Google, Fitbit, and Apple produce health-related devices that operate well, however, according to physician Dr. Jeffrey Wessler, unless they target consumers, their clinical impact will be minimal. Why? Because it’s consumers who can truly benefit from small randomized clinical trials, increased exercise, and linking a health tracking device to doctors. By so doing, millions of lives could be saved a year.
Meaningful Clinical Impact
Dr. Wessler, who is a Columbia University Medical Center cardiology fellow and creator of preventive cardiology company Heartbeat Health, says that over the last decade he’s seen thousands of people with severe heart conditions. These range from arrhythmias, to heart failure, heart attacks, and more. He has also witnessed a burst in the production of novel consumer software and gadgets for health by mega tech companies like Fitbit, Google’s new Fit app, and the Apple Watch. However, he believes they won’t have much meaningful clinical impact.
Target Those Who Need It
If these major companies wanted to easily create solutions with real clinical benefits, there are three major ways they can do so without having to wade through loads of regulations.
3 Ways Google & Apple Can Create Solutions
Firstly, they could offer these devices to consumers who would benefit most from them. If they targeted interventions for particular people at a higher risk of specific outcomes (e.g. heart disease), they could provide them with a chance to survive, for example, by increasing their exercise. These commercial organizations clearly want to make a profit, so they could team up with insurance cos. and offer subsidizations for specific patients on condition that there is an evident benefit clinically. Apple, for example, has looked into doing so with US health insurance co. Aetna.
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The second way to achieve real benefit is to conduct a controlled randomized trial comparing outcomes of those who use the device and those who don’t. The trial is the foundation for producing data in clinical practice. Showing enhanced outcomes in a trial group of people using the device in a particular way, will prove to clinicians and patients that using the device can improve health.
Thirdly, the device should be linked to a doctor. Many of these devices are excellent in their capacity to identify when a person needs help — dipping levels of activity, irregular variations in heart rate, or low levels of oxygen. So, to truly help the user, they should be directed to getting the correct type of care, in the correct place, at the correct time. In this way the outcome might be timely diagnosis, suitable management, and enhanced results.
Starting Small
Should Google and Apple really want to make a change in the outcomes of healthcare, they should change their done-to-date business models for their devices, yet take it slow by starting small.
In the early 70’s the kick-off randomized trial for aspirin was piloted and included 1,239 UK men who’d had a heart attack. Currently, more than 40 million people in the US alone take aspirin daily, cutting the number of heart attacks by around 20 percent.
Now, if Apple and Google chartered a similar path — i.e. chose a high-risk populace to test drive their devices, ran a controlled randomized clinical trial, and provided a distinct path that linked patients most in need with the right care — the outcomes might be enormous. If they aren’t, it’s time to move on to the next great idea.
