The preliminary results of the Apple Heart Study highlight the potential role that consumer digital technology can play in providing predictive and preventive health care. However, the study had limitations and whilst it demonstrates the growing role of digital technology in healthcare, we were left asking what was the impact of the technology on the users and what would be the longer-term health outcomes?
The collaborative Apple and Stanford University virtual study of more than 400,000 participants used a study mobile app and the Apple Watch, series 1 to 3, not the latest version with a built-in ECG (NCT03335800). The objective of the study was to determine if the technology could identify irregular heart rhythms and ultimately atrial fibrillation, a leading cause of stroke and hospitalisation in the United States.
Preliminary results shared in the Medical Express concluded that Apple’s wearable technology can identify heart rate irregularities that subsequent testing confirmed as atrial fibrillation. Heart irregularities often go undetected because many people do not experience symptoms before a more debilitating medical event such as a stroke occurs. With the current healthcare system of mostly reactive medicine under strain there is a clear unmet need to expand healthcare systems centred on predictive and preventative healthcare. This study certainly highlights the opportunity for a common wearable technology, which does not make the user feel like a patient, to contribute to such a preventative healthcare system.
However, the results fall short of demonstrating if the technology will really improve outcomes. The availability of this kind of information can, in theory, empower users to follow up with the right treatment. But we are left wondering about the short and long term outcomes of this research, in particular did the technology encourage lifestyle changes amongst the participants and if so what impact have these had on their longer term health and well being?
Market research with Apple Watch users who receive a heart irregularity alert would go some way to bridging the current knowledge gap. We would recommend engaging participants over the subsequent year from their positive heart irregularity result using a combination qual and quant approach. Firstly, a quarterly survey to generate comparable quantitative data on health and well being attitudes as well as tracking use of digital technology, health events and relationship with their healthcare provider. We would couple this tracking data with ‘day in the life’ mobile ethnographies and accompanying telephone interviews to explore how, if at all, their real world behaviour and habits have and continue to change. Results from such a research project would provide invaluable insight into real world usage of this type of preventative healthcare application.
Later in 2019, Janssen will launch a research study to examine outcomes of the Apple Watch irregular rhythm notifications and ECG app in diagnosing atrial fibrillation and stoke prevention. Perhaps this study, and an accompanying patient focused research piece will provide greater insight into how digital technology can and will shift our healthcare system from reactive to preventative.