Once, they were all about how many steps we took. Now, smartwatches can track the most intimate details of our health and fitness. Asad Khattak, mobile computing and health informatics expert at Zayed University, evaluates the impact of next-generation wearable technology for the healthcare industry

In a few short years, technological advancements have given our everyday fitness trackers a new lease of life. The smartwatch is now on course to be a genuine game changer in the world of healthcare. In future, these compact wearable devices could help extend life expectancy and enhance quality of life � as well as dramatically reduce medical expenses worldwide.

There are two key enablers driving this paradigm shift. First, smartwatches allow an individual to become personally invested in their own healthcare, as an adjunct to sought-after advice and the traditional support of doctors, pharmacists and other caregiving experts.

Second, they're easy to use. Strap on a smartwatch and it's a 24-hour health monitor that requires minimal upkeep beyond regular recharging and system syncing. A convenient solution for regular health monitoring, in many ways smartwatches are the ultimate medical sensor. Suitable for use outside a clinical environment, from home to the workplace to the gym, they are constant providers of real-time information.

Smartwatches are also more data precise compared to mobile phone apps because they can distinguish between numerous active states such as walking, sleeping, driving and even smoking or eating � on a 24/7 basis.

Collected data can then be shared with healthcare professionals, helping them monitor and capture vital information about topics such as heart rate, activity levels and blood oxygen levels. This capability to connect patients to caregivers is transforming healthcare and driving the creation of revolutionary new care models.

For you and me, smartwatches can also deliver important alerts, for example, by using specific algorithms to detect an abnormal heart rate. They can also send out reminders to take medication or other health-essential notifications.

Other noteworthy applications include the ability to detect if a wearer, who may be elderly or infirm, has fallen down, and then automatically send an alarm to the relevant emergency services. The end result is that smartwatches are now increasingly part of a fully connected technology ecosystem, alongside a raft of other medical devices and online data repositories.

Tracking wellness beyond the basics

Not exclusively targeted at users or patients with known conditions, smartwatches are a healthcare support system for everyone, even the healthiest among us. Today's devices can measure rising stress levels, thus enabling us to proactively manage lifestyle factors influencing stress, and foster healthier long-term behaviours.

It's no wonder then that global sales of smartwatches continue to climb. According to Strategy Analytics, 12.3 million devices were sold worldwide in the second quarter of 2019: that's a 44 per cent increase over the same quarter in 2018. And 2018 was a record-breaking year, with a total of 45 million units sold across the globe.

But it's not just about growing volume, it's the changing buyer rationale that really matters. There's now a clear groundswell away from using smartwatches for simply motivation to follow an active lifestyle and towards using them to manage top-to-toe, inside-out health.

One key long-term benefit of this widespread adoption is the positive impact on soaring healthcare costs. According to a 2017 report from the London School of Economics, healthcare costs among the senior elderly in the United Kingdom increased by around 70 per cent between 2010 and 2014. If smartwatch-wearing patients could be monitored from the comfort of their own homes, it's reasonable to assume that this figure would be significantly reduced.

Technological advancements will help us to reduce such cost burdens on governments and institutions, and also free up healthcare professionals to focus on other more pressing issues. Technology can also engender a citizen-led culture of healthier lifestyle so that, in the long-term, there will be fewer healthcare requirements. The potential cost savings are so compelling that health insurers are already looking into the prospect of reducing premiums, or even subsidising customer smartwatch purchases.

Addressing wearable healthcare challenges

Of course there is still a long way to go and the idea of being able to obtain a 'medical-grade' reading from a smartwatch device isn't a current reality. That's why smartwatches are � for now � useful accessories to conventional medical devices and focused on taking readings and feeding back data.

That next step will also involve regulatory considerations, as well as development of the necessary clinical data.

Another area that we are exploring at Zayed University is profiling people based on their metabolism. This will require extensive and continuous data gathering and analysis and will open up lively debate on trust and data protection. For this type of application to move forward, clear and uniformly applied regulations will eventually be needed on the sharing and use of personal information.

It's only a matter of time and, once live, this will help enable predictions and diagnoses from smartwatch data, rather than just the monitoring of individual conditions.

One initiative we are working on is centered on research into the possibility of predicting Parkinson's disease. This work isn't yet published, but is already showing strong accuracy rates, superseding a similar study conducted at Google, that showed 55 to 58 per cent predictive accuracy.

If we take the example again of an elderly patient who has suffered a fall, in the not too distant future, smartwatches will actually be able to spot patterns that will enable highly accurate predictions of imminent falls linked to an individuals' personal information and history.

This could logically be extended to predict patterns of falling asleep or entering a stressful state, further enabling us to use our smartwatch to self-manage personal wellbeing.

Strokes are another area benefiting from smartwatch technology. Apple's recently released software update enables its watches to detect irregular heartbeats, by using an optical sensor to analyse pulse rate data and identify something called atrial fibrillation.

A preliminary study submitted to the US Food and Drug Administration showed that the watch correctly identified this condition in 99 per cent of cases. This is a perfect example of how watches can do things that other devices can't. Atrial fibrillation is difficult to diagnose because it's so inherently irregular it can easily be missed, but because a smartwatch is worn 24/7, it vastly increases the chances of spotting it.

For other diseases, an extended period of data gathering will be required to create case-based reasonings. These cases would factor in things like age, gender and race, and then monitor sleep patterns, active lifestyles, stress levels, increases in blood pressure and so on, to support early detection and management.

Source: Zayed University, United Arab Emirates