“Wearable Health Technology: A Critical Look at Benefits and Boundaries”

Introduction: Expanding Sector of Wearable Health Technology

Wearable technology is at the forefront of a meaningful and practical change in patient observation and care within the current healthcare landscape. Commonly known as “wearable devices” or “wearables,” wearable technology generally describes any small electronic device that can be easily worn on the body or embedded in clothing and other body-mounted accessories.

With the rise of the internet, smart hardware, and big data in recent years, wearable technology has experienced significant growth across diverse areas, including healthcare, education, culture, social networking, and military sectors. As a result, some of these technologies are now becoming integral to people’s everyday routines. The field of smart wearable devices has experienced significant growth in recent years, driven by the emergence of mobile medicine, advancements in smart sensing technologies, and the increasing acceptance of personalized health concepts. In 2024, the global fitness tracker market was assessed at US dollars (USD) 62.03 billion. Forecasts indicate that it will grow from USD 72.08 billion in 2025 to USD 290.85 billion by 2032. The market for wearable medical devices in 2024 was primarily driven by the diagnostic and monitoring devices segment, which held the largest share. (Source: https://www.fortunebusinessinsights.com/fitness-tracker-market-103358 ).

Classification of Wearable Health Devices

Wearable health devices can be segmented into distinct categories based on function, form factor, technology used, or sensor used. The details are discussed below.

A. Based on Function

These categories are established according to the key health-related activity that the device executes.

• Fitness and Activity Trackers– Monitor steps, calories burned, distance tracking, and active minutes. Example: Fitbit, Xiaomi Mi Band, Garmin
• Sleep Trackers– Track sleep duration, sleep stages, and disturbances. Example: Oura Ring, Whoop Strap, Fitbit Charge.
• Blood Oxygen Monitoring (SpO₂)– Useful for detecting respiratory issues, sleep apnea. Example: Pulse oximeter-enabled smartwatches (e.g., Garmin, Apple Watch Series 6+).
• Heart Rate and Heart Activity Monitoring – Measure heart rate, ECG, blood pressure. Example: Apple Watch, Withings BPM Core, AliveCor Kardia.
• Glucose Monitoring-Especially important for diabetic patients. Example: Dexcom G6, FreeStyle Libre [Continuous glucose monitoring (CGM)].
• Body Temperature Monitors- Track body temperature for fever, ovulation, or illness monitoring. Example: Tempdrop, Ava Bracelet.
• Stress Monitoring– Measures skin conductance to detect stress levels. Example: Fitbit Sense, Empatica E4.
• Fall Detection – Often used in elderly care or for people with mobility challenges. Example: Medical Guardian, Apple Watch fall detection.

B. Based on Form Factor

Wearable health devices can be categorized according to their form factor, which encompasses the physical shape, design, and how an where they are worn on the body.

• Head-Worn: Includes smart glasses, headbands, and other devices worn on the head. 
• Patches and Skin-mounted Sensors: For glucose, ECG, hydration, etc.
• Footwear/Smart Insoles: Smart shoes or other devices worn on the feet. Used for gait analysis, pressure monitoring.
• Wrist-Worn: Smartwatches, fitness trackers, and wristbands.
• Torso-Worn: Includes clothing with built-in sensors or technology, such as smart shirts or underwear. 
• Smart Jewelry: Devices like smart rings, necklaces, and bracelets. 

C. Based on Technology and Sensors Used

• Accelerometers and Gyroscopes – Track movement, activity levels, and posture. 
• Photoplethysmography (PPG) – Monitor Heart rate and SpO₂.
• ECG Sensors – Record electrical activity of the heart, enabling detection of heart rhythm abnormalities. 
• Electrodermal Sensors – Measures stress and emotional states.
• Temperature Sensors – Measure body and skin temperature.
• Bioimpedance Sensors – Monitor hydration and body composition
• Optical Sensors – Measure blood oxygen saturation and glucose levels.

Key Benefits of Wearable Health Devices

The key role of wearable health devices is to observe and document a wide spectrum of health data, which helps users better understand their health and well-being and potentially share this information with their healthcare providers. The main applications are described below.

A. Health and Fitness Monitoring

Wearable technology is often used to assess numerous health parameters, including heart rate, blood oxygen levels, sleep quality, and levels of physical activity, such as the number of steps taken and calories burned.

B. Chronic Disease Management

The chronic diseases contribute to 75% of all deaths worldwide and result in substantial economic burdens (Source: https://www.who.int/news-room/fact sheets/detail/noncommunicable-diseases). Thus, ongoing and real-time surveillance is crucial for the effective management of patients suffering from chronic conditions such as cardiovascular diseases, diabetes, and neurological disorders.

Examples:

• CGM device
  • These devices help individuals with diabetes regulate their blood sugar levels by offering real-time glucose information.
  • The FDA has approved several wearable CGMS, including implantable and non-implantable varieties. The Eversense is a prominent implantable CGM, while the FreeStyle Libre and Dexcom G7 are well-known non-implantable systems
  • (Source :  https://pmc.ncbi.nlm.nih.gov/articles/PMC8120065/#:~).
• Wearable ECG monitors
  • Provide constant, real-time observation of heart activity, facilitating the early identification of arrhythmias and various heart disorders.
  • The FDA-approved devices are the AliveCor Mobile device, Apple Watches, ZioPatch and the ECG Check.
  • (Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC9244148/#Sec14).
• Wearable BP monitors
  • Similar to features available on certain smartwatches, these devices facilitate continuous blood pressure monitoring and tracking, providing a convenient method for individuals to monitor their blood pressure throughout the day.
  • This is especially beneficial for those managing hypertension or requiring regular blood pressure assessments.
  • The Omron HeartGuide is a distinguished FDA-cleared device that resembles a watch and employs the oscillometric method, much like standard blood pressure cuffs.
  • Additionally, Nanowear’s SimpleSense-BP is an AI-enabled wearable system for blood pressure monitoring that has achieved FDA clearance.
  • LiveMetric has also developed a cuffless blood pressure sensor designed like a smartwatch, which has received FDA approval
  • (Source: https://www.healthline.com/health/best-blood-pressure-monitor-watches; https://www.mdpi.com/1424-8220/25/3/640)

C. Disease Screening

Wearable devices provide a practical and non-intrusive method for tracking health information and detecting irregularities that might necessitate additional medical evaluation.

Examples

• Atrial Fibrillation Screening
  • Atrial fibrillation, abbreviated as AF or AFib, represents the most frequently encountered serious heart rhythm disorder, classified as an arrhythmia.
  • A variety of FDA-approved devices and functionalities are available for the screening of atrial fibrillation. These include the AliveCor Heart Monitor, the Irregular Heart Rhythm Notification feature on the Apple Watch, and the Irregular Heart Rhythm Notification (IHRN) feature on the Samsung Galaxy Watch.
  • (Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC8386822/#:~:text)
• Sleep Apnea Screening
  • Sleep apnea is a widespread and serious condition that involves repeated interruptions in breathing while a person is asleep.
  • Numerous FDA-cleared devices are offered for the purpose of home screening for sleep apnea, encompassing wearable gadgets and smartphone applications.
  • Examples – Drowzle app, SleepCheckRx app, AcuPebble SA100, SANSA patch, and the WatchPAT device. These instruments are specifically designed for the initial screening of adults suspected of having obstructive sleep apnea.
  • (Source: https://aasm.org/novel-devices-applications-diagnosing-obstructive-sleep-apnea/#)

D. Postoperative Monitoring

• Postoperative monitoring is essential in modern surgical practice, as it seeks to support a quick and safe recovery process.
• Innovative wearable devices present a valuable opportunity to monitor and enhance postoperative recovery through continuous, noninvasive data collection.
• These devices can track vital metrics such as heart rate, activity levels, sleep patterns, and pain levels, thereby assisting healthcare professionals and patients in evaluating recovery progress and detecting potential complications at an early stage.

E. Remote Health Monitoring

• Smart wearable devices are becoming more prevalent in remote healthcare systems, allowing for continuous monitoring of patients and the proactive management of their care.
• Often fitted with a range of sensors, these devices capture real-time health data and transmit it wirelessly to healthcare providers for analysis enabling remote, real-time monitoring of patients’ symptoms.
• By implementing this strategy, patients can prevent unnecessary trips to the hospital, which saves time and enhances the efficiency of medical resource utilization.

Limitations of Wearable Health Devices

Wearable health devices hold great promise; however, they face notable limitations. The main issues are as discussed below.

A. Challenges of Data Accuracy and Dependability

Wearable health devices encounter difficulties regarding the accuracy and reliability of the data they collect. The several factors that can affect data accuracy are as shown below.

B. Data Security and Privacy Issues

The use of wearable health devices brings forth important privacy concerns due to the ongoing collection of sensitive data. Many users might not be fully aware of the risks that could lead to unauthorized access or discrimination if their health information is disclosed without their consent. However, even users who are informed about these privacy risks may still opt to share their data.

Apart from data collection, various wearables are instrumental in treating patients, emphasizing the vital importance of ensuring their security and privacy. Violations in these domains can greatly compromise patient health.

C. Other Practical Issues

Limitations of Battery Life- Several wearable devices are equipped with batteries that have a limited lifespan, requiring them to be charged often, which may influence the effectiveness of data collection.

Connectivity Issues- Interruptions in Bluetooth or Wi-Fi connections can cause data loss or monitoring gaps. Furthermore, there are potential compatibility challenges between different platforms, including iOS and Android.

Cost Issues – Cost is a critical consideration for wearable health devices, affecting various elements including accessibility, user acceptance, and their sustained usability and efficacy over time.

Overdependence Issues—People may become fixated on achieving their daily goals. If the metrics do not correspond with their expectations, this can lead to stress, frustration, or compulsive behaviors. Moreover, ongoing monitoring can result in individuals ignoring their natural signals.

Conclusion

The advent of wearable health technology has profoundly altered the manner in which individuals monitor their health, delivering real-time data, encouraging preventive measures, and assisting in the management of chronic conditions. The potential of these devices to improve health outcomes, inspire changes in behavior, and empower patients is considerable. However, as they become more prevalent in daily life, it is important to be aware of their limitations.

To effectively leverage the potential of wearable health technologies, it is essential to strike a balance between innovation and thorough assessment. This involves enhancing the precision and accessibility of devices, safeguarding data privacy, responsibly incorporating wearables into healthcare frameworks, and informing users about healthy usage practices. Only by achieving this can these tools transcend their status as mere gadgets and become significant assets in the quest for improved health.

Further Reading

• https://www.nature.com/articles/s41528-021-00107-x#Sec1
• https://pmc.ncbi.nlm.nih.gov/articles/PMC7946921/#Sec12
• https://pmc.ncbi.nlm.nih.gov/articles/PMC7683248/#sec6
• https://pmc.ncbi.nlm.nih.gov/articles/PMC9931360/#pdig.0000104.t001
• https://pmc.ncbi.nlm.nih.gov/articles/PMC9244148/#Sec14
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8120065/#:~
• https://www.healthline.com/health/best-blood-pressure-monitor-watches
• https://www.mdpi.com/1424-8220/25/3/640
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8386822/#:~:text
• https://aasm.org/novel-devices-applications-diagnosing-obstructive-sleep-apnea/#:
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8325475
• https://janesthanalgcritcare.biomedcentral.com/articles/10.1186/s44158-024-00154-6
• https://wires.onlinelibrary.wiley.com/doi/abs/10.1002/widm.1535
• https://www.sciencedirect.com/science/article/pii/S0167404825001427#d1e5736