Across the U.S., wearable devices are worn by roughly 10% to 20% of the population, with projected increases in use each year. Most devices offer tracking of parameters such as steps, heart rate, sleep, and calories burned. Though there is great potential for their use in health monitoring, little is known about the role wearables play in current care delivery models, and even less is known about their use in perioperative optimization and monitoring.
In this article, we discuss the current use of wearable devices in health care and review recent studies examining the role of wearables in the urologic surgery setting.
Google has recently joined forces with Stanford University and Duke University on Project Baseline, a study seeking to enroll 10,000 participants to wear a proprietary wearable device that measures heart rate, steps, movement, and electrodermal activity. With this, researchers aim to establish baseline health characteristics across a wide spectrum of the population (ages 18 to 80 years) as well as understand how different activities and health events affect the wearable data (www.projectbaseline.com). Studies such as these will be transformative in understanding how to implement wearables in health care.
Use of wearables in surgical patients, particularly those undergoing major surgery, poses some unique challenges. Current trackers are adept at recognizing and recording step and movement data; however, after undergoing major procedures, individuals don’t move as purposefully as prior to surgery, with gait patterns often becoming more shuffled. Current trackers aren’t tuned to recognizing these subtler movements and likely understate postoperative activity. This has led to the development of more surgery-specific activity trackers, though their testing remains unreported and none are commercially available.
Heart rate monitoring has become a standard feature on nearly all wearables on the market today. This is clinically useful as heart rate acts as a surrogate for a number of common postoperative complications such as dehydration or infection. For this reason, many of the wearables designed for patient monitoring focus their capabilities on heart rate monitoring, such as VitalPatch by VitalConnect (figure), which is an adhesive wearable patch worn over the heart. It is designed to identify cardiac arrhythmias in addition to respiratory rate, skin temperature, steps, and fall detection.
The potential that heart rate monitors have for early detection of illness was made manifest by a Stanford study of 43 individuals who wore activity trackers for 11 months. The study showed they were capable of detecting heart rate aberrancies 48-72 hours prior to reported episodes of illness and was the first to suggest wearables may be capable of early detection of illness (PLoS Biol 2017; 15:e2001402).
Next: Wearables in urology