Grandma is frailer and more forgetful than ever, and since Grandpa died, she lives on her own. But she’s not really alone: on her wrist is a watch-like band that measures and reports her vital signs to her doctor. It alerts neighbours and family if Grandma falls, tracks her location in case she gets lost, reminds her to take her tablets and provides her a panic button for the worst. Grandson, meanwhile, has a watch-like band that measures vital signs plus sleep patterns and exercise. He uploads these data regularly to a personal website, where he tracks his weight and health. This is the world of ‘medical wearables’, and these examples are only the tip of the iceberg.

Mostly monitoring, for now
Grandson and his like were the early adopters, starting about a decade ago. Today, bands like his, known as ‘fitness trackers’, are worn by some 600 million people worldwide, according to Statista.com. Numbers are soaring by 20-25 per cent each year, says Gadgetsandwearables.com, with 2017 seeing some 120 million units cross the counter. Grandma came more recently to the wearables trend, but ‘illness trackers’ (you heard it here first) also promise to become huge. According to a recent report by Julius Baer, close to 5 million people worldwide are currently home-monitored through a medical device. Illness trackers take on tasks such as diagnosing heart disease, monitoring asthma and supervising diabetics’ insulin intake. For now and the near future, trackers are mostly just that – body monitors – but in future they will broaden their now-small role of delivering medicine or therapy.

Make money to save money
A huge potential user base of device-wearers is certainly attractive to makers of illness trackers, but a far bigger prize will be earned by healthcare systems in general. Trackers deliver savings to healthcare systems: both in human labour displaced and in care-costs prevented through smart monitoring. According to Julius Baer investment specialists, remote patient monitoring alone could potentially lead to up to a USD 200 billion cut in global healthcare costs! Uptake of illness trackers might be less speedy than that of fitness trackers, however, because the former will be regulated on three fronts. First, medical regulators will want robust proof that illness trackers do what they promise. Second, healthcare regulators will need to integrate trackers into billing and insurance systems, just as drugs and therapies are now integrated. Without this infrastructure, says Waqaas Al-Siddiq, founder of tracker-maker Biotricity, doctors will not be inclined to prescribe them. Finally, privacy regulators would need to allow enough flow of sensitive medical data. There are serious concerns, says Al-Siddiq, “among users, medical professionals, and the health technology community that this information could end up in the wrong hands.”

More than a patch
Illness trackers monitor, diagnose, guide and maybe even treat patients, up-to-date, on-the-spot and all-the-time. Just one example is ‘ambulatory arrhythmia monitoring’. When it was invented in the 1940s, irregular heartbeats could be monitored on outpatients – all they had to do was to strap on a 35 kg backpack that included a tape recorder and a cardiac sensor. Of course this was a step up from spending days or hours in a hospital or doctor’s office hooked up to a machine, but today all has been miniaturised and automated to the point that it’s almost unnoticed. Users wear a ‘patch’ – about the area of a normal plaster, but 1 cm in height and weighing some 20 g – that monitors the heart over days or weeks, and reports back to the doctor. It saves labour, it saves lives and it saves money: according to Cardiac Rhythm News, USD 23 000 per patient in medical bills.

Prescription clothes
The long game here is what Julius Baer specialists call ‘digital health’, which will deliver better results at less cost than today’s healthcare, and where wearables, alongside population health management and value-based care, will play a key role. The ultimate appeal of wearables is their invisibility, their inconspicuousness. “People generally don’t like to actively participate in monitoring their health,” says CEO of Misfit Wearables, Sonny Vu. He sees a future where trackers are built right into otherwise normal clothes that are washable, affordable – and medically approved. Next thing you know, Grandma and Grandson might buy their wardrobes not online nor at a high-street shop, but at the local pharmacy.