'Wearables are irrelevant,' says technoskeptic Ezekiel Emanuel

BOSTON—“Wearables are irrelevant for what we need to do,” said Ezekiel J. Emanuel, MD, PhD, vice provost for global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania. Emanuel spoke during the 2015 Connected Health Symposium held by Partners HealthCare.

Users of wearables tend to be young, rich, healthy and easily connected, he said. “We’re not going to get anything out of them from a healthcare standpoint.”

Calling himself a technoskeptic, Emanuel said there are great ideas but lots of failed companies. “It’s important to be very skeptical about the whole continuum.”

Investing in individuals who truly need healthcare resources—those with chronic conditions, older, poor—is not going to pay off now, he said, but the big issue is what it’s going to do in the whole flow of the healthcare system.

These top spenders in the healthcare landscape need “stupid, invisible devices that stay behind the scenes. The ROI is mostly going to come from helping them avoid the healthcare system." They don’t have to be engaged in the same way but being connected is only going to work by keeping them healthy and keeping them out of hospital."

There is a lot in the connected health sphere that can help with that, Emanuel said. There is good technology that is easy to use for the patients who need an option that isn't 911, he said.

There are seven steps between the technology and the end result, Emanuel explained:

1. Engage in some way, even if it's only to install the connection.
2. Get data from people.
3. Transmit data reliably.
4. Use the data inside a healthcare system.
5. Use the information to have sustained behavior change.
6. The behavior change has to lead to a health improvement.
7. Improvements lead to saving money.

Each step is challenging, but required for successful adoption. But, successful adoption means taking that business from someone else. "There are very big hospital systems that are not interested in risk. They are going to ride the fee-for-service pony as long as they can because they don't make money keeping people out of the hospital."