Using a device such as a Fitbit or Apple Watch can make a big difference for patients and doctors.
"It occurred to me that modern technology, (such as) wearable devices, could be a nice tool to get a sense of what’s happening to our patients in a more complete sense,” said Dr. Nitin Ohri, a radiation oncologist, during an interview with CURE. “Over the years, I’ve learned we do our best to evaluate our (patients with cancer), and they do their best to tell us how they’re feeling and what they’re experiencing.”
Ohri realized that communication between doctors and patients can sometimes be imperfect and that important information sometimes is lost in translation.
He noted that time and availability constraints could contribute to some of the loss in communication.
“We’re not with our patients 24 hours a day; we’re seeing them at snapshots in time, typically in the clinic, not in their native home settings,” he said. “We only get a very specific view of the patient’s experience.”
Ohri has been an associate professor and radiation oncologist for 11 years at Montefiore Medical Center and Albert Einstein College of Medicine in New York, with a primary concentration on lung and gastrointestinal cancers. He previously helped lead his team’s clinical trials and has focused on patient-generated health data, specifically with patient-reported outcomes and wearable monitoring device data, to further care for patients with cancer.
Wearable monitoring devices, such as Fitbits and Apple Watches, are typically used as fitness trackers but are becoming more advanced with the addition of health metric tracking. Now certain monitoring devices can track heart rate and irregular rhythm, blood oxygen levels, breathing rate, skin temperature and more. Some have even advanced to electrocardiogram tracking via the device and a smartphone app.
For patients with cancer, these wearable monitoring devices have the potential to aid doctors by collecting medical data. “The idea is that these devices are available, very-user friendly, relatively inexpensive and they’re becoming more and more powerful,” Ohri said.
The rising popularity of fitness trackers sparked an idea in his mind: What if patients used these devices to help inform doctors about how diseases and treatments affected their daily lives? Ohri carefully considered the logistics and how these devices could ultimately benefit both patients and doctors.
“There (are) so much data that could be collected relatively easily if we were to provide our patients with these devices. The activity data like step counts (are)
far more objective and will be far more meaningful than more subjective measures, such as the performance status that we assigned to patients, which is often misleading,” he said. “So the potential benefit to the patients would be that their doctors have a better understanding of how the patients are doing and the kind of aggressive treatments they are likely to tolerate or not tolerate, or perhaps proceed when there’s a risk for severe toxicity or hospitalization in the next few days.”
He acknowledged that utilizing wearable monitoring devices for patients was still not a common practice and that doctors are not yet used to reviewing the activity data collected from the devices. “At present, I believe it’s still something where we need to do a lot of clinical research to make this something that becomes more standard,” Ohri said.
Still, there are still several aspects of accessibility to be considered. “It’s imperative that (doctors) are the ones providing the devices,” he said. “We help collect the data or do all the data collection ourselves, so that all of our patients can have the opportunity to benefit from this monitoring.”
Ohri recommended that patients with a cancer diagnosis or who are receiving treatment who already have wearable monitoring devices should continue wearing them. “If you notice any changes, I think it’s worth mentioning to your doctors. They may or may not be used to thinking about things like step counts in their patients, but I think the extra information can only help.”
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