A brief history of medical wearables- Ed Bauter

A Brief History of Medical Wearables

Ed Bauter

            Last week, Apple held their annual September Event, and true to form they introduced new products and materials that had the internet all abuzz. Now, in the interest of disclosure, I write this from an Apple laptop while periodically purusing Instagram and Snapchat on an iPhone, that sends notifications to my now-obsolete Apple Watch, so I was a little excited about this event too. At any rate, Apple did what they always do and introduced updated products for the teeming masses to buy before the holiday season. The products seem okay, typical upgrades you’ve come to expect every year. But there was one particular addition that had the social media EMS world all a tizzy: Apple watches will now perform rudimentary EKGs and advise the wearer that they have A-Fib or another tachydisrhythmia, and will use the accelerometer in the watch to note mechanical falls. Now, before we get too far into this, it’s important to note that this “new” addition, is not new at all. Apple watches have been capable of determining EKGs for at least two years.  But that’s not the point. 

            Whenever new technology is developed and introduced into the EMS world, there is a predictable backlash from providers with complaints that range for the extraordinarily valid to the patently absurd. In any case, it seems that wearable technology is here to stay, and as providers it would likely be in our best interests to welcome the changes and do what we can to further patient care using this tool. As it turns out, wearable technology isn’t really that new. Let’s explore, shall we? 

Leonardo Da Vinci “invented” the pedometer

            In the late 15th Century, inventor, painter and all around literal renaissance man Leonardo Da Vinci conceptualized the first pedometer. His plan was to track the steps Roman soldiers took and determine how many steps the soldier would take over a certain distance. Does this sound familiar to you? Yeah. Da Vinci was rocking a Fitbit before Fitbits were things. Drink that in. (He never really wore one, he just had the idea first.)  

Thomas Jefferson wore the first pedometer

            Yes, that Thomas Jefferson. While walking through the streets of Philadelphia, and later at his home in Monticello, Thomas Jefferson never stopped his pursuit of knowledge. Jefferson was someone who loved to measure things. So, after the tools were available to make a measurement device to track his steps, Jefferson went about making the first pedometer. He took so much pleasure in this device that he sent one to James Madison in 1788 with instructions on how to customize it. 

So What About Modern Day Wearables?

            We’ve all become somewhat accustomed to medical wearables, and we may not even have realized it. Technology tends to move very fast, and we sometimes can miss evolution happening right in front of our faces. Today, we take hearing aids for granted, but we forget that this almost ubiquitous wearable was introduced in the 1940’s. That’s not even counting analog hearing aids (ear trumpets) that can be seen in some archival films and photographs. So, we see that wearable technology tends to be produced, the population gets nervous about the new technology, and eventually we accept its presence as an inevitability. So it goes. 

What Could the New Apple Watch Mean For EMS? 

            Well, that all depends. It’s impossible to know what apps will be developed over the coming years, and it’s certainly not predictable how reliable the technology is, or where it will go. But something that should be food for thought for all EMS providers is that this is technology that is not going away. We can choose to move ahead with it, or we can choose to be left behind by it. The reality of the situation is that patients that have these devices, and especially those that are no accustomed to such technology, will probably overuse the alert system in the watch. That means that yes, there will probably be more people calling 9-1-1 because their watch told them they were in A fib when it really reading artifact. Or the watch will alert the wearer or a call center of a mechanical fall when the watch was just dropped or misplaced. These things happen. It’s something we’ll have to accept. 

Fine. But I still don’t like it. 

            That’s okay. When new technology, procedures, or protocols are introduced it’s natural to feel anxious about the learning curve that’s associated with them. There will be people in the field who don’t know how to interpret the data that’s been presented to them (looking at you, automated blood pressure cuffs), but I think that in the long run, we’ll all be better for this technology. Remember, the technology that’s out now is only in its infancy. Think of the changes to patient care that Holter monitors provided. What’s more, thinks back 20 years ago before wearable VADs were a thing that people had. Now, I don’t mean to compare the humble Apple Watch to a VAD, certainly their impact on health care will not be the same. But the tacit comparison remains. Better technology is just that. Better. 

            As it is, the more technology we see, the more technology we’re going to see. That genie is out of the bottle. As I said, we can accept it and move on with it, or we can reject it and get left behind with all the other dinosaurs that refuse to adapt to change. I’m sure we’ll all complain when we get dispatched to “Another Apple Call”, and that might be frustrating from time to time. But, think of the long game. Consider that as this technology develops, our patients might actually be better for it, and we might actually see improvements in primary care and in long term outcomes. These are all good things. 

            In the meantime, I’ll be anxiously awaiting the development of the flying cars I was promised would exist in the year 2000.