Fitness trackers could give a helping hand to people doing cardiac rehab

Three NHS healthcare trusts are taking part in testing the Digitally Enhanced Rehabilitation in Cardiac Patients (DERIC) care platform. These are the Northumbria Healthcare NHS Foundation Trust, Imperial College Healthcare NHS Trust, and Sheffield Teaching Hospitals NHS Foundation Trust. 

These trusts are working in collaboration with Fitbit, Google and ConnectedLife, using smartwatch data and a connected app to enable cardiac rehabilitation to be delivered to patients in their own homes. Cardiac rehab is a programme of exercise, support and information sessions to help patients recovering from a heart attack or heart surgery.  

The DERIC programme will use Fitbit smartwatches to measure heart rate, rhythm and monitor both general activity and exercise levels. Andrew Edmunds, Director of Innovation at Northumbria Healthcare NHS Foundation Trust, told us: “The Fitbit activity monitor is an efficient and objective way of collecting and storing this information rather than patients self-reporting.”

In other words, it makes it easier for the patient to collect this information to share with their care team. The ConnectedLife mobile app then allows patients to add further information, including weight, blood pressure, diet and other health data.  

This can then be shared with the patient’s care team, to support their rehabilitation. Nicola Maxwell, from Fitbit, said: “This collaboration helps doctors, nurses and other health professionals to remotely monitor their patients. It could lead to better condition management and potentially reduce the burden on the healthcare system.” 

According to Health Data Research UK (the national institute for health data science) more than 100,000 patients use cardiac rehab services each year. Rehab services are believed to “reduce the risk of heart attacks, death and hospitalisation; lower healthcare costs; and improve quality of life”. 

However, despite these benefits, “UK hospitals consistently fail to achieve targets for cardiac rehabilitation uptake and completion…Women and those from deprived areas, who are already at higher cardiovascular risk, have poorer rates of cardiac rehabilitation uptake and programme completion.”  

Around 50,000 people a year do NHS cardiac rehab. Hospitals are increasingly offering “virtual” cardiac rehab that people can complete at home, as a way of trying to increase uptake.  

The app, coupled with the Fitbits, will allow care teams to access information about their patients, to then use when having conversations and exchanging messages with those patients about their care plan. The hope is that this may improve completion rates in cardiac rehab, as well as making virtual rehab more effective in improving people’s health. 

Patient data from during the trial will not be accessible to the tech companies involved. As Professor Cathie Sudlow, Director of the BHF Data Science Centre, explained: “To ensure that the assessment of DERIC is independent, the companies involved in developing DERIC – ConnectedLife, Fitbit and Google Health – will not access patient medical records or be involved in the analysis of the trial results”. 

Should the trials prove successful, the programme could then be tested in other ways. Dr Susan Thomas, clinical director at Google Health London, said: “There is the potential to extend the programme to other NHS sites and explore its use in other care pathways which might benefit from remote patient monitoring and communication.” 

Northumbria Healthcare NHS Foundation Trust told us: “The trial will be open to suitable patients that will be selected by cardiac specialists at the three trusts.  

“Our aim is that the outcomes of this study will be applicable to the wearables market in general regardless of brand”. So if the trial goes well, the hope is that this system could potentially be used by anyone with a suitable smartwatch or fitness tracker. 

The NHS long-term plan emphasises the importance of digitally enabled care in the future of the NHS – and not just fitness trackers. One example of this is the NHS Digital Weight Management Programme, which uses apps such as Slimming World and More Life to support weight –loss.  

Other examples include the Clin-e-cal ASSIST study, which is testing the use of a smartphone app to help people with asthma use their inhalers properly, and the ongoing EMBRaCE trial, in which the Oura Smart Ring, Withings ScanWatch and Isansys chest-worn sensor are being tested to see whether they can help doctors in assessing the progress of their cancer patients, and whether they can support patient recovery.  

For anyone who can’t access their local cardiac rehab services, the British Heart Foundation has a wealth of information on cardiac rehab at home, including an eight-week cardiac rehab e-mail programme. They also offer a range of cardiac rehab exercise videos, created by their team of medical experts.