This is a guest post from Tom Giannulli, MD, MS, the Chief Medical Information Officer at Kareo.


It seems like everywhere you look you see someone with a wearable health tracker like a fitbit or (forthcoming) Apple Watch. According to a recent survey conducted by TechnologyAdvice, one quarter of adults are now using either a fitness tracker or smartphone app to track their health, weight, or exercise.

fitbit wearable technology
fitbit wearable technology

Despite growing popularity, the majority of people don’t use one of these devices or apps and cite lack of interest as the reason according to the survey. However, more than half said they would be more likely to use a health tracking app or device if it might lower their insurance premiums, and over 40 percent said better advice from their healthcare provider would be an incentive to use a fitness tracker.

So, the question for healthcare providers becomes, “How can these apps and devices be used to improve patient care and outcomes?”

One of the biggest challenges is finding a way to get the data into an electronic health record (EHR). Currently, these types of devices and apps don’t generally connect to or interface with EHRs.

This was the topic at a recent twitter chat where industry experts and healthcare consultants discussed how wearable technology will fit into the bigger picture. Everyone agreed that the whole industry has to get on board to make them really useful. Vendors need to look for ways to get the right data to the EHR in a way that can actually be used by providers while providers and payers need to look for opportunities to encourage patients to use them.

Moving in this direction will be critical if the wearables and health apps industry grows as expected. There are currently tens of thousands of these apps and devices, and the Robert Wood Johnson Foundation says this number will grow by 25 percent a year. Their research also shows that by 2018 1.7 billion people worldwide will download a health app.

In the meantime, there are some ways to use certain apps and wearables. Healthcare providers can “prescribe” apps for things like diet and exercise that are driven by a clear set of goals which are established by the provider and patient. For example, the patient and provider decide on a healthy goal weight or amount of exercise per day or week. Other goals could include target calories, target heart rate. Patients can report back data at appointments with no need for EHR integration.

For more complex conditions, simple apps and wearables are part of the solution, but need to be fed into a system where healthcare professionals can assist in decision making. Given the interdependency and potential life threatening complications between multiple chronic conditions, software alone is not a good approach. To avoid FDA scrutiny, devices and apps will not venture into the realm of clinical decision making, and in this scenario the need to feed wearable data into an EHR becomes essential to practical use.

Given the current environment related to wearables and EHR integration, it makes sense for providers who are interested in “prescribing” apps to spend some time looking at the wellness focused marketplace and get comfortable with the more popular apps. There are a couple apps that I like that help with tracking calories and exercise. They can help patients check calorie counts and store diet intake, and then use a fitbit or other activity monitor to look at calories burned. Lose It! is a good example of these integrated into a single app, as is myfitnesspal.

myfitnesspal fitness and health app
myfitnesspal exercise and diet app

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