Ethics of Wearables: How Health Providers Use Health Data Insights from Wellness Technology

While wearables offer a number of applications for individual health, they also present some significant ethical concerns. In particular, questions have arisen about the role of organizations that harvest and store the information recorded by wearable devices. These issues surrounding the ethics of wearables touch on a number of hot-button issues, including individual privacy rights and data consent.

What Is Wellness and Wearable Technology?

The wearable technology market has surged in popularity in recent years. Research indicates that the total number of connected wearable devices worldwide will surpass 1.1 billion by the year 2022. This includes a wide range of different wearables that are designed for an array of health and wellness applications.

Types of Wearables

Wearables include any electronic devices that are worn by individuals for the purpose of collecting data about their personal fitness and daily exercise. There are several specific types of wearables that are popular today.

• Fitness trackers. Products such as the Fitbit are simple wristbands with built-in sensors. They are designed to gather a variety of information including the number of steps a user takes over the course of the day.
• Smart heart watches. Wristwatches now come with sensors that monitor heart rate trends throughout the day.
• Wearable ECG monitors. Some doctors ask patients to wear these portable ECG devices. The goal is to provide information about heart rates during daily activities such as walking, running or swimming.
• Wearable blood pressure monitors. For patients with blood pressure concerns, these monitors can look just like ordinary wristwatches.
• Wearable blood sugar monitors. These track glucose levels and help users manage their diabetes.

Wellness Technology Applications

Given the range of wearables on the market today, it should come as no surprise that these devices support many different health and fitness applications. Some examples include the following.

• mHealth apps. These applications enable patients to automatically transmit information to their physicians who can monitor heart rate, blood pressure level and other vital signs.
• Sleep trackers. Some apps are designed to monitor sleep cycles and provide automated suggestions about ideal bedtimes or wake-up times.
• Heart trackers. A number of apps specifically designed for patients with cardiac issues enable them to monitor their core vitals.

Wellness Information

Ultimately, the goal of wearables is to collect information. Sometimes, this information simply enables users to track their own progress and take stock of personal fitness goals. In other cases, it is shared with healthcare organizations or doctors.

There are several types of information that wellness and wearable technology can document:

• Heart rate
• Blood pressure
• Sleep patterns
• Steps taken/pace while walking or running

Additionally, some wellness apps ask the user to manually input important information, such as medications they take, blood sugar level and more.

5 Ethical Issues of Wearable Technology

The use of wearable technology for data collection has generated a number of ethical questions, including concerns about disclosure of data collection, the selling of data, manipulation of insurance premiums, different ways of interpreting data and concerns about data loss due to poor cybersecurity.

1. Disclosure of Data Collection

One source of ethical concern is the nature of data authorization and consent. Generally speaking, when users sign up for an app that gathers their data, it requires them to sign a privacy agreement that authorizes the app to gather and store their health vitals. However, some experts warn that these privacy agreements do not sufficiently explain who uses that data and how, making the consent anything but informed.

2. Selling of Data

While many users expect their data will remain private and anonymous, there are concerns that data will be sold to health analytics companies, or used to target ads for weight loss supplements and other personal wellness products. Again, clear policies about the sharing of data may help, but the notion of meaningful informed consent is shaky.

3. Insurance Premiums

Many insurance companies have encouraged users to adopt wearable devices, which has generated concerns about personal health data being used to manipulate insurance premiums. Simply put, an insurance company that has raw data showing an individual to be in suboptimal health may use that as a license to increase charges.

4. Data Interpretation

Wearables are sometimes criticized for offering inaccurate information, which can lead to misguided data interpretation. Step counters provide the best example. While these applications often fare well in tracking steps taken while walking, they can be ineffective when documenting the results of a swim or a bike ride.

5. Cybersecurity

Finally, there are concerns that wearables have lax cybersecurity protocols, which could allow the breach of sensitive information. For example, some users may connect their wearables to unsecured networks, or connect them to other apps and platforms with insufficient cybersecurity protections.

How Health Providers Use the Data

By gathering and analyzing data, health providers can develop preventative care strategies, track patients’ compliance to those strategies and measure vital signs. Health informatics professionals play a crucial role in ensuring there is sound, usable data for physicians to draw from.

Types of Data

Health providers may seek different types of data depending on a patient’s clinical needs. For example, patients who are in a high-risk category for heart disease may agree to have blood pressure or heart rate numbers transmitted to their physician. For patients with diabetic concerns, a physician may ask them to manually input blood sugar numbers which can then be uploaded to the physician’s health informatics system. Physicians can also track elements such as posture and daily activity levels, helping them advise their patients on overall wellness and lifestyle goals.

Preventative Strategies

One of the main purposes of data collection is to help physicians create prevention strategies. For example, by collecting blood pressure numbers for cardiac patients, doctors may advise changes to medication, diet or exercise level in the interest of preventing heart attack and stroke. For elderly patients, physicians can use mobility data to create fall prevention strategies.

Reducing Clinical Visits

Another perk of wearable technology is that it can help prevent the need for clinical visits. For example, there may be no need for a patient to come in for a regular blood pressure checkup if their wearable device transmits healthy or positive numbers. As long as physicians can be alerted to important shifts in patients’ vital signs, they can minimize the need for routine follow-ups. This provides convenience to the patient and also lowers healthcare costs.

The Role of Health Informatics

Health informatics professionals play an important function in ensuring that data transmitted to a health organization is properly stored, and that physicians have the proper analytic tools at their disposal. Health informatics professionals can also scrutinize the data for trends that may reveal population health issues, an important consideration for public health officials.

Wearables Provide Many Benefits, but Also Ethical Concerns

There’s no denying that wearable devices have opened up new opportunities for physicians and their patients to communicate, and also for health officials to track population health data. However, the benefits of this up-and-coming technology are accompanied by some clear ethical concerns. As technology becomes even more widespread, it’s more critical than ever for health providers and patients alike to think through issues related to informed consent, data storage, and security.

Further Reading

• Medical Economics, “How Physicians Can Get Useable Data from Wearables.” Discover the different ways in which health providers can collect and analyze data.
• Fierce Healthcare, “Patients Will Use Health Wearables to Reduce Trips to the Doctor.” Read about how wearables can reduce the need for clinical visits.
• ZDNet, “Why Your Smartwatch and Wearable Devices are the Next Big Privacy Nightmare.” Learn more about some of the privacy concerns related to wearable technology.
• Science Daily, “Examining Ethical Issues Surrounding Wearable Brain Devices Marketed to Consumers.” Discover more about a specific realm of ethical concern: Wearable brain monitoring devices.
• Leidos, “Wearables and Their Cybersecurity Implications.” Take a closer look at the security concerns related to wearables.
• Business Insider, “Latest Trends in Medical Monitoring Devices and Wearable Health Technology.” Take a closer look at some of the types of wellness devices available today.
• WellSteps, “Wearables and Wellness Programs: The Complete Guide.” Review some of the pros and cons of wearable devices.