Digital Transformation, Wearable Technology, and Physician Wellbeing

by Julie L. Wei, MD •

What I found most interesting was that through multivariable regressions the researchers discovered that high stress was reported as the greatest factor related to burnout, followed by poor values alignment and then poor work control. —Julie L. Wei, MD

But what I found most interesting was that through multivariable regressions the researchers discovered that high stress was reported as the greatest factor related to burnout, followed by poor values alignment and then poor work control. (We in medicine use the word “stress” to describe experiences, events, a work environment, and/or a workplace culture that creates negative physical, emotional, and psychological strain.) Excessive home electronic health record use—what we commonly call “pajama time”—which was often reported as the top key factor for physician burnout in the past decade, was found to be the least associated factor based on adjusted odds ratio.

I find the contrast interesting that in industries that focus on performance, such as the training of professional athletes and even U.S. Navy Seals, the term “stress” is used coupled with the term “recovery” and is accepted as a positive and critical factor for growth and improvement. Given that the perception, experience, and response to stress is highly variable for physicians as individuals, global and efficacious solutions to reduce physician stress often seem futile. Is wearable technology combined with various platforms our new great hope?

Advanced Wearable Technology

Wearable technology (wearables) is a category of electronic devices that can be worn as accessories, equipped in clothing (shirts, belts, glasses, etc.), implanted in the user’s body (medical devices for drug delivery), jewelry, shoes, or even tattooed on the skin. They are often hands-free and powered by microprocessors, and they send and receive data via the internet. Artificial intelligence hearing aids and virtual reality headsets for gaming are two other examples.

Wearables are embedded with built-in sensors that track bodily movements and provide biometric identification and/or location tracking. Many devices track steps, distance, intensity, calories, electrocardiography results, heart rate and heart rate variability, and sleep monitoring. Most smart watches monitor vital signs using a strap around our wrists and can measure pulse rate variability.

Both heart rate variability and pulse rate variability are noninvasive techniques for monitoring changes in the cardiac cycle and assessing autonomic activity. Heart rate variability reflects changes in the cardiac sympathetic and parasympathetic branches of the autonomic nervous system. Most wearable technology uses the wrist and may report heart rate variability, although it’s arguably pulse rate variability since heart rate variability is measured from an electrocardiographic signal. (Pulse rate variability has been used to refer to heart rate variability information obtained from pulse wave signals such as photoplethysmograms and has been accepted as a valid surrogate for heart rate variability, but the relationship is not entirely clear as they can differ significantly under certain circumstances.)