Over the past few years, the wearables market has not just expanded—it has exploded. Fitness trackers have lead way to smart watches and more niche offerings such as smart bandages, stress trackers and more. And that doesn’t even include other mHealth solutions, such as web-connected glucose meters, that still deliver health data to the cloud without the need to wear them 24/7. CDW Healthcare even estimates that wearables could save the healthcare system $200 billion over the next 25 years.
PM360 wanted to know: Where is this all headed? We asked the industry to tell us how they think wearables will change the game moving forward and found 10 areas in which wearables or mHealth will have the most impact.
We are entering a “productization” era in biopharma, and vendors on both the clinical trial and commercialization side of the business will need to develop platforms and offerings that provide drug sponsors with the ability to create more complete products. Given the pricing pressures of specialty pharma and rare disease, drug sponsors will need to create fuller products that justify high price tags in the eyes of a pharmacy benefit manager or managed care organization.
Clinical trials will also be more efficient as mHealth can provide a more comprehensive view of the patient state. This comprehensive look will allow drug makers to better understand adverse event triggers, possibly drive real differentiation around delivery mechanism, or even develop adherence programs during a trial for when the drug is commercialized.
mHealth will also become a key component in the biologics/biosimilars battle, as these tools will likely provide a way to differentiate products beyond pricing. Products such as the Apple Watch represent proof of concept and category building, whereas the efforts of companies such as Medidata Solutions, AdhereTech and iRhythm with its ZIO XT cardiac monitoring patch (shown), among several others, represent the real industry opportunity.
The Ingestible Market
The wearables market, and particularly devices that can interact and leverage the computing power and connectivity of mobile phones, creates a very disruptive category within the healthcare space. In addition to hundreds of innovative start-up companies, some very large technology market participants such as Google, Apple and Microsoft are committing significant resources to the healthcare field with a focus on wearables. From patients to providers to health systems and payers, each will gain different advantages and receive differ value from adopting certain tools.
But the ingestible market, led by Proteus (shown), in which a pill communicates with a patch and then provides data to a phone, should be of particular interest to pharma on many levels. That is why pharmaceutical companies can’t afford to sit idly by and wait for solutions to evolve, as they risk getting further disintermediated from their customers. They need to be involved in the solutions that are evolving, or at the very least a voice at the table.
Here’s how I envision the future:
It’s 4:45 a.m. My sleep tracker awakens me at the optimum point of my REM sleep. I step on a digital scale, such as Withings Smart Body Analyzer (shown). My body weight, BMI, sleep and other information is captured and virtually sent to the cloud. At 5:15, I head out for my morning run and the sensor in my shoe captures my steps, my stride, and integrates my weight information in the cloud. I experience pain in my left heel, which is captured from the shoe’s technology and sent to the patient side of my physician’s EHR.
At 6:10, my doctor sends me an alert and digitally coordinates an appointment with a foot specialist while also writing a digital Rx to the pharmacy. At 7:30, we do a telehealth appointment which saves time for both of us. My insurance payments are sent automatically while my flexible spending health account captures the difference and alerts me to automatic savings on my first script. The doctor advises me to use a new bloodwork app on my phone. I prick my finger, and the app instantly alerts me that I am Vitamin D deficient and offers some suggestions of supplements with digital coupons. All of this happens before most people have had their first cup of coffee.
This information exchange allows me to manage my healthcare and realize the full benefits of interconnected health. This has high value, high utility and is where I see the marketplace going.
The Healthcare Wearable
Currently, wearable devices give us real-time, all-the-time access to data such as steps taken or calories burned. But it won’t be long before we perfect our data collection to include blood pressure points, blood sugar levels, or repository tracking such as with Propeller Health (shown). This is where healthcare wearables will become distinct from fitness wearables. The potential to someday prevent strokes or even heart attacks is real. Not only will we find healthcare wearables more common—it will soon be hard to imagine healthcare without them.
The current medical/regulatory model may need to move from paper and pencil to digital reviews. And we may need to begin incorporating “glance-able” reviews into the process. Privacy policies may also need to be revisited. Many companies are already hiring and training “privacy officers,” and the healthcare industry may need to consider adding this role as well.
To take full advantage of wearables, brand managers, MLR decision makers and agencies need to find ways to get messaging out the door as quickly as it can be produced. Pre-approved outlines or templates of content could be one solution, but we need more innovative thinking in this area.
Sensors and Sensing Technology
The introduction of the Apple Watch has the healthcare industry wondering if we’re finally seeing game-changing digital health technology. Sadly, we’re not quite there. It’s not that there aren’t great wearables on the market, but there is still a gap in taking these products from novel to clinical application.
This year’s CES brought us sensors that can read brain activity in a way that an MRI can’t (SenseLabs) and even a belt that monitors waistline measurements and automatically loosens and tightens depending on the wearer’s movements (Belty, shown). But it’s not so much the “wearable” itself that’s going to make a major impact in healthcare—it’s the sensors and sensing technology under the hood.
This technology has moved far beyond the wrist, and we’re seeing the emergence of “smart” cars that can alert you to a potential heart attack as well as home sensors that can track a person’s lifestyle habits. However, we need to understand that the output of this technology is adding even more information to the pile. The key is to make this information actionable.
To do so healthcare marketers need to find connected health devices that will change the game. The devices that are driven by human-centered design and, most importantly, answer the questions “Why?” and “What do I do now?” for consumers.
Compliance and Efficacy
mHealth will have groundbreaking implications for drug compliance and efficacy. Therefore, future pharmaceutical brand launches will need to include a data eConnectivity strategy out of the starting gate.
So for any prescription brand, the marketing team would need to establish all the biometrics that would best establish efficacy, then ascertain which mHealth devices, sensors or applications are best suited to capture those metrics. In the case of devices such as connected glucose meters (such as the Dexcom G4 PLATINUM, shown) regulatory approval would have to be taken into account.
Marketing then needs to determine how patients and their doctors, families and caregivers want and need the data presented to them for easy analysis and understanding. New drug launches could include branded mobile apps that can connect with the selected devices and apps for biometric capture. In the past, prescription branded mobile apps mostly consisted of limited value functionality such as reminder alerts to take medication and information around a condition and the drug brand. Providing an application that offers feedback to patients about how their bodies are responding to a drug and disease management routine would be far more valuable and encourage compliance which, in turn, would improve efficacy.
Apps for Smart Watches
Although the Apple Watch (shown) isn’t reaching consumers’ wrists as fast as planned, the smart watch is here to stay. And health and fitness applications show us why there are expected to be more than 100 million smart watches sold by the end of 2019.
Both the Apple Watch and Android Wear watches have sensors and health applications, but the Apple Watch demonstrates that, when designed well, the use can significantly enhance the health experience. However, while a bloated app or experience can sometimes get a pass on the phone if the user still gets value out of some portion of the experience—marketers have no such room for error on the wrist.
Marketers need to determine what functions of an existing app are easier to do on a watch. Then they should examine what functions can be done now on the watch that would not work on the phone. For instance, logging medication or activity fit naturally on the watch with the right interface. You can also display relevant notifications or messages and deliver content previews to draw them back to your app. As the possibilities continue to grow, marketers have a shrinking list of reasons not to have a plan for these devices.
The Intelligent Bra
Sadly, each year it is estimated that more than 220,000 women in the U.S. will be diagnosed with breast cancer and more than 40,000 will die, according to the National Breast Cancer Foundation, Inc. But what if wearable technology could help reduce the growing number of cases? While at SXSW, I came across a wearable that’s not yet available to the public but is positioned to be a potential game-changer in early breast cancer detection.
The iTBra (Intelligent Bra), by Cyrcadia Health, contains comfortable and intelligent patches that detect tiny circadian temperature changes within breast cells and communicates the data via smartphone to the Cyrcadia Health solution laboratory to analyze.
The iTBra is powered by predictive analytic software. Algorithms and neural networks identify and categorize abnormal temperature cellular-signaling patterns and behaviors in otherwise healthy breast tissue to deliver accurate, automated results to healthcare providers.
During SXSW, Cyrcadia Health partnered with Cisco to premier the trailer for “Detected” (bit.ly/1JEx209) an indie documentary film that followed the journey of this new player in the Internet of Everything space. This approach was perfectly suited to this product, not only to promote the iTBra, but also to have content that lives on and can inspire others to build life-changing products.
Wearable and quantified technologies can begin to focus on individuals and their needs to give patients, payers and professionals the information required to make informed choices. Consider how easy it is to find something on Amazon.com versus a department store despite Amazon having many times the choices. Through data integration with our lives, we will see fewer, but better, choices.
Leading healthcare companies will focus their attention as much on the behavioral context of living with an illness as on the biomedical context, if not more. Bio-psychosocial medicine will come of age as the data increasingly takes care of the “bio” and companies turn to the “psychosocial,” especially for chronic conditions. The leaders will be those that focus on the patient and design their support and adherence models around them.
Looking ahead, wearables will make the HCP-patient encounter more productive because less time will be spent “guesstimating.” HCPs will have less redundancy in their lives as data and decision support will help specify treatment and illness trajectories by enhancing, not replacing, the role of the HCP. Patients will also experience less redundancy as follow-up appointments will be driven by their personal responses to treatment rather than the current cadenced model.
Recently, Health 2.0 held a Meet Up in New York focused on digital innovation and entrepreneurial solutions in the mental health category. If you look at an underserved category like this, there is such an incredible opportunity to move beyond the obvious deficiencies in the massive array of existing pharmacologic therapies and leverage wearable trackers for cues and positive reinforcement.
A colleague, Craig DeLarge (www.linkedin.com/in/cadelarge), has done amazing work in this space to levy the application of innovative ideas and wearable technologies in the mental health category continuum. Current players in this space include “Muse,” a brain sensing headband (shown above); “Thync,” a wearable mood modification device; “Spire,” a wearable breath tracker that detects tension and anxiety (shown below); and “Psious,” a virtual reality psychotherapy also designed to help with symptoms of anxiety.
These types of alternative treatment approaches represent incredible complementary value, licensing and investment opportunities to more classic marketed brands. They also represent examples of how the world of disease and health management will blow wide open with alternatives to biochemical and biological compounds.