Consumer wearables become the new gatekeepers of clinical health care

JMIR Publications today released a News and Perspectives expert analysis on consumer wearable platforms' forays into the clinical health care space. Authored by MedTech expert Blythe Karow, MBA, "Meet the New Health Care Gatekeeper: Your Wearable" lays out the implications of wearable tech companies owning the first conversation about a patient's health, as well as the potential impacts on patient trust, policy, and regulation.

Owning the first conversation 

For decades, primary care physicians have served as the entry point to medical care, organizing referrals, tests, and treatments, writes Karow. Now, consumer wearable platforms are accumulating continuous physiological data-such as sleep patterns, heart rate variability, and blood pressure trends-allowing them to detect health changes before the user does. By incorporating artificial intelligence to interpret this data, these platforms effectively own the first conversation about a patient's health, positioning themselves to influence which specialists users see, which treatments they consider, and which care programs they enroll in.

The shift toward clinical routing 

Major investments and strategic shifts signal that wearables are no longer just consumer tech plays. Karow notes that the fitness wristband company WHOOP recently closed a $575 million funding round with investments from Abbott and Mayo Clinic, and its newly created affiliate has been selected into a Medicare outcome-based chronic care model. Similar moves are occurring across the industry, with companies like Oura integrating with Medicare's electronic health record infrastructure, and others such as Apple, Samsung, and Verily building clinical, regulatory, and reimbursement infrastructures. Wearables are now competing to become the routing layer for clinical care, helping to alleviate the strain on overworked doctors and assisting patients with proactive monitoring.

Navigating new regulatory risks 

While there are clear benefits to continuous monitoring, Karow cautions that the rapid consolidation of these platforms raises significant regulatory and ethical concerns. Consumer technology companies operate on business models traditionally built on user attention, subscription revenue, and the monetization of user data. Unlike American physicians, who are legally prohibited from financially benefiting when referring patients to specific specialists, wearable platforms that control physiological monitoring, AI interpretation, clinical routing, and reimbursement under one roof have yet to face the same structural antitrust scrutiny. Policy and regulatory frameworks in the United States, writes Karow, are not yet ready to handle the risks brought on by integrating consumer wearable platforms into health care-and so far, consolidation hasn't waited for policy to catch up.