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How Wearable Devices are Improving Clinical Outcomes: Q&A with Fitbit’s Amy McDonough

Published on 8/22/2018

Wearable health and fitness technology has exploded in popularity with consumers – and now, the health care industry is beginning to see an opportunity to integrate the devices into the continuum of care.

As a leading global wearables brand, Fitbit designs products and experiences that track and provide motivation for everyday health and fitness. In a recent episode of The Cerner Podcast, we welcomed Amy McDonough, the chief operating officer of Fitbit Health Solutions. She discussed the real impact that wearable technology can have on patient outcomes and where connected devices are heading next in the industry.

How wearables benefit employers and employees

Let’s get a sense of wearables today: What are some of the benefits, both for individuals and for companies, who incorporate wearable devices – like the Fitbit tracker – into a wellness routine or program?

The wearable industry has evolved a lot in the past 10 years. Devices that initially just counted our steps really track so much more now – activities, heart rate, sleep – all happening seamlessly and available automatically to consumers right on their wrists. This allows consumers, oftentimes employees, to take better control of their own health. They’re able to proactively know their numbers. Heart rate, for example, was pretty inaccessible a couple years ago, unless you were willing to wear a chest strap. Now this information is available right on your wrist, so we’re really taking charge of our own health for the first time.  

For employers, I think there are much greater benefits even. We’re able to see trend analysis, real-time results and real-time data from employees who choose to share that data, and then make educated decisions that are personalized to specific organizations depending on the trends that they’re seeing.

The role of wearables in health care consumerism 

The rise of consumerism in health care has led to increased focus on emotional, meaningful patient interactions, especially as consumers have higher expectations around technology and the health experience. Where does wearable technology sit in the continuum of care, considering the consumerization of health care?

Consumerization is really the exciting area where wearables have a unique use case. Again, back to the proactive nature of these devices – where these tools reside in the health care experience is still so broad. Wearables allow the user to have access to health data, but there’s also a big social piece to this puzzle that didn’t exist a decade ago. We actually see a great deal of activity stemming directly from the social-sharing functionalities of wearable devices. People take approximately 700 more steps per day when they have a friend on their network. People who participate in challenges with others average more than 2,000 steps per day. Social ecosystems, like the one Fitbit introduced about a year ago, are making an impact. We see 20 million active users on that.

These are creating meaningful interactions and connecting patients with their care teams – their practitioners, their nurses, their health care coaches – to help them manage their conditions. We believe Fitbit sits across this entire spectrum to help the individual take charge of their health, but now more than ever, wearables are creating even more meaningful interactions within the health care experience. 

Improving outcomes with health and fitness technology

Fitbit Health Solutions has positioned wearables as a legitimate tool for improving clinical outcomes. Can you discuss some of these results? How can clinicians and hospital leadership leverage wearables to improve patient outcomes?

This is an area where we believe Fitbit is making incredible strides. Many of the studies that we have take on an employer wellness perspective –  that is, working with employee populations on general wellness and population health. The first study looks at the Greater Dayton Regional Transit Authority and their bus drivers, who are forced to sit all day. They really wanted to empower these employees to get regular active exercise and take charge of their health. In the program that they rolled out, in which they incorporated Fitbits, they saw a 17-point average drop in glucose levels and a 12-point drop in LDL cholesterol, which is a bad cholesterol. People were able to see meaningful results in their population, which led to health care costs savings.

A study of a very different organization with similar results was centered around Indiana University Health, a hospital and health care system. The ironic part to me is that you often see health care systems where employees are taking great care of others and yet they forget to take care of themselves. In this population, which spanned multiple hospitals, they said 40 percent of their participants decrease their body mass index through a walking program enabled through Fitbit, and 60 percent of participants with diabetes were able to decrease their hemoglobin A1C levels. In both cases, we saw really meaningful results, both in cost savings and in health care outcomes.

One last program I would like to share regarding hospitals systems is our recent work with Cedar-Sinai Medical Center in Los Angeles. Hospital administrators were looking to improve post-op recovery success rates, specifically with hip and knee replacements. If they could get their patients to get up and take about 1,000 steps per day, they found their recovery was much more successful and their discharges were often much faster. We’ve seen many examples like these where wearables have driven meaningful outcomes, offered a higher return on investment and improved cost savings. 

Delivering insights through data access

Let’s talk about data collection and access. When it comes to working with hospitals and health care systems, how does Fitbit integrate data into the clinical record?

We believe this area has a tremendous opportunity for growth. Fitbit has an open application programming interface ecosystem, so we are able to share data with the consent of an employee, member or a consumer, as we call them. These individuals are able to share activity data with their care teams and within other applications that support their journeys to health. In addition to this, we do integrate with electronic medical records and electronic health records, and we’re excited about this opportunity as we see it as a chance for growth. We have the ability to make meaningful and personalized data connections that will make a difference, not only for the consumer, but for everyone who is helping on that path to care. My physician might not care whether or not I walk 10,000 steps on any given day, but they will care if my activity levels drop off significantly, or if my weight changes drastically, or if I stop sleeping well. These are things that can be shared through a clinical record to better shape proactive health measures. 

How wearables can shape care experiences tomorrow

There’s a lot of potential for Fitbit Health Solutions’ growth in the health care market today. Can you give us a sense of the company’s direction? What are some opportunities you’ve identified, and where do you think the market is heading?

With the acquisition of Twine, we see a big opportunity for us to help across the continuum of care. Our health solutions division is really working to improve employee engagement and retention to develop excitement about these technologies, but we’re also looking at health care cost savings and improved outcomes. I think opportunities for improvement in the future will really be centered around continuing the work we’ve been doing in partnering with health plans, with employers directly and with health systems to help improve the metrics that we’ve been talking about. We need to be sharing valuable data, providing social opportunities and to meet consumers where they are to personalize their journey to health. 

Sharing data is foundational to Cerner's patient-centric interoperability. We're focused on strengthening patient experiences and clinical workflows. Learn more about how our innovative, open platforms can strengthen scope and services across the continuum.