Prescribing wearables

Exciting opportunities arise in the ­healthcare sector for wearable technologies and Dr Maloof is guiding companies in these uncharted waters. A look at the present and future of wearable technologies in medicine.

Molly Maloof, M.D. posesses a unique blend of know­ledge. She stands at an exciting junction where consumer technology meets medical science. Beside her medical career, she is an entrepreneur, strategist and health technologist, not to mention keynote speaker, who consults technology companies in Silicon Valley on the use of wearable technology in medicine. More and more companies are starting to see the potential in this area, providing a fertile ground for Dr Maloof’s ideas and vision. “Future Marktes. Discovered Today” spoke with her about the current state of affairs and where the future lies.

What role are wearables currently playing in medicine, and what will they be capable of in future?
Molly Maloof: When I first started getting involved in wearable technology a few years ago, the available devices on the market were mostly just for wellness and fitness, because those areas are much less regulated than those of medical devices. But what’s happening now is that companies saw this gigantic opportunity with half the people in America having either diabetes or pre-diabetes. Also there are a lot of people with high blood pressure. So now companies are rushing to develop technologies that would report metrics that are clinical; like blood pressure monitoring. We are going to see a big shift towards chronic disease management. It will take some time before they are approved by the FDA but I believe in the end, these technologies will become commonplace in medicine.

How do you see the timeline for this?
M.M.: As patients start getting their money back from insurance, that’s when this becomes a real thing. Oscar Health Insurance based in New York gives a Misfit wearable to every new client, and it tracks your steps and your sleep. I see this as insurance companies realising that wellness is worth investing in. There are companies that do chronic disease management through tracking. There are also companies just for hosting data and connecting it to the doctors. So once all these little pieces get put together and it is possible for doctors to get paid for looking at the data, and the data is easily made accessible for both the peers and the caregivers, then the healthcare system will take notice.

You have created a new business area with a holistic approach using medicine and wearable technology. How is the feedback from your patients?
M.M.: It is the early adopters who like this the most and athletes tend to adopt it first, but I think what most people are looking for is a doctor who cares, so if there is one more data point where I can give them guidance on, they are happy for the feedback.

So the chronic patients will come later.
M.M.: The chronic patients will come when the insurance companies start paying for these monitoring methods. My clients are generally healthy, but I do have some patients who have high blood pressure and I prescribe them the Withings blood pressure monitor. We will also see little kits with wearables that get prescribed for specific problems. I am predicting fertility kits that get sent to your home, with luteinising hormone testing and wearable temperature monitors. With the guidance of doctors and the help of these digital health platforms, you will make better use of your information. Companies are focusing on specific use cases such as diabetes and pregnancy. When they can demonstrate that this is an effective and affordable option, the insurance companies will start paying these companies to deliver the prescription.

What wearables are you using currently?
M.M.: Pebble, because I recently started consulting them on this technology. I use a Withings scale. Thync is another one that boosts your energy or reduces your stress with neurosignals transmitted directly through your skull.

Where do you see the financial benefits of wearables in medicine?
M.M.: All these technologies give you metrics that you can use to change something, but it is down to the individual’s motivation to stay healthy. I don’t think these replace the doctor or the experience in the clinic but they can amplify it. They can go home and track their health, providing more data for the doctor to back up their decision-making. I think the first big hits will be in diabetes, with packages for monitoring glucose, weight and excercise, all of which are really important for controlling the blood sugar.

What is your advice for companies developing wearables for healthcare?
M.M.: Don’t be afraid of regulation and don’t be afraid because it is a medical device. If you develop a clinical device, once you are approved by the regulatory bodies, you will see real success. Once you have data to prove that your device is making a difference in a person’s health, look for ways to get approved so that your technology is paid for by the insurance companies instead of by the patients.

Do you think it will raise data protection issues?
M.M.: I think technology will do more to protect this data than the regulation will, but it also has to be compliant.

Before we go, we would like to ask you about your dream product. What would be the ideal wearable for you?
M.M.: It would probably be a wearable technology that does not only measure my vital signs, but also my glucose and my heart rate variability, because there is a huge interaction between stress and blood sugar balance and our blood pressure. When our stress goes up, our heart rate and blood pressure go up and our rhythm is out of sync. The more chronically stressed we are, the more we crave carbs and see big glucose spikes. We only notice this in hindsight. So if a technology can warn us in the moment, make us aware of the stress, that would be really cool. It doesn’t exist yet, because the sensors are not quite there yet – but we are getting there.

(picture credits: Molly Maloof MD)

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