March 2024: Key Issues as Wearable Digital Health Technologies Enter Clinical Care
The issue
Wearable digital health technologies—everything from smartwatches and glucose sensors to fall‑alert pendants—offer unprecedented, real‑time insight into daily health, but six interlocking problems still block routine use: data ownership, patient trust and literacy, standards, clinical integration, patient empowerment, and reimbursement. If they aren’t solved, seniors may be left on the wrong side of a widening “digital divide.”
What do I need to know?
Wearables stream physiologic and behavioral data outside the clinic, giving doctors and patients a clearer picture of health trends. Yet uncertainty about who owns those data, whether different brands can “talk,” and how safely information is stored remains. Limited digital literacy and patchy internet access mean many older adults cannot benefit, while clinicians struggle to digest the flood of raw numbers. Regulators now insist on stronger cybersecurity and validation, but insurers often wait for cost‑saving proof before paying. Together, these hurdles can deepen health inequities unless addressed directly.
Potential risk of a digital‑health gap
An older adult is curious about tracking steps or heart rate but has never used a wearable.
Recommended Actions
Ask the doctor whether an FDA‑cleared basic tracker makes sense and request a short training session.
Confirm reliable home internet or phone data before purchasing.
Read the device’s privacy notice together and verify that data can be deleted on request.
Imminent risk of digital‑health overload or mistrust
A new user feels overwhelmed by alerts or unsure who sees the data.
Recommended Actions
Book a “digital health check‑up” with the care team or a community tech coach to adjust alarm thresholds.
Upload only summary reports (steps, glucose trends) to the patient portal instead of raw streams.
Ask the clinician to explain security protocols and how data flow into the electronic record.
Confirmed risk of harm or inequity from wearables
False alarms, privacy concerns, or cost are already causing anxiety or skipped care.
Recommended Actions
Re‑check that the device is FDA‑cleared for its purpose; switch or pause use if accuracy is doubtful.
Work with a social worker to access subsidized connectivity or loaner devices; Medicare covers remote monitoring under CPT codes 99453‑99458.
Keep a log of nuisance alerts and share with the provider to refine settings or discontinue the device if harms outweigh benefits.
What can I do?
Ask three questions at your next visit: “Do I need this wearable? Who owns and sees my data? How will we use the information without overload?” Keep a simple diary of key readings and technical hiccups. Choose devices that export in standard formats (e.g., FHIR) so future doctors can read them, and explore library hotspots, senior‑center grants, or Medicare programs if internet cost is a barrier. The best technology is one you understand, trust, and can afford to use consistently.
