The Spotlight’s on Apple Watch as an mHealth Tool for Cardiac Care

November 30, 2017 - The Apple Watch is becoming a popular mHealth wearable for people with cardiac conditions.

Two separate announcements have positioned the smartwatch at the center of the remote monitoring ecosystem, giving mHealth and telehealth advocates some hope that the healthcare community is coming to find value with consumer-facing wearables.

Stanford University’s School of Medicine and Apple have launched the Apple Heart Study, a clinical research project enabling consumers with cardiac issues to use the Apple Watch and an accompanying app to collect data on irregular heart rhythms who may be experiencing atrial fibrillation (AFib).

“Through the Apple Heart Study, Stanford Medicine faculty will explore how technology like Apple Watch’s heart rate sensor can help usher in a new era of proactive health care central to our Precision Health approach,” Lloyd Minor, Dean of the Stanford University School of Medicine, said in a press release.

The Apple Watch is key element in Stanford’s mHealth research. Earlier this year, the Stanford Center for Digital Health offered $10,000 and 1,000 Apple Watches (https://mhealthintelligence.com/news/stanford-mhealth-grant-offers-giveaway-of-1000-apple-watches) to innovators who “stimulate and support” creative uses for the smartwatch in mHealth projects.

Among those using or favoring the Apple Watch in remote monitoring programs are New Orleans-based Ochsner Health, Johns Hopkins University (which is using the smartwatch in a research study on triggers for epileptic seizures) (https://mhealthintelligence.com/news/apple- watch-helps-researchers-study-epileptic-seizures), Aetna and Humana.

Separately, AliveCor, a California-based developer of digital health technology for heart care, has announced that its KardiaBand has received clearance from the U.S. Food and Drug Administration as a medical device accessory, the first such accessory to be approved for use with the Apple Watch.

Along with the KardiaBand, an mHealth-enabled watch band that records a patient’s EKG in 30 seconds, AliveCor is launching  within the company’s Kardia mobile app that allows Apple Watch users to synch heart rate and activity sensors in the in the watch too.  

As with the Apple Heart Study, AliveCor’s rollout is targeted at detecting AFib early, before it progresses to a serious health issue.

“Kardia Band paired with SmartRhythm technology will be life-changing for people who are serious about heart health,” company CEO Vic Gundotra said in a press release “These capabilities will allow people to easily and discreetly check their heart rhythms when they may be abnormal, capturing essential information to help doctors identify the issue and inform a clear path of care to help prevent stroke and other serious conditions.”

In an earlier interview with mHealthIntelligence.com (https://mhealthintelligence.com/news/healthcare-looks-to-digital-health- tools-to-measure-heart-health), Gundotra said an mHealth monitor that can track EKG holds promise for treating much more than AFib.

“The ECG holds a vast amount of information about a person's overall health, and applying machine learning to millions of ECG recordings is an important enhancement to traditional ECG analysis,” he said. “We look forward to continuing to apply deep machine learning techniques to uncover hidden physiological signals in ECGs to improve heart and overall human health.”

The Apple Watch uses green LED lights that flash hundreds of times per second and light-sensitive photodiodes to analyze blood flow through the wrist, from which heart rhythms are isolated by software algorithms in the watch.

For the Apple Heart Study, the accompanying app will analyze those heart rhythms for evidence of AFib, a leading cause of stroke that’s responsible for some 130,000 deaths and 750,000 hospitalizations per year in the US.

If an irregular heart rhythm is identified, study participants will receive a notification on their Apple Watch and iPhone, a free consultation with a study doctor and an electrocardiogram (ECG) patch for additional monitoring. The telehealth consultations are arranged by Massachusetts-based telehealth provider American Well.

“The Apple Heart Study will advance the boundaries of clinical medicine significantly,” Ido Schoenberg, Chairman and CEO of American Well, said in an e-mail message. “This study is the first to bring connected care to clinical research, moving the cycle from the hospital to the home through a combination of wearables, analytics, telehealth and consumer devices. We see this as the beginning of a revolution that will save lives through early detection and more precise treatment, with applicability to many chronic conditions and millions of people.”

Healthcare has been looking to mHealth and digital health devices – particularly wearables – for many years in an effort to detect AFib conditions earlier, a difficult process given the lack of noticeable symptoms.

Some 6 million Americans are living with AFib and are five times more susceptible to sustaining a stroke, with one in every three experiencing a stroke in his or her lifetime, according to the Centers for Disease Control and Prevention. More importantly, as many as 30 percent of those living with AFib haven’t been diagnosed.

For all the promises of digital health technology in cardiac care, providers and patients have to be sure that the technology is accurate and reliable. Earlier this year, New York’s Attorney General announced settlements with three companies (https://mhealthintelligence.com/news/mhealth- apps-for-cardiac-care-sanctioned-for-misleading-claims) marketing mHealth apps over “misleading claims and irresponsible privacy practices.”