Is the wearable health revolution over, or only just beginning?

It’s human nature to think that your own unique experience is the definitive one. With that in mind, I believed most fitness-tracker owners treat them as I do, minus the indecisive switching with each new review.

That is to say, they charge them, wear them, and get a brief glow of satisfaction when the wrist buzzes to tell them they’ve hit their step goal, but mostly just go about their daily business as usual. Fitbit tells me that on average I walk 8,998 steps per day – which is great, but that’s chiefly because if I walked fewer than that I’d not get to work, earn any money or be able to afford food. Ironically, this would do more for my weight than wearable tech has to date, but I don’t think anyone would consider this a healthy lifestyle.

It’s clear that’s not the case for everyone, however, and this morning I attended an interesting panel discussion on the future of healthcare and wearable technology, hosted by Fitbit. The panel was made up of Hugh Thompson, health co-ordinator at Fulham Football Club; Amy McDonough, vice president and general manage for Fitbit group health; The One Show’s GP, Dr Sarah Jarvis; freelance journalist Katherine Templar Lewis; and former Olympian, Professor Greg Whyte.

The first thing that was almost universally acknowledged was that wearables aren’t for everyone. That may seem self-evident, given that not everyone has a Bluetooth doohickey on their wrist (McDonough gave estimates of around 15% in the UK and 25% in the US), but the point actually goes deeper than that – some people just won’t ever see the benefits. They’re not of the right mindset to benefit from wearables’ unique attraction. Jarvis acknowledges that, but says that she can see a real difference in her patients who “get it”. “The people who do engage, about 40-50% of them are still using them six months, a year later,” she explains.

Competitive element

Fitbit has a number of tricks up its sleeve to hook people into healthy living. Some people will be drawn in by the sense of achievement unlocking another badge on the profile brings, but others thrive on the competition. “Just by having a friend on the Fitbit ecosystem, you’re likely to have 11% more steps every day,” explains McDonough.

This sense of competition was harnessed by Thompson, who oversaw a steps challenge among football fans. “We’re still tracking them, and they’re still using the wearables, still having the competition element,” he explains. The NHS has seen the evidence and is backing the health kick, signing up another eight clubs to the trial. “We’re talking about stereotypical people – Strava’s not for them, they’re not going to go to the gym, they’re not getting a PT [personal trainer]. We’re talking a small behavioural change to get more active, influence their family and think differently about prevention of ill health.”

This may sound like a small impact, but a lot of small impacts can make a huge difference to squeezed health budgets. Jarvis points to a study from many years ago that found that with two-and-a-half hours of tailored supervised exercise sessions every week, a motivational interview and two dietician sessions per month, after four years, subjects were 58% less likely to develop type 2 diabetes. Ten years later, that has only dropped to 34%. When the study was written, this would have accounted for a lot of expensive doctor hours for the admittedly impressive results, but nowadays every single aspect of the nudging can be handled and monitored by a fitness tracker. A doctor would need do nothing other than set the plan.

A fitness tracker prescription?

So, does this mean that wearables have a future on the NHS? Fitbit already has a deal with some insurers in the US where patients can earn back $4 per day by completing 10,000 steps and doing 30 minutes of active exercise, meaning that over a year they can be $1,460 richer, as well as feeling fitter. “Are we going to replace your GP? Absolutely not,” says McDonough. “But can we provide data so that the time you have with your GP can be spent more effectively? I think that’s where it’s really going.”

Jarvis, herself one of those GPs not facing replacement by a wearable, is keen on this idea. “I’d love to see the NHS have wearables that they can give out in pilots to see who engages. Get them onboard and say ‘right, if you keep wearing this, then these are the benefits’ – and maybe provide them, because actually I think it would be cost-effective, almost certainly. But for those that didn’t engage say ‘okay, we’re not going to dump you now because you didn’t engage with that, let’s look how we can tailor our advice.’”

Whyte agrees that this isn’t a one-fits-all solution. “Inactivity is an incredibly complex problem – we’re not going to give out Fitbits on the NHS and find everything’s fine.”

But as part of an overall strategy, it certainly can’t hurt. “Preventing ill health is what we should be aiming for. I think that comes from empowerment, and for me wearable tech is one part of that jigsaw,” he explains.

Suffice it to say that as jigsaws go, the health of a nation in the midst of a full-blown NHS crisis is like one of those intricate 20,000-piece puzzles with infuriatingly similar-looking pieces. But if money-saving and getting more for less is the order of the day, perhaps wearable technology has only just begun its journey into our wellbeing. In the future, the NHS may increasingly welcome assistance in its mission to see the general public from cradle to grave – and if fitness trackers are a cost-effective assistant, then what’s to lose?