Smartwatches for Chronic Disease Prevention?

A Step in the Right Direction: Exploring the Potential Role of Smartwatches in Supporting Chronic Disease Prevention in Healthcare

In their thought-provoking article, "A Step in the Right Direction: The Potential Role of Smartwatches in Supporting Chronic Disease Prevention in Healthcare," The authors shed light on the pressing issue of chronic diseases in Australia and the need for a paradigm shift towards preventive healthcare. The authors emphasise the potential of smartwatches in contributing to a predict-prevent model of healthcare, highlighting the importance of clinical regulation as a crucial first step. The article presents an insightful analysis of the current role of smartwatches in chronic disease prevention, regulatory frameworks in Australia, and proposes a roadmap for integrating these devices into a digitally enabled precision prevention model of care.

The concept of predict-prevent healthcare is explored, leveraging real-world data to predict risks, intervene, and prevent adverse clinical outcomes. The authors assert that digital health innovations, such as smartwatches, play a vital role in enabling this proactive model of care. Smartwatches generate real-world data and have gained popularity among Australians, offering the potential to provide health information in real time. While acknowledging the varying accuracy of smartwatch data across metrics and manufacturers, the article highlights the positive impact of patient-generated real-world health data in enhancing patient engagement, trust with care providers, and autonomy.

The article explores the ability of smartwatches to track various health metrics, such as step count, heart rate, sleep stage estimation, and heart rate variability. Although the evidence supporting the use of smartwatches in chronic disease prevention is limited, the potential for individualised care and early detection of deteriorations related to chronic conditions is emphasised. Smartwatches can complement the predict-prevent model of healthcare by facilitating disease physiology understanding and providing lifestyle recommendations based on user data. However, the article acknowledges that to date, only one study has demonstrated a reduction in all-cause hospital re-admission using a smartwatch-based digital intervention.

The authors touch on the regulatory frameworks surrounding smartwatch applications in Australia. The Therapeutic Goods Administration (TGA) is responsible for regulating medical device software, including smartwatch applications. However, only a few smartwatch-enabled applications have received TGA approval, primarily as disease-focused diagnostic support tools. The example of the Apple Watch's electrocardiogram algorithm, which prompts users if an irregular heart rhythm is detected, is given. It clarifies that while this algorithm has potential diagnostic benefits, it cannot be used independently for diagnosis or treatment initiation. The need for improved accuracy, clarity, and trust in smartwatch applications, as well as the necessity for formal training for clinicians to interpret the vast amounts of data generated is emphasised.

To overcome the challenges associated with integrating smartwatches into existing models of chronic disease prevention, the authors propose a roadmap aligned with three horizons for precision prevention. The roadmap focuses on addressing issues such as data accuracy, interoperability, data familiarity, equity and accessibility, and implementation. The article highlights the importance of bridging the digital health divide between socio-economic groups to ensure equal access and benefits of digital health technologies. It also underscores the need for data protection laws to safeguard privacy and prevent financial discrimination by health insurers. 

In conclusion, the article provides valuable insights into the potential role of smartwatches in supporting chronic disease prevention in healthcare. It emphasizes the importance of clinical regulation and accuracy of smartwatch applications while outlining a roadmap for their integration into precision prevention models of care. By addressing the challenges identified and promoting further research and understanding, smartwatches have the potential to enhance autonomy, improve health outcomes, and contribute to the much-needed shift towards preventive healthcare in Australia. 

MNCLHD staff can read the full article via CiAP click on the tile linked below. SSO required.

A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care, by Mattison, Graeme: Canfell, Oliver J; Forrester, Doug; Dobbins, Chelsea; Smith, Daniel; Reid, David; Sullivan, Clair. Medical Journal of Australia, Issue: Volume 218(9), May 2023, p 384-388.