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Key points
- The popularity of Wearable and Implantable Medical Devices (WIMDs) is booming.
- Future WIMDs may be able to detect cancer biomarkers and recognise symptoms of infectious disease.
- Significant security enhancements are needed to prevent the risk of life-threatening hacks to WIMDs.
The popularity of Wearable and Implantable Medical Devices (WIMDs) has soared in recent years. Smartwatches, activity trackers, and implantable monitoring devices can be used to monitor a range of health analytics, as well as to administer life-saving treatments. The ability to harness large quantities of data from these devices could help generate health solutions for a variety of conditions, as well as optimise healthcare.
The most common forms of WIMDs are commercially available health trackers that monitor things like heart rate, blood pressure, blood oxygen, glucose levels, and breathing. However, WIMDs can also include devices such as insulin pumps, pacemakers, and implantable cardioverter-defibrillators that are used to manage life-threatening health conditions.
Connecting WIMDs to a wider network of health data may provide the possibility for the continuous collection of real-world health data that could help to improve diagnosis and treatment. The surging popularity of health technology has led to the rise of WIMDs and their use is expected to transform healthcare in the decades to come.
Public health benefits
Using WIMDs to track and monitor symptoms and health behaviours may assist in providing timely diagnosis. Excitingly, the next generation of WIMDs offers potential features such as the ability to detect cancer-related biomarkers and even recognise symptoms of infectious diseases such as COVID-19. This might help to move beyond traditional healthcare approaches, where efforts are largely directed at treating rather than preventing ill health.
Remotely delivering treatments through implantable devices also has the potential to save lives by offering an immediate response to critical health incidents (such as heart arrhythmias and convulsive seizures). WIMDs can empower individuals to take control of their health by arming them with the tools they need to better understand the symptoms they experience. WIMDs have also been shown to encourage physical activity, and can be "gamified" to provide real-time feedback and incentivise positive behaviours. Finally, by using big data practices in health, the information collected from WIMDs could be analysed to generate insights into numerous conditions, helping to identify long-term patterns of disease that would ordinarily be blurred by the daily fluctuation of symptoms. However, a number of challenges to the widespread use of WIMDs must be considered in order to capitalise on the potential benefits.
The challenges of WIMDs
Privacy and security concerns pose a significant challenge to the widespread use of WIMDs in healthcare. Both passive attacks (eavesdropping on wireless devices) and active attacks (controlling and manipulating devices) can be successfully launched to penetrate the security of WIMDs. Security concerns may stop the public from using WIMDs to collect and share their data. This would prevent public health researchers from being able to utilise large quantities of health data to learn about various disease patterns.
Some WIMDs are uniquely vulnerable to hacks due to inherent design restrictions. For example, WIMDs need to be small, light and able to come into contact with human flesh, creating limitations in terms of power supply and computing. Insulin pumps, pacemakers, and implantable cardioverter-defibrillators have all been shown to be hackable and could be controlled by malicious actors to remotely administer fatal doses and shocks. These concerns present a direct threat to life and highlight the need for improved technological solutions to tighten the security of WIMDs before they are more widely used in healthcare settings.
In the UK, the future use of WIMDs aligns with the NHS’ commitment to a digital future in which patients become active participants in "citizen health" to both benefit from and contribute to their national health service. However, people have different preferences, abilities, and levels of access when it comes to using digital devices. It is important to understand these differences in order to avoid burdening individuals with unwelcome responsibility. There is also a growing digital divide in health in which those with insufficient access, knowledge, or ability to successfully manage digital health tools may be less likely to experience positive health outcomes. Therefore, health initiatives that look to promote the use of WIMDs must be careful not to digitally exclude those pockets of society less likely to engage.
Looking forward
WIMDs have the potential to produce vast amounts of data that could be used to generate innovative health solutions and optimise care. The emergence of WIMDs, combined with big data practices, could become a goldmine for public health researchers. However, health systems must be mindful of the numerous challenges to the widespread use of WIMDs. These include generating public trust in the data practices of large health organisations, addressing the unique vulnerabilities of medical devices and tackling existing inequalities in digital health. Therefore, though the WIMDs of change offer health providers the possibility of reaching promising unchartered waters, they also bring forth choppy seas that require careful navigation.
