If digital health tech is going to be a fundamental part of healthcare going forward, then we need to be on guard against practices that encourage a digital divide. A team of researchers from the Massachusetts General Hospital, Demoulas Center for Cardiac Arrhythmias and Cardiovascular Research Center recently published a research letter regarding wearables discussions in healthcare settings. Recognizing that wearables that track activity, heart rate, ECGs, atrial fibrillation, and other factors that relate to heart health, the researchers analyzed provider notes of more than 520,000 primary care patients.

The study data included patients who had two or more primary care visits in from 1 to 3 years apart from 2005 to 2019. The team screened the data for device brand names such as Fitbit and Apple Watch and generic terms such as step tracker, and smartwatch. The researchers also looked for medical codes and conditions — such as arrhythmias, AF, and coronary artery disease — and for demographic characteristics including age, sex, race, ethnicity, and median zip code income.

The group reported a significant increase in mention of wearables from 2005 to 2019, with the fastest rise between 2012 and 2016. Among patients who owned digital health devices, 74.1% had Fitbits. In the patient notes that mentioned devices, the most common demographic factors were female, higher income zip codes, and self-identified white persons.

The Mass General study revealed patterns that suggest exposure to digital devices hasn’t been universal so far, but these are still early days. As digital health devices and practices such as remote patient monitoring and telehealth continue to spread, this study raises an early important flag to pay attention to inclusiveness so that we can realize the maximize beneficial outcomes of digital health for all populations.