A Tech-Savvy Nurse’s Initial Take on Uses for the Apple Watch

Megen Duffy, RN, BSN, CEN, is currently working in hospice case management and writes AJN‘s iNurse column, which focuses on technology and nursing.

AppleWatchMegenPhotoBPMI’ve had my Apple Watch for several months now. I ordered it at 12:01 the morning they went on sale, and it arrived the Saturday after its Friday release. I was fairly certain I’d return it or sell it for a profit, but I still have it and keep finding new uses for it. I also have ideas for how it could be handy for a variety of fitness and health care scenarios.

Health tracking. Even at this early stage, though, patients and their families are using Apple Watches to track and enhance their health. The Watch tracks your heartbeat—not every second, but often enough that a useful bank of data results. Rumors say that a mystery port on the back of the watch will allow SpO2 tracking soon. I have already busted out my phone to show my cardiologist my heart rate trends, and it saved me from wearing a Holter monitor. That kind of thing is exciting!

Fitness wearables (e.g., Fitbit) and smart watches (e.g., Pebble) have been around for a few years, with sharply increasing popularity. The (often) colored plastic bands people wear around their wrists are the kind of wearable I mean. Pedometers (included in the wearables category) also come in small clips that attach to pockets or bras, but those typically have fewer features than are relevant medically. These bracelets/watches track some or all of the following: steps taken, calories burned, distance covered, heart rate, and weight.

Wearables have ways of nudging people along in their fitness goals. They tap, send inspirational messages, and even post movement statistics on social media.

Peer pressure works, even in adults. Reaching the daily step goal becomes oddly alluring. Americans are sedentary people, and we like our gadgets and video games. Gamifying fitness could be a winning strategy for getting people up off the couch—both nurses and patients. It is not unusual to see bands of roving nurses in hospitals, walking the halls on break to get their steps in. Every little bit helps.

So far, the Apple Watch does not have any third-party applications, and, though it can do a number of things on its own, its main users for now will be those who already have late-model iPhones (which can pair with the Apple Watch to share data and some functionality). Other devices, such as the Pebble, have a huge library of third-party applications, but they still require proximity to a cell phone. Fitbits do not allow software installation.

Apps for medication tracking, etc., with more likely to come. The Watch has a number of applications that integrate usefully with iPhone applications. Patients and caregivers will have another option for keeping track of medications and treatments because of this integration. An application on your wrist saying “it’s time for your Cardizem” is much more insistent than a phone alarm, for example. An update to the Watch operating system is supposed to occur this fall, and I am excited about what developers will have come up with. Wouldn’t it be fantastic, for example, to have a CPR application on your watch that taps your wrist at the appropriate tempo?

Finally, the Apple Watch comes with ResearchKit, which is a way to collect data from research subjects. This is the most exciting part of the wearables future to me, because currently, tracking activity and health information in real time and then getting it to researchers is onerous. In the post-wearables world, a research oncologist may have her study patients check an “allow watch tracking” box. The selection bias is huge, but the fact that this framework is available and in active development fills the experimental mind with possibilities.

The Apple Watch is a work in progress, but it’s not just a redundant shiny new toy. Over time it, and inevitably other devices as well, could start to revolutionize medical research and patient self-care.
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