Dr. Tariqshah Syed remembers seeing a patient who complained of heart palpitations — but the Holy Name Medical Center chief of cardiology was unable to detect any abnormal activity during the seven days the person was outfitted with a cardiac event monitor, a wearable but cumbersome EKG device. “Of course, the day after they removed the monitor, they experienced symptoms,” he noted.

Traditional facility-based monitors just capture a snapshot of a person’s activity at a particular moment; while a bulky cardiac event monitor – which trails wires from an individual’s chest to a hip-mounted device that captures the data – is not feasible for long-term use. But so-called smartwatches, or wrist devices that can record and display heart rate and other vital signs, are another story. Thanks to “wearable technology,” an increasing number of people are seeing their doctor or other health care professional from the comfort of their home.

“Smartwatches are less of a burden, so they can be used to monitor a patient for extended periods,” Syed explained. “We often use the data to see how their heart is behaving over an extended period of time. For example, we can see the lowest, the highest and average heart rates, which can provide clues to an individual’s health. Some higher-end smartwatches can also monitor and record an EKG [electrocardiogram, which can screen for abnormal heart rhythms], which may be an indicator of atrial fibrillation.”

He noted that younger patients typically have an Apple smartwatch, although Fitbit and other “trackers” are also often used. “And ever since COVID, I’ve seen a rise in the number of people who have an inexpensive fingertip pulse oximeter, or ‘pulse ox,’ that measures the saturation of oxygen carried in their red blood cells,” Syed added.

Still, some people are unable to afford the price of higher-end smartwatches, which can easily reach $700 or more. “And some older individuals have difficulty adjusting to them,” said Syed. “It’s sad, because older Americans are more likely to suffer from heart palpitations and other cardiac conditions.”

But there are alternatives, like an implantable loop recorder that can record a person’s heartbeat activity continuously for two years or more. “It’s a small device that is placed just under the skin of the patient’s chest during a minor surgery,” he explained. “Wearables and other devices are important, because they help us to personalize medical care.”

Besides commercially available products like Fitbits and smartwatches that have some wearable technology, “we have been using portable blood pressure cuffs and continuous glucose monitors for appropriate patients,” according to Bergen New Bridge Medical Center Chief Medical Officer Dr. Gian Varbaro. “For patients for whom it is appropriate, the added data allows a provider to get a deeper and more specific insight into the patient, which allows them to develop a more personalized and targeted treatment plan.”

In one case, a patient had a history of “poorly controlled hypertension [high blood pressure],” but with the portable blood pressure cuffs, “our nephrologist was able to see how their blood pressure was changing throughout the day, which allowed the doctor to adjust the medications and get the blood pressure controlled quickly, after it had been uncontrolled for a long period of time before the wearable,” he noted. “The biggest issue, though, is availability of the devices and their price, especially for a safety net hospital such as ours.”

Health care professionals can tap wearables for a variety of uses. For example, Atlantic Health System Exercise Physiologist Cyndee Wong said that Apple watches, Garmin and other fitness wearables help individuals to document their anaerobic threshold — the highest exercise intensity that they can sustain before building up a substantial blood-lactate level, which can cause their muscles to stiffen.

The data delivered by the wearables is typically supplemented by a VO2 max test, or maximal oxygen consumption, which lets a physiologist know the maximum amount of oxygen that an individual can use during intense or maximal exercise. “Doctors often recommend moderately intense exercise for 30 minutes a day, five days a week, and these kinds of wearables help us to design a personalized, data-driven sustainable exercise routine for patients that reflects four or five ‘heart zones,’” Wong said, referring to the percentage of maximum heart rate that’s safe for each person.

Wearables typically collect a lot of data, “which can be intimidating because some people are not sure what it all means,” she added. “But our training and knowledge lets us interpret it for them.”

Wong mainly works with recreational athletes, and she noted that this kind of evidence-based training approach is quite an improvement over the “push it till you drop” philosophy that used to be the rule.

“Wearables have come a long way,” she added. “In my experience, Garmin has become the go-to wearable for many endurance athletes, but a lot of people also favor the Apple watch because it easily ties to their iPhone.”

A lifeline

The BD Libertas Wearable Injector is a self-injection drug delivery solution designed for people with chronic conditions requiring large volume subcutaneous biologics – like certain monoclonal antibodies and other medicines – at home or in clinical settings.

“Many chronic disease patients receive intravenous treatments in the hospital or infusion clinic setting,” according to a spokesperson for BD, the Franklin Lakes-based global medical technology company. Self-injection systems allow some patients “to receive subcutaneous treatments outside of those traditional settings and enables treatment in the convenience and comfort of patients’ homes,” potentially reducing “cost and treatment time while allowing for greater patient autonomy, and convenience.”

The wearable injector is designed as a pre-fillable drug delivery system. “Transitioning chronic disease therapies from intravenous infusion to large volume subcutaneous injection requires reliable and accurate delivery devices that may enable intuitive self or care-giver administration,” according to BD. “The wearable injector’s patient ready-to-use design requires no end-user filling or assembly eliminating concerns for patient-end user filling and assembly related breakage, contamination, and dosing errors.”

Another product, the BD Vystra disposable pen, “is an intuitive, high-quality and customizable disposable pen injector designed to support therapies that require frequent, low-volume injections or variable dosing,” according to a BD announcement.

Editor’s note: This story was updated at 12:44 p.m. ET Nov. 29, 2023, to clarify details about the BD Libertas Wearable Injector.