Nancy Griffin interviews the "Oracle of AgeTech" on trends and predictions in wearable technology
Laurie M. Orlov is a tech industry veteran, writer, speaker, and elder care advocate. Her popular report Aging and Health Technology Watch provides thought leadership, analysis and guidance about health and aging-related technologies and services that enable boomers and seniors to sustain and improve their quality of life. Here we interview Laurie about her comprehensive report The Future of Wearables and Older Adults 2021.
Nancy: Tell us why you are so excited about wearables for older adults.
Laurie: Wearables can change the lives of older adults. I think we have just begun to scratch the surface. What gets me very excited is what a wearable can do in our future. They haven't done it yet, but they will.
The measurements that wearables yield closely align with the needs of an aging population. Either older adults already see these benefits, or those who care for and about them will. As wearables improve in quality and accuracy over time, they will enable asking questions that invite longitudinal understanding and proactive intervention.
Older adults in 2021 are at the same point of awareness and adoption of wearables as was the case with Voice First technology in 2018. According to AARP’s recent tech survey, most have not adopted wearables – and they may be particularly unfamiliar with those that capture and track health-related status. But that will change in the coming years as broad market acceptance drives interest among the 65+ population. Adoption will grow as the price points become more affordable; and most important, as the data from wearables becomes more actionable, informative, and predictive of future change.
Nancy: Beyond Measuring data such as activity and sleep patterns, you see wearables going farther into healthcare. Can you elaborate?
Laurie: Digital therapeutics and wearables could be very useful for monitoring the health of patients. Given the preponderance of chronic conditions among the 65+ population, the opportunity to detect, intervening at the right time, may be one of the most significant digital health advances in recent years.
One of the companies I interviewed developed a wearable that can detect the oncoming symptoms of a stroke before you have a stroke. Another can track steps and length of stride and note that a person with Parkinson's has changes in gate or stride.
Nancy: What are some of your predictions for the future of wearables?
Laurie: Within five years, doctors will see benefits in guiding older adults to their usage. Chronic disease monitoring by consumers using wearables will see the most substantial growth. There will also be stigma-free and lower cost hearables to provide customizable sound improvements to a far broader population than current hearing aids.
Predictive analytics approaches that incorporate Big Data plus personal information will enable insights about individual and general population wellbeing. Privacy concerns will be addressed with clearly described protections and well-understood permissions.
Technology firms will examine ways to incorporate voice interfaces to get health status changes from a device in an ear, on a hand, or strapped to a wrist. The next generation of wearables will have reduced dependency on the wearer’s smartphone, instead supporting remote configuration by caregivers and family.
Wearables with actionable health information will increasingly appeal to the 80% of older adults who have at least one chronic condition. In 2019, HIMSS published a literature review about wearable technologies in medicine, observing from its research that medical-grade wearables had potential, but that it might be difficult to get seniors to wear them, perhaps due to lack of awareness. But just two years later, attitudes have changed. The smartwatch was legitimized as an alternative to the Personal Emergency Response Service (PERS) pendant on the day that Apple announced fall detection in 2018. The Apple Watch was a pioneer in offering health-related information.
Nancy: What trends make wearables viable for older adults now?
Laurie: ‘Quantified Self’—tracking every step and activity from the first “I got up at 6:20 this morning” to measuring mood, sleep, heart rate, food, exercise – has become mainstream by 2021 – with wearables market size projections exceeding $100 billion by 2027. Specific market trends converged to enable the change. Self-service hearables have made hearing improvements cool – and cheap. Just as the smartwatch disrupted the medical alert world, so too have hearables jostled the world of hearing aids.
Smartwatches have also eliminated the stigma of wearing a pendant that declares ‘You’re Old.’ And app makers like Fall Call Solutions and Best Buy crafted apps to run on the watch that offer the fall detection service connected to a needed 24x7 response center.
Nancy: Please share some of the research studies on wearable technology.
Laurie: Researchers today are looking at the possibility of wearables being used to predict strokes (based on motion changes) before they occur – or to guide a Parkinson’s patient to get a new prescription (based on gait changes). In early 2021, Boston University selected Shimmer wearables for a brain-heart health study; Scripps Research launched a study about wearables and precision medicine; and Penn State is studying the medical application of wearable antennas.
Nancy: Tell us about some of the investments in wearable technology.
Laurie: Investments into wearable health offerings are staggering. The Series C announcement for the Ōura Ring is a case in point – $100 million of investment as of May 2021, with multiple research initiatives underway in the context of chronic and acute diseases. The wearables market is now measured in trillions of dollars worldwide. Hinge Health just raised $300 million for its health-coaching offering that has a wearable sensor, and Kaiser Permanente and Mayo Clinic just put $100 million into Medically Home. In 2020, health measurement startup Whoop raised $100 million.
Nancy: Do you see the medical system adopting technology?
Laurie: Health-tracking devices and usage grew in 2020. According to Rock Health, 66% of those who started using a wearable did so to manage a diagnosed health condition. And more than 51% of wearables owners use the device to manage a diagnosed health condition. Specific health attributes included weight, heart rate, blood pressure. It should be noted data was collected prior to the 2020 Covid-19 lockdowns.
Advances in wearable technology, vendor excitement, and growing consumer adoption might lead one to think that the integration into healthcare processes is a given. But while some leaders are excited by possibilities, other health professionals express doubt about near-term data integration of consumer wearable data. Yet clearly researchers and investors don’t believe it – innovation is accelerating, and huge streams of money pour into new companies.
According to a 2020 survey by Deloitte, while interest in wearables has increased, the actual integration of data from patient wearables has grown little in the past two years – from 5% to 10% of surveyed physicians. And Forrester’s survey of 40 physicians and patients concluded that wearables today are for consumers, not physicians – asserting that “doctors don’t need the data.” But that may change if worried well consumers walk into the office with higher quality blood pressure data than the physician can obtain during intermittent visits.
Utility of wearables will transcend practitioner reluctance to prescribe. More Medicare Advantage plans could reimburse the cost of a wearable for certain patient groups. For example, Fitbit devices are currently included in Medicare Advantage plans offered by insurers. Devoted Health was the first Medicare Advantage plan to subsidize an Apple Watch, though Aetna Attain provides a health incentive for an Apple Watch -- others will follow. With health insurer pressure, eventually the ‘doctors don’t want your data’ mantra will end.
Nancy: How do you see wearables playing out in senior living?
Laurie: In the post-Covid era, some senior living companies are promoting technology for residents, and some are touting the benefits of wearables. Those with fall detection, RPM and a 24x7 notification process are being described by senior-focused websites as useful to older adults and caregivers.
In the future, the identification band worn in senior living communities and nursing homes could be a smart band with ID information, medications and allergies, all part of a GPS-trackable tag, particularly useful in dementia care. Firms that provide care for older adults will evaluate health-related wearables for care recipients that have specific health conditions, and some will provide their services as a subscription offering that could include personalized advice or alerts.
Click here to read the full report.