Health technology has made significant gains in recent years, especially in the wearable technology space. Watches in particular have multiple health features that can impact modern healthcare. These smartwatches are a developing area of interest in functional medicine. A smartwatch is a wearable that can track heart rate, sleep, temperature, exercise, and blood oxygen levels. In some cases, these watches can take an electrocardiogram (ECG). There is also ongoing research about the use of these devices in detecting tremors and seizure activity. Smartwatches can give individuals agency in their health by providing data and ongoing monitoring of health metrics.

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Overview of Smart Watch Technology

Features of smartwatch technology are evolving rapidly and this sector of the marketplace is slated to continue to grow. The first digital watch was released in 1972, and significant advances have been made in the last ten years. There is also an option to use wearable technology (WT) in ring form. These wearable fitness trackers range in price and technology sophistication. Even the most basic and affordable models can provide valuable information for patients and providers.

Most smartwatches can track heart rate, including heart rate variability. The user can track their resting heart rate, and heart rate during exercise, and may be alerted when their rate differs from their normal patterns. These devices can detect fitness levels through heart rate variability, including how quickly an individual's heart rate recovers during a fitness effort.

More sophisticated wearables can perform an electrocardiogram, which can be a very helpful tool for patients with cardiovascular conditions. Sleep is also a metric tracked by WT. Many people do not get enough sleep or have more significant sleep interruptions than they realize. Accurate data about sleep can help individuals make behavioral modifications or seek medical help if needed. Physical activity is tracked by smartwatches and rings, including steps, stairs, and workouts.

The Role of Smart Watches in Functional Medicine

Real-time data collection in functional medicine can be used for motivational interviewing, setting goals, and tracking progress. This monitoring can be used to establish a baseline for a patient’s overall health and activity level. Additionally, this information can allow the patient and functional medicine provider to assess and make a plan for enhancing their overall health. The patient can then track their progress, as well as send data to their care team. Increasing steps is an example of a health metric that can be monitored by wearable technology. The provider can assist the patient in making a daily step goal, and they can both monitor progress over time and follow up on the intervention. Ongoing research has shown that wearing these devices can be a helpful and accurate way of measuring physical activity. Seeing progress detected by physical activity tracking may increase patient compliance with fitness interventions. An additional benefit of real-time data collection is fall detection and the ability to make an emergency call. Wearable technology can be very useful in the elderly population in not only monitoring activity but also providing a way to detect falls.

Monitoring Vital Health Metrics

Monitoring health metrics with smartwatches provides more information for patients and providers than was previously available. One example of a valuable metric is heart rate variability. Heart rate variability can be a measure of stress and fitness and is influenced by activity levels, sleep, and diet. From a functional medicine perspective, ongoing monitoring of an individual's heart rate variability can provide insight into whether a patient needs to rest more or change the intensity or duration of their physical activity. Resting heart rate measurements through WT can help determine an individual's fitness levels and stress levels. Significant vacillations in heart rate may help a provider decide whether a patient should be tested for heart rhythm abnormalities or cardiovascular disease.

The importance of high-quality sleep in overall health cannot be understated. Many people do not get enough sleep or have interrupted sleep. It is recommended that adults get a minimum of seven hours of sleep per night, but more than 25% of adults fall short of this target. Watches that track sleep duration and quality can be a valuable tool in assessing a patient’s sleep, as well as tracking progress toward improvement. In a recent study, sleep data plotted by a smartwatch and a popular smart ring were accurate and correlated with formal sleep testing. This shows promise for WT as an accurate assessment of sleep. In a functional medicine setting, a provider could assess a patient’s baseline sleep habits, make recommendations for improved sleep, and evaluate data from wearable technology in a follow-up visit.

Chronic stress can be detrimental to many aspects of health and its reduction can improve overall well-being. Wearable technology can detect and track stress over time by assessing resting heart rate and heart rate variability. In some cases, an EKG is taken via watch to assess for high heart rate and rhythm changes that may indicate acute stress. If an individual is experiencing high-stress levels, the functional medicine provider can work with them to integrate relaxation and mindfulness, improve sleep, and optimize nutrition. Many popular watches can also remind patients to perform a breathing exercise if a high heart rate is detected.

Enhancing Patient Engagement and Compliance

Smartwatches and patient engagement are an interesting area of behavioral analysis. For many patients, seeing real-time data about their habits and progress can improve motivation. Smartwatch prompts to exercise, meditate, take medication, and start a bedtime routine can help promote adherence. Most fitness trackers and wearables provide progress tracking toward daily goals and positive reinforcement when goals are met. Both of these features encourage maintaining a healthy lifestyle. There is increasing interest in the role of wearable technology and rehabilitation after orthopedic injuries and surgeries. Many surgical interventions, such as rotator cuff repair, require detailed adherence to rehabilitation. Smart watches can help providers track adherence to exercise regimens to promote recovery.

Data Analysis and Interpretation

Interpreting smart watch health data can help functional medicine providers tailor recommendations for their patients, rather than making a treatment plan based on generalizations. Providers can utilize resting heart rate, heart rate variability, steps, and physical activity data to build a picture of a patient’s overall health. They can then use this baseline to make tailored, achievable goals for the patient. The data collected by the wearable could then be discussed at a follow-up visit to assess progress. Smartwatches also can provide prompts to take medication or supplements which could be assessed by providers at follow-up visits. Data about cardiovascular health, in particular, could be integrated with other clinical assessments to form a treatment plan. For example, resting heart rate, EKG results, and heart rate variability data from a wearable can complement other assessments such as blood pressure and cholesterol assessments. All of this information could be used to compile a comprehensive treatment plan and monitor progress. Information about activity levels from WT can help a care team compile a plan for treating obesity and preventing metabolic disease.

Some smartwatches gather information about body temperature and menstrual cycle regularity. This information can be used, along with other assessments, to evaluate fertility and hormone balance. Changes in basal body temperature (BBT) detected by wearable technology can provide information about whether or not ovulation has occurred. This data can be used by providers to assess the hormone health and fertility of a patient.

Sleep information can provide insight into patient reports of fatigue or mental health concerns. Patients may report that they get enough rest, but data from wearables can provide more objective data about sleep quantity and quality.

Privacy and Data Security Concerns

Data security with smartwatches is an important consideration, especially when patient health information (PHI) is being discussed. Patients may be reluctant to share their health information unless it is properly encrypted. If PHI from a wearable is being shared with a provider, it should only be transmitted via encrypted communication. This may include secure patient portals and encrypted email. It is recommended that patients and providers only transmit and analyze sensitive data on secure, password-protected networks. It is also best practice for patient devices to have passkey protection and only use secure Bluetooth transmission.

Challenges and Limitations

Challenges with smartwatch technology include accuracy concerns and the possibility of data misinterpretation. There is some variability among devices regarding the accuracy of data. Step counts, for example, may be higher or lower depending on the device. Most data gathered by a wearable health device can be utilized as long as it is generally accurate. However, certain parameters need to be sensitive to avoid false alarms. Measurements with little room for inaccuracy include blood oxygen levels and electrocardiograms. The accuracy of these measurements is still being validated and should be double-checked with established testing.

Future Trends and Developments

Developments in health-tracking technology will potentially allow for more applications in functional medicine. Continued accuracy and more streamlined interfaces will enable more practical data to be gathered by patients and providers. One feature under development is the ability of wearable technology to monitor blood pressure. This feature is not yet widely available in watch technology. Hypertension is a prevalent and deadly disease, and the integration of accurate and convenient blood pressure monitoring could have widespread applications. There is early technology to measure body fat through watch bands, but the accuracy of this measurement is not well established. If this technology develops, the ability to evaluate body composition through WT would be very applicable in the functional medicine specialty.

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Smart Watches for Advanced Health Tracking: Final Thoughts

Smartwatches can transform functional medicine by providing the opportunity for tailored recommendations and precise progress reporting. Holistic care involves integrating modern technology with healthcare practices to provide patients with the best care possible. Wearable technology can be utilized by providers for accurate baseline measurements, realistic goal-setting, and progress evaluation.