Why Stanford is spending millions to incorporate Apple Watches and Fitbits into medical care

• Health systems are exploring the clinical usefulness of consumer tools that can monitor heart rates.
• Wearable devices can continuously measure vitals, as opposed to one-time measurements in the doctors' office.
• Stanford executives spoke with Insider about the medical center's approach to wearables.

Patients no longer have to trek to doctors' offices for detailed heart rate or blood pressure readings as consumer tech giants churn out increasingly sophisticated smartwatches and high-tech rings that can measure vital signs and sleep patterns continuously.

And as companies like Apple, Fitbit, and Samsung push to integrate these sleep trackers and heart rate monitors into medical visits - including by funding large-scale clinical studies in a bid for wider adoption - large health centers like Stanford Medicine are taking note.

Though the market for people to track their own vitals is growing, getting buy-in from doctors and hospital systems could vastly increase their customer base.

In turn, it's up to health systems to quickly figure out whether the data's useful to doctors and how to efficiently extract it from the devices, said Stanford's Michael Snyder, who leads many of the health systems' wearable projects. He added that Stanford likely spends millions researching these products.

Stanford's wearables experiment

Stanford has been working with Apple on a large-scale study assessing whether the smartwatches can detect irregular heartbeats. It's also exploring whether other consumer devices like Oura Rings and Fitbits can give doctors better insight into patients' health by taking more accurate and more frequent measurements.

For instance, researchers have developed a system using heart rate and temperature data to predict the onset of COVID-19 symptoms, which could eventually be used to alert patients to stay home.

While Stanford's health record system can't currently pull wearable data into health records in real time, researchers have built a separate database that can group together medical records, data from wearable devices, and other information that patients contribute. The health system recently submitted the prototype for that system to a major research journal, Snyder said.

It's not clear yet how the devices stack up to clinical-grade heart rate monitors, which doctors typically use to take snapshots of patients' heart activity while they're in the office, in detecting irregular heartbeats, Snyder said. But passively taking readings from smartwatches, which patients would already be wearing at home, could potentially help doctors establish a better baseline for heart activity.

"There are circadian rhythms, there's just natural fluctuations during the day," Snyder said. At the doctor's office, he added, "they're literally measuring you for 15 seconds. It's just a very poor measurement, and the devices are measuring 24-7. Some of those measurements are so much more accurate, so much more reproducible."

Some physicians still aren't sure the data's from consumer devices is valuable, Snyder said, but added that that's why the health system is proactively investigating whether the technology really can be useful.

"Everybody sees it coming," Snyder said. "We're in this sort of twilight zone where some are very actively embracing it," he said, adding, "others are more dismissive."

Making wearables more equitable

There's also the challenge of ensuring that patients who can't afford the devices - Apple Watches, for example, retail for a few hundred dollars - aren't excluded from cutting-edge medical programs.

Though most of its wearables programs are still in the clinical trial phase, Stanford is also examining how lower-cost options like the Fitbit compare to the higher-end devices, Sumit Shah, Stanford's director of clinical innovation and digital health, told Insider.

"It's really important that we're able to use a device agnostic approach," Shah said.