With Fitbits, STSI Adds mHealth to its Precision Medicine Project

Scripps Health’s Digital Health research unit is providing as many as 10,000 Fitbits to participants in a precision medicine program to track how home activities may affect their health.

The Scripps Translational Science Institute will provide the mHealth devices – Fitbit Charge 2 and Alta HR – to selected participants in the All of Us research program, established by the Obama Administration in 2015 and funded in part by a National Institutes of Health grant. This is reportedly the first consumer-facing wearable to be selected for the program.

The All of Us program seeks to capture personal health and activity data from one million participants “to learn more about how individual differences in lifestyle, environment and biological makeup can influence health and disease.” The STSI-Fitbit portion of the program will last for one year.

“As part of the global shift towards precision medicine, wearable data has the potential to inform highly personalized healthcare,” Adam Pellegrini, General Manager of Fitbit Health Solutions, said in a recent press release. “Through this historic initiative, we will be able to see the role that Fitbit data can play on the path to better understanding how individualization can help to prevent and treat disease.”

San Diego-based STSI has long studied the intersection of digital health and healthcare, in looking for ways to extend the care coordination and management process to the home.

“The Fitbit devices selected track a combination of physical activity, sleep and heart rate parameters,” Eric Topol, STSI’s founder and director, noted in the release. “The popularity of Fitbit devices among millions of Americans, combined with their ease of use, including multi-day battery life and broad compatibility with smartphones, made Fitbit a natural choice for this pilot program.”

“Most of what researchers know is based on intermittent snapshots of health in an artificial setting or based on personal recall,” added Steven Steinhubl, MD, a cardiologist and Director of Digital Medicine at STSI. “Through this research program, we’ll have access to comprehensive activity, heart rate and sleep data that may help us better understand the relationship between lifestyle behaviors and health outcomes and what that means for patients on an individualized basis.”

Adding the Fitbit to this latest research project puts another tool into a healthcare ecosystem that is slowly coming to accept consumer devices as instruments for remote monitoring. According to
the Federation of American Societies for Experimental Biology (FASEB), Fitbit devices are the most commonly used tracker in biomedical research, including published work (89 percent), clinical trials (83 percent) and NIH-funded research (95 percent).

At a panel discussion on wearables in the clinical setting at the recent Connected Health Conference in Boston – moderated, coincidentally, by Pellegrini – digital health experts noted that healthcare providers are finding value in home-based data, with limits.

“Wearables have very near-term profound clinical relevance in nearly every setting that you can imagine,” said James Mault, MD, FACS, Senior Vice President and Chief Medical Officer of Qualcomm Life. “When somebody leaves the hospital, we have no data. It’s a black hole.”

Among the goals of the STSI study is a determination of how Fitbits – and, more broadly, wearables – can be more broadly adapted to the All of Us program. At the Connected Health event, panelists pointed out the providers need to create specific use cases for wearable data, as well as a

filter to separate useful information from data that might otherwise clog up the physician’s time and make the process more intrusive than beneficial.

“We’re now generating more data than ever before,” Pellegrini noted. “I’ve already got plenty of data that I can’t pay attention to.”

Drew Schiller, co-founder and CEO of Validic, said wearables offer “massive opportunities” for providers looking to capture specific data from patients outside the office or hospital.

“There’s very low-hanging fruit there today that we can make meaningful impacts with,” he pointed out.

On the other hand, Schiller and others noted, providers have to learn how to incorporate health and fitness information into care management.

“How do we map data from a fitness model into an episodic care model?” he asked.

Richard V. Milani, MD, Chief Clinical Transformational Officer at New Orleans-based Ochsner Health and a developer and coordinator of several digital health programs over the past few years, said wearables do hold value for clinicians, but they still have to be kept at arm’s length, so to speak. Use specific devices and focus on specific variables, he said, and make sure the data is reliable.

Mault said providers need to carefully select which devices they can use – a particular challenge in a consumer market that offers thousands of options – and which data they can trust. There needs to be an “intelligence layer” between consumer wearables and doctors, he said, so that doctors don’t simply go out and make life­and­death clinical decisions based on uncertain data.

“These are the kind of things we have to figure out as an industry,” he said.

Written by: Eric Wicklund

Published in: mHealthIntelligence