Smartwatches and smart rings that track our fitness and sleep stats have been available for years. But in 2024, a growing variety of everyday products worn on the body (think: headphones and tampons) will function as packaging for wearable health technology that can measure all kinds of biomarkers. And as these products make certain components of health information more readily accessible and easier to grasp, the relationship between patient and physician stands to evolve. “Digital devices can help patients take active part in their own health or disease management,” says Bertalan Meskó, PhD, director of The Medical Futurist Institute, which analyzes the role of digital technologies in shaping the future of health care. “They can finally become members of their own medical team.”
Research supports that a number of patients are here for that shift: According to a 2023 study from Yale University, more than a quarter of Americans now use a wearable health-tracking device. And the market is only growing: The medical wearables market had an estimated value of $31.06 billion globally in 2023, and is projected to reach $63.68 billion by 2028, according to a July report conducted by market research firm Infogence Global Research. “We are receiving emails almost every day from all around the world asking us, ‘Okay, how can I use the device and when will it be launched?’ even though we didn’t make any marketing yet,” says Savas Komban, CEO and co-founder of Smartlens, which is developing glaucoma-detecting contact lenses.
But what does this tech actually look like and how will it fit into your life?
Imagine you wake up in the morning and go into the bathroom. If you’re menstruating, you can get a whole host of information about your blood and vaginal microbiome. If you have a Tulipon (early access available via Indiegogo) or Emm menstrual cup (now offering waitlist access), a connected app will tell you all about your flow level; Tulipon will also tell you about your vaginal pH, and eventually Emm aims to give you a heads-up on early signs of diabetes, cholesterol, and gynecological diseases. You can use a Q-Pad (planning to launch early 2024) to collect your period blood so you don’t need to have a needle prick your skin to test blood for markers associated with thyroid health, blood sugar levels, or fertility hormones. You can mail in your NextGen Jane smart tampon (available to volunteers of its clinical studies) to identify gynecological conditions like endometriosis or fibroids, or your Daye tampon to check your vaginal microbiome for things like bacterial infections, potential fertility issues, and whether you’re showing signs of entering perimenopause. (Starting in early 2024, the Daye tampon will also be able to identify sexually transmitted diseases like chlamydia and gonorrhea, and later, HPV).
You’re still in the bathroom, and it’s time to put on your contact lenses for the day. If you’ve been diagnosed with or told you’re at risk for glaucoma, you can put on your miLens from Smartlens (on track for FDA approval in late 2024). This device measures your eye pressure—since high levels can damage the optic nerve, leading to glaucoma—by testing how much your cornea is pressing on the microfluid built into the lens. And, if all goes well, in a few years, the company’s smart glasses, called THERmic, will allow doctors to remotely program a personalized microdose of medication based on the miLens measurement, which the glasses will then administer to maintain your eye health.
Now, you’re ready to get dressed. Your Prevayl SmartWear shirt or sports bra (launched in 2022, and since adopted by prominent clients including the UK Ministry of Defense) comes with a small sensor that captures nearly 1,000 data points per second, like your breathing rate and body temperature. In 2023, its clinical-grade electrocardiograms (ECGs) were independently validated against the hospital-grade standard for heart rate monitoring. On your feet, you slip on Milbotix socks (going to market in early 2025), which will measure your stress and anxiety levels by tracking your heart rate, sweat levels, and movements. And if the research of Aldo Faisal, PhD, professor of artificial intelligence (AI) and neuroscience at Imperial College London, is successful, down the line you’ll be able to put on clothing with sensors that can pick up on movement patterns that may be invisible to the naked eye but are indicative of certain neurological disorders like Friedreich’s ataxia or Duchenne muscular dystrophy. This information may allow doctors to catch symptoms early and tailor treatments to match the progression of the disorder.
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Apple is reportedly designing AirPods that will screen for hearing issues—a natural evolution of Apple’s existing Health app warnings about dangerous volume levels.
Photo: Stocksy/ Atolas, United Arab Emirates
You start working and put in your headphones. If your ears haven’t been feeling so great lately, you could choose a pair of earbuds from EarHealth (still in development) to screen for ruptured eardrums, earwax blockage, or an ear infection. Or you could choose a pair of AirPods Apple is reportedly designing that will screen for hearing issues—a natural evolution of Apple’s existing Health app warnings about dangerous volume levels.
Throughout the day, you peek down at your smart tattoo that changes colors in response to your blood sugar levels or your kidney or liver function or your hydration levels (now in development by researcher Ali Yetisen, PhD, at Imperial College London) or that lights up in response to radiation and UV light exposure (available for preorder through Magic Ink).
Then, after a long day, it’s time for bed. You put on your byteSense Smart Night Guard (currently offering waitlist access) that tracks your teeth grinding and sleep quality, then uses AI to detect patterns and make lifestyle recommendations in a connected app.
Many experts say that beyond providing increased information, this explosion of digital health devices is transforming the medical field in a number of ways. For instance, Hemalee Patel, DO, senior medical director for chronic care management at One Medical, says, “I’m able to check in more frequently,” rather than allowing a year to pass between appointments, during which time a person’s health can deteriorate. Particularly for seniors and those with chronic conditions, health monitoring devices like clothing that tracks your heart metrics can help people continue living independently while a doctor checks those stats remotely.
The increasing amount of information these wearable devices can collect is also accelerating the rise of precision medicine—or treatment tailored to each person’s genes, environment, and lifestyle—which is shown to lead to more effective outcomes than traditional, generalized treatment. “We’re going to personalize recommendations and interventions,” says Stefano Canali, PhD, a philosophy researcher who analyzes the ethics of wearable health technology.
Meanwhile, these upcoming trackers, along with existing wearable health devices like continuous glucose monitors, will encourage patients to take a more proactive approach to their health care, whether that’s experimenting with lifestyle changes or seeing a specialist sooner. “It’s empowering the patient to understand that, actually, there’s quite a bit in terms of behavior that can shift and improve,” says Dr. Patel. “You’re getting bite-sized education as you’re going.” Having a doctor tell you that cutting caffeine will decrease your teeth grinding is one thing; seeing it actually work from one night to the next is another.
The genius of this current wave of devices is that by putting sophisticated health tracking tech into familiar, everyday items, patients are more likely to actually use it.
The genius of this current wave of devices is that by putting sophisticated health tracking tech into familiar, everyday items, patients are more likely to actually use it. “The limiting step is just how comfortable [patients] are with technology—otherwise you could recommend a number of devices, and they’ll just sit on the shelf and collect dust,” says Dr. Patel. If all you have to do is slip on some fancy socks, there’s far less of an intimidation factor.
Take, for instance, the miLens. An estimated 45 million people in the US already use contact lenses, so putting on one that tests your glaucoma risk feels like no big deal. “It’s very comfortable to wear,” says Komban. “It’s made of soft material—you don’t have any chip or batteries inside, it’s electronic-free.” (Compare that to the awkwardness of a machine shooting air at your eye in the optometrist’s office, which is the current standard for testing for glaucoma.) With miLens, those who need it can easily and comfortably check their eye pressure a few times a month or year, and ideally catch any changes before glaucoma progresses to the point where they lose their vision.
“People are slowly realizing it’s better to stay healthy than enter the ‘sick-care system.’ Wearables play a crucial role in this shift.”
Gary Monk, health care innovation consultant
This convenience of routine testing, often with little-to-no effort on the patient’s part, will likely increase how much focus many of us put on preventive health care, predicts Gary Monk, a health care innovation consultant. “People are slowly realizing it’s better to stay healthy than enter the ‘sick-care system’,” he says. “Wearables play a crucial role in this shift.”
One limitation to the growth of wearable health technology, however, is that while some of these devices, like miLens, are obtained by a prescription and covered by insurance, others are ordered—and paid for—directly by consumers, which means they’re only available to those who can afford them. (And insurance coverage doesn’t guarantee accessibility, either.) Most are not cheap: For instance, a Prevayl sports bra costs £220 British pounds, or about $280, while the Q-Pad that collects your period blood is $199. And although the Daye diagnostic tampon is working to forge relationships with insurers, right now it’s an out-of-pocket $199-plus cost. (Though once Daye can screen for HPV, it could potentially help people avoid an invasive and costly—without insurance—Pap smear.)
As with most any new tech, there are lingering questions to consider surrounding health-tracking wearables: Who owns the data that’s collected? And how secure is it? The use of collected data in this emerging industry is not yet regulated, so there are no uniform answers, and it remains up to the patient to carefully read the fine print (which is often pages long and in confusing legal jargon).
“Rethinking data ownership and how consumers can maintain control over their own data is more essential than ever,” says Unity Stoakes, president and co-founder of venture capital firm StartUp Health. The only current federal legislation regulating personal health information, he adds, is sorely outdated. (For instance, the Health Insurance Portability and Accountability Act, better known as HIPAA, hasn’t had major updates since 2013, and changes planned for 2023 don’t address wearables.) “The data world has changed by several orders of magnitude since these laws were passed, and [the laws] largely predate today’s troves of personalized health data generated from consumer devices and diagnostic tools,” says Stoakes.
Although some devices send results directly to a connected app, rather than to health-care providers, experts agree that patients shouldn’t be left alone with this information without a physician’s input. That’s partially because not all measurements are always 100 percent accurate—many of these devices still need to be clinically validated in peer-reviewed studies. Also, without a full understanding of what the numbers mean, our minds can quickly start to spin. “There is already some research about the fact that constant monitoring with self-tracking technologies can create anxiety, stress, and doubt concerning your health,” says Dr. Canali. Dr. Patel points out that a certain value that a tracker spits out might not actually mean anything bad about your health, but without the medical education necessary to interpret that value, patients can panic.
For those who have illness anxiety in particular, “they’ll get caught up with compulsive reassurance-seeking by constantly checking their pulse [oximeter], or their ECG,” says psychologist and anxiety disorder expert Karen Cassiday, PhD. Although remote monitoring might be convenient, it can also lead to unnecessary worry, she says. “One good thing about making that appointment with that doctor is you could get corrected information.”
“We see ourselves as the connector, the bridge between the patient need and the medical community. We never want to leave the patient stuck with a set of confusing or potentially troubling results.”
Valentina Milanova, founder, Daye
Some direct-to-consumer companies like Daye are getting ahead of these concerns about patients spiraling by offering a consultation with a provider as part of the package (for an extra fee). “We see ourselves as the connector, the bridge between the patient need and the medical community,” says Valentina Milanova, founder of Daye diagnostic tampons. “We never want to leave the patient stuck with a set of confusing or potentially troubling results.”
Yet it’s easy to see how people who don’t like going to the doctor could embrace these wearable health trackers as a convenient replacement. “There’s a possibility that users might become too dependent on these devices, potentially overshadowing the importance of regular checkups and professional medical advice,” says Monk.
Despite concerns, this innovative tech is spurring a cultural transformation in health care. And the number and types of trackers we can access may well continue to expand. “Every device in and around our lives can become a tool to improve our health. Not just the things we wear, like watches, but the cars we drive, the couches we sit on, the pillows we use, the refrigerators where we store our food,” says Stoakes. “If today’s most amazing innovators do it right, they will design health into the fabric of our lives.”
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Dhingra, Lovedeep S et al. “Use of Wearable Devices in Individuals With or at Risk for Cardiovascular Disease in the US, 2019 to 2020.” JAMA network open vol. 6,6 e2316634. 1 Jun. 2023, doi:10.1001/jamanetworkopen.2023.16634 -
Mathur, Sunil, and Joseph Sutton. “Personalized medicine could transform healthcare.” Biomedical reports vol. 7,1 (2017): 3-5. doi:10.3892/br.2017.922 -
Canali, Stefano et al. “Wearable Technologies and Stress: Toward an Ethically Grounded Approach.” International journal of environmental research and public health vol. 20,18 6737. 11 Sep. 2023, doi:10.3390/ijerph20186737