care. Our recent report on The future of diagnostics found that there was a general reluctance among health care providers and clinicians to accept results from wearables and at home diagnostics which presented a real challenge to diagnostic companies in being able to grow and maintain the market for their products. In this week’s blog, which appeared first as a US Center Health Forward blog, senior manager Urvi Shah provides insights from a discussion with several colleagues on the findings published in the US Center for Health Solutions’ health care consumer survey on using and sharing data from wearable devices and their views on the future of virtual and digital health devices.
Many of us wear smart devices or download various apps to help us track our daily steps, calories, or heart rate. At this point, we tend to look at this information out of curiosity rather than to make health decisions or lifestyle changes. And we generally don’t share this data with our doctors. If we did, it is unlikely they would want it, or know what to do with it, according to our latest research.
Wearables, apps, and connected medical devices generate enormous amounts of health data. These digital tools, combined with the increased adoption of virtual health, hold tremendous potential. The Deloitte Center for Health Solutions separately surveyed health care consumers and physicians to get their thoughts on virtual health, digital health tools, and other topics (see our report, Tapping virtual health’s full potential.) Nearly half of the 4,545 people who participated in our 2022 Consumer Survey said they use wearables, digital assistants, or smart devices. That’s up from 42 per cent in 2018. While 80 per cent of respondents said they would be willing to share their personal health data with a physician, just four per cent of the 660 physicians we surveyed have integrated such information into electronic health records, a decrease from 2020.
I recently spoke with my colleagues Bill Fera, M.D., and Leslie Read—both principals at Deloitte Consulting LLP—to get their perspectives on our survey results and on the future of virtual and digital health devices. Bill is a founding leader of Deloitte’s Virtual Health practice, and Leslie leads our Customer Experience in Health practice. Here’s an excerpt from our conversation:
Urvi: While many consumers are willing to share information generated by their devices, only a small percentage of physicians use it. Why is that?
Bill: It was interesting to see that even fewer physicians are using this information than before the pandemic. Some physicians might be nervous about having to manage huge amounts of data. For example, if a physician misses a problem that was indicated in the data, that physician could be liable. It also can be difficult to turn consumer-generated data into meaningful information. We are missing a layer of analytics that should sit between the data and the clinical team.
Leslie: A tremendous amount of data is being generated, but it is in a variety of different formats and there really isn’t any way for physicians or care teams to turn it into something actionable. In the future, it could be useful for clinicians to see how much a patient exercises and the food choices they make, for example. But the real power will likely be the ability to view patient health data in real-time and take an immediate action because of it. I don't think we're anywhere near that right now.
Urvi: What value do consumers hope to get from wearable devices, apps, and connected medical devices?
Bill: Consumers generally want information that allows them to make informed decisions about their health. They also want feedback…they want to see how their decisions affect their health, and they want validation that the things they are doing to improve their health are having an impact.
Leslie: Many consumers also want their physicians to see this data and use it. In the future, I suspect there will be a segment of consumers that wants to engage their doctors or care team with the data. That means certain expectations will need to be addressed.
Urvi: What is the potential for wearables, apps, and connected medical devices? Do you expect they will be more integrated into the health care system over the next five or ten years?
Bill: I do expect that information will begin to flow from these devices to patients’ medical records. I also expect devices will start to share information with each other. Interoperability between systems of record and systems of analysis can help create that analytic layer I mentioned that can help separate signal from noise. Once actionable insights from the data are available, physicians will likely be more interested in using it. Growth in team-based care could also boost the acceptance of patient-generated data.
Leslie: I agree that data ingestion and data integration is a barrier today. Work is being done in those areas, but a lot more work should be done before this information influences real care decisions. Another challenge is that consumers generally don’t understand how this data is being used. Some consumers are concerned about privacy. I think over time, we'll be able to overcome these barriers. Early adopters on both the clinical side and the consumer side should come together and show the proof points.
Urvi: What do you see as the role of virtual health? Can it replace in-person doctor visits?
Leslie: We have grown accustomed to virtual interactions in just about everything we do—from Zoom meetings to remote education, to online dating…whatever it might be. In-person visits will always be important, particularly for older patients, and patients who have complex health conditions. But for other people, virtual health can improve access to primary care, and could also make it easier to meet with specialists who might be far away. Virtual health is just another access point, and some care is shifting there, which is a good thing.
Bill: There will always be a need for in-person visits, but we could wind up with a hybrid environment. A challenge is in switching between in-person and virtual and determining which type of visit is the most appropriate. The combination of virtual care—which could include texts and phone calls—and in-person care might be useful for patients who need regular touch points with their care team. Virtual connections should complement, not replace, in-person touchpoints. There is a richness in meeting a doctor in person that is impossible to replicate in virtual settings. The physicians we surveyed said in-person visits help them establish a rapport with their patients. But virtual encounters could help to keep the physician-patient relationship strong and can help create more longitudinal care.
Urvi: Few physicians have had formal training on providing virtual health. Is that beginning to change? Could training help increase adoption?
Bill: Yes. That is starting to happen, but there is still a lot of room to grow. Training could start in medical school, be integrated into the educational requirements, and layered into board certifications. Boards could mandate that some virtual health training be included in the certification process and in continued medical education.
Urvi: Virtual health has the potential to make health care more accessible and equitable. But could it also cause the equity gap to widen even further?
Bill: We need to be mindful of those risks. We try to use virtual technology to replicate the richness of an in-person visit, and that might require complex video interactions where 5G is needed. In the meantime, there is a lot that can be done with text messaging and a camera. Our survey results indicate that audio-only communication was most commonly used by underserved populations. If we can ensure that patients have access to the technology they need, we have an opportunity to close the equity gap rather than widen it.
Urvi: Could virtual health options become a competitive advantage for health systems and clinicians?
Leslie: Absolutely. Think about frictionless, seamless omni-channel, always-on access to clinicians. That could be quite a differentiator. It will likely require new strategies around marketing and branding. Those are newer muscles, at least for provider systems and health plans, in terms of how they go to market.
Bill: It is all about access and meeting patients where they are. Virtual health can help create stickiness by making initial access easier via telehealth or digital engagement, and also increasing patient interactions between in-person visits. There is also a loyalty quotient that comes from a differentiated experience, which can create a competitive advantage.
Urvi: What role might patient-generated data play in disease prevention and disease management?
Bill: These data points could allow us to avoid health crises in real time. We can identify patients who are on the verge of a health crisis or complication and intervene before that complication occurs. Rather than providing care on an episodic basis we can prevent complications by monitoring on a longitudinal basis. Then we can move further along the curve to prevention where we're able to stop some people from developing certain diseases in the first place based on behaviour-modification programs that become part of those virtual-health programs.
The future of wearables and consumer-generated data?
I’ve been wearing a smartwatch for the past three years. I primarily use it to count my steps, track my fitness goals…and check my email. In the years ahead, I expect smartwatches and other wearable devices will become far more sophisticated, and the health data they generate will be richer, more interoperable, and actionable. The ability to see highly personalised health information in real-time could have a significant impact on the food choices I make and how I exercise. Being able to share this information with my doctor could help us both make more informed decisions about my health.