HOUSTON
Volume 16 | Issue 2
Inside This Issue
February Edition 2026
As Wearables Improve, They Can Boost Patient Engagement and Lower Risks By Daniel Kent Cassavar, MD, MBA, FACC, Medical Director, The Doctors Company and TDC Group
Keys to Healthy Aging See pg. 9
INDEX Legal Matters........................ pg.3 Oncology Research......... pg.5 Mental Health...................... pg.6 Healthy Heart....................... pg.7 Financial Forecast............ pg.12
Just 20 Minutes of Activity Twice Weekly May Help Halt Dementia See pg. 10
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oughly one-third of Americans own a smartwatch, and the market for smart rings and other biometric-tracking gadgets is growing, though some metrics are more reliable than others. It’s not surprising that many of our patients seek to improve their health by sharing data from their devices with their practitioners. Technology skeptics are asking: Remember when EHRs were going to lighten our burdens, not add to them? Remember when patients first got smartwatches, and our inboxes flooded with unusable, clinically irrelevant, low-quality data? Some got fed up and swore off looking at patients’ wearables, but it’s time to take a breath and try again. As the data quality of consumer wearables improves, we can combine new capabilities with patient education to boost engagement and lower risks for patients and practitioners. It’s Not About Tech Perfection—It’s About Patient Engagement Often, data from wearables is less than optimal: A smartwatch can easily mistake a downhill run for tachycardia or commit other errors, because optical sensors worn at the wrist can be tricked by motion. Moreover, optical sensors’ accuracy degrades for patients with darker skin tones—obviously, that’s a problem we must pressure developers to fix. Still, wearables present us with opportunities. If we educate our patients
about which metrics are relevant to their health concerns, and if we give instructions for how to tell us about those metrics, then we can reap immediate rewards in patient safety while kicking off longer-term positive feedback loops through patient engagement. Here are some considerations when incorporating wearables into clinical practice: It’s not an EKG—but it is a rhythm strip. As a cardiologist, it’s not ideal for me if a patient comes in and says, “My watch told me I had AFib last week,” and I say, “Well, let me see the strips,” and they don’t have them. Fortunately, I can teach the patient how to store this data on their iPhone, and then I can actually look at the tracings, which can be very high quality. A wearable, even one with imperfect data, still gives me a general sense of a patient’s heart rate variability, which is a measure of how well they adapt to scenarios such as workout, stress, activity, or sleep. People with poorer prognoses don’t move much off of their baselines. Someone with significant heart rate variability is healthier. And rhythm strips can let us know if the patient’s heart rate is fast or slow and regular or irregular, which moves us
toward diagnosing life-threatening conditions like atrial fibrillation (AFib) or making recommendations for improving overall health. A wearable doesn’t have to provide a full-on EKG for me to start getting a sense of a patient’s baseline, or for me to start using their wearable’s data to explain some of these concepts to them. It’s not a sleep study—but it’s a start. Smart rings help evaluate sleep patterns, though they vary in their degree of accuracy. For instance, some commercially available rings have trouble distinguishing waking up from being an active sleeper. That said, they’re still a place to start when we suspect a patient has sleep apnea. One reason we don’t test enough for sleep apnea in this country—although we know that sleep apnea raises patients’ risks for high blood pressure, AFib, and all sorts of other medical issues—is that it’s difficult to get approval from insurance companies. Depending on the details of your patient and your institution, a smartwatch or smart ring reporting hypoxia or bradycardia can be a place to start. Speaking of wearables and testing, see Wearables ...page 14
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