Insights into how AI and wearable technologies are impacting the future of healthcare

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Imagine a world in which the digital watch on your wrist tracks not only your step count, but also your blood sugar, heart rate, blood pressure and respiration. Then, the watch automatically sends a personalized health snapshot to your physician, alerting them to early signs of disease.

That scenario could become reality in the near future, according to Joseph Schwab, MD, director of the Cedars-Sinai Center for Surgical Innovation and Engineering, who is leading innovative research in wearable healthcare technologies.

Schwab, also Cedars-Sinai's director of Spine Oncology for Orthopaedic Surgery, will present the latest trends in his research about wearable health technology during the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting in San Francisco, Feb. 12-16. During the conference, Schwab also will participate in the President's Symposium, sharing insights on generative artificial intelligence (AI), such as ChatGPT. He also will discuss healthcare privacy issues that can occur with these technologies.

The Cedars-Sinai Newsroom sat down with Schwab to discuss the scope of his research and how he sees AI impacting the future of healthcare.

What makes your lab different from other research facilities?

My co-director, Hamid Ghaednia, PhD, is a mechanical engineer and our lab is unique in the sense that it is heavily engineering-based. A lot of what we are doing day to day is building things. So rather than test tubes and microscopes, we have lathes and band saws. We have several 3D printers and a whole room dedicated to electronics, where we solder devices together. The research team's engineering expertise is a key differentiator, and our clinical and engineering partnership is distinctive to what we do. Not only do we have the equipment, but we have the know-how to go with it.

We are one of the few research facilities in the country where we can identify a clinical need, discuss it, come up with a potential solution, build that solution and begin testing, all within one center.

What are a few of the innovations you're working on?

Our focus area is wearable devices. Consumer wearables on the market are essentially motion trackers. They may have an accelerometer or gyroscope that can simply measure your position or motion to track steps and other data. What we're doing is different in that our devices are sending energy-;in the form of light, electrical energy and sound-;into the tissues, and we can measure that energy as it leaves the tissue, and we can deduce things based on how the energy was affected by the tissue.

For example, when you are at the doctor and they use a reflex hammer above your knee to test for a reflex reaction, they are only able to identify the presence or absence of the reflex. Instead, wearable devices that we are developing can quantitate the reflex response-;things like how long it took to respond, the robustness of the response, etc. We can give a very specific number connotation to these data points, which we hope will translate into better diagnoses.

How is AI used in the work you do?

The sensors on our wearable devices receive an incredible amount of data from the energy after it has traveled through the tissue, which requires advanced computing power to interpret. At its core, AI is just that-;very advanced mathematics and computer programming. We utilize AI to interpret the data captured and correlate it to clinical problems.

Separate from our wearable technologies, we are also able to use AI to make predictions on a smaller scale for use in clinical practice, such as interpreting electronic health data. For instance, a patient may be considering a procedure that has a 5% risk of complication for the whole population; however, using AI to interpret their personal health information, we may learn that their individual complication risk is closer to 25%. This could heavily impact their decision-making. Giving more precise predictions like this is a form of personalized medicine. 

Who can benefit from these new technologies? 

These technologies can truly benefit everyone across the healthcare spectrum. Patients whose health data is analyzed could receive more personalized care. They could be directed to more precise tests to get an accurate diagnosis and personalized treatments, for example, and may ultimately have better outcomes.

There's even the potential for a positive impact on healthcare payers and insurance companies by making the right treatment decisions, and thus reducing health expenditures. There are so many opportunities and benefits.

Where do you see this field headed in the next five to 10 years?

In my opinion, it won't be too long before we stop using the terms artificial intelligence and machine learning altogether because it will just be integrated into everything we do, running in the background as common practice. It will no longer be a mystery.

As it relates to wearable technologies, I see these becoming part of the expected process of medical assessments. There is the opportunity to learn so much more through these devices than you would glean from a basic physical examination, and the data can be captured in advance of a patient even seeing the provider. A medical appointment can become much more accurate and efficient when the provider has already been able to review and interpret the data collected.

Wearable technology and the integration of AI into the consumption and delivery of healthcare is only going to continue to grow with time, and I think people will become very comfortable and begin to rely on these devices in a good way.

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