As we wrote last time, proposed rules for the final stage of meaningful use would require providers to incorporate data from “non-clinical” settings from at least some of their patients. Among other things, this could mean monitoring a patient’s activity using a pedometer on their smartphone or health wearable and importing this data into their electronic health record.
As with many mHealth tools, this promises to improve care through a more complete picture of patient health. But what happens when the pedometer is wrong?
As the New York Times reported, researchers at the University of Pennsylvania tested pedometer accuracy and published the results in a February study. They found that most activity monitors are generally accurate, but that some are way off. For example, the Fuelband underreported steps by more than 20 percent. This is a problem if doctors are going to accept fitness data from these devices and use that information to make a diagnosis.
The good news, as Dr. Patel who oversaw the study points out, is that the free iphone pedometer apps are just as accurate as the fancy health wearables like Fitbit Flex or the Jawbone UP24. So at least you don’t need an expensive wearable to (more-or-less) accurately count your steps.
The bigger problem, which Patel and his colleagues pointed out, is that no fitness tracker has yet proven able to motivate people to start moving. Pedometers are widely available and (generally) accurate, but their widespread availability hasn’t led to an overall increase in how much people walk.
Even with lots of pedometer users out there (Accupedo for android has more than 5 million downloads) – and say we solved the accuracy problem – users don’t seem very interested in integrating their health data into electronic medical records. Cloud-based EHR provider Practice Fusion recently sent a survey to 20,000 of its medical professional user base, and 85 percent of respondents said that patients have not asked them about incorporating data from apps or wearable fitness trackers. As the article reports, “The patient-led, smartphone-based healthcare revolution is not knocking at the door of practices across America.”
Another study found that doctors and providers still have significant concerns about health wearables – not just about accuracy, but also about data sharing, privacy issues, and technology requirements.
Even as devices become more accurate and we overcome the hurdles of data integration, the pedometer might still be wrong.