The Apple Watch was launched in March to much fanfare in San Francisco and is now on sale in the UK. Apple hopes that its Watch will change attitudes to wearable technology and prove to be another big commercial hit for the company that brought us the iPhone and iPad. But the Apple Watch may prove to be more than just the latest “must have” gadget: Apple’s CEO Tim Cook described it as “a comprehensive health and fitness companion”. Insurers in the Life Sciences sector may look back on 2015 as the year when consumers’ use of their own clinical data changed for ever, with as yet unpredictable consequences. We look at what insurers should do now to limit the risks posed by the public’s increasing enthusiasm for wearable health technology.
Apple keeps the doctor away
Clinical information harvested by wearable devices includes heart rates, activity levels and sleep patterns. The Apple Watch uses its built-in accelerometer and heart rate sensors, in tandem with GPS on an iPhone, to track motion and provide a user with feedback on their fitness levels. If that is the extent to which Apple Watch and similar devices will be used for health reasons, then insurers need not be too concerned.
However, Apple has announced that apps will be able to measure activities and use risk factor information to evaluate the user’s lifestyle and how it relates to key health indicators, such as cardiovascular health, cancer and Parkinson’s. According to Apple, this information will be provided to researchers “empowering people to participate in and contribute to medical research”. Apple has made it clear that the intention is to benefit the research community and that data will be protected. It is, though, possible to imagine how technology-savvy consumers may use this information, in tandem with software that drills into the raw data collected by such a device, and draw their own conclusions on lifestyle and propensity to suffer serious conditions such as heart attacks. Devices are even said to be in the pipeline that will allow a smartphone to take ultrasound images of a user’s heart or abdomen.
Activinsights, a UK company supplying wrist-worn monitors for researchers, already manufactures wearable devices which generate reports for doctors on their patients, covering physical activity, calorie expenditure and sleep patterns. Doctors use Activinsights’ data to treat their patients. It is not too fanciful to speculate that consumers might follow this approach but cut out the doctor, diagnose themselves and put themselves on a treatment plan.
Doctor Google will see you now
In recent years, individuals who have noted their own symptoms, or have read about a worrying condition, have searched the internet for answers and attempted to diagnose themselves. There is little risk for suppliers or insurers in this if the member of the public then takes the findings to a doctor for a discussion. This already happens where people read about health scares in the mainstream media, or medical alerts generated by the UK’s Medicine and Healthcare products Regulatory Agency (the MHRA). This is part of the dissemination of information in the internet age. But the concern for manufacturers of health-monitoring devices is the risk lurking in the unpredictable nature of worried people. Faced with long waiting lists or a doctor who appears unsympathetic, an individual might rely on the smart device data, self-diagnose and try to self-medicate. Smart devices could fuel a demand for prescription-only drugs available illegally on the internet as users seek treatment based on the information fed to them by their new gadgets. Alternatively, inaccurate data or an incorrect self-diagnosis might give false reassurance and so lead to avoidable injury.
Insurers should watch out
Consumers who are unaware of the potential consequences and implications of using unfamiliar software may blame the manufacturer when something goes wrong. The key for insurers of wearable devices is to communicate where responsibility lies for acting on the information generated by the product. A gadget is unlikely to cause injury on its own: the risk lies in a consumer acting (incorrectly or unwisely) on complex health data.
Insurers should consider working with manufacturers to ensure that the following steps are in place before a product that collects clinical data, and offers the user the chance of interpreting it, is brought to the market.
- Manuals: The literature that accompanies the product should set out the limits of the data for diagnostic purposes, emphasising the need to exercise common sense.
- Disclaimers: The literature should warn against predictable, but unreasonable, uses of the product, for example members of the public choosing to self-medicate based on readings from their device.
- Marketing: Suppliers should not let their marketing and sales departments make unsustainable promises. Promising a consumer that they will be able to use their device to see less of their doctor should be avoided.
- Third party software: Care should be taken if third parties are permitted to develop programs that interpret clinical data taken from the device. Manufacturers should be comfortable with the nature of the medical “advice” provided by an app.
- Regulatory: Specialist advice should be taken to determine whether a product would be considered a medical device and so subject to regulatory oversight; this is particularly the case where a device is designed to assist doctors with treating particular conditions.
These are exciting times for consumers who are eager to buy the latest wearable devices, download apps and access data on their health, which until recently was the preserve of clinicians. This is good news for the balance sheets of companies that manufacture these devices but their insurers should watch out.