Apple has made health — and helping people keep tabs on theirs — a cornerstone of how it is presenting the benefits of its newest Apple Watch, and today comes news of another way that this is taking shape. Zimmer Biomet, a world leader in developing the components and systems for joint replacements, says that it is working with Apple on a new clinical study focused on people who get knee and hip replacements.
The trial will come in three stages, and within two years, Zimmer Biomet projects that there to be up to 10,000 people involved, Ted Spooner, Zimmer Biomet’s vice president of connected health, said in an interview.
It will cover three aspects of patient care, he said: monitoring patients before and after operations using sensors on the Apple Watch and iPhone; providing education and information to patients to help improve their pre- and post-operation care; and providing a communications channel between doctors, caregivers and patients to ask questions, give answer and more, using Zimmer Biomet’s mymobility app.
Institutions that will be participating include University of Utah Health; Rush University Medical Center; University of Pennsylvania Health System; Emory University Orthopaedics & Spine Hospital/Emory Healthcare; Hoag Orthopedic Institute in Southern California; Newton-Wellesley Hospital, member of Partners HealthCare founded by Massachusetts General Hospital and Brigham and Women’s Hospital; Centura Health, Porter Hospital – Colorado Joint Replacement (CJR); ROC Orthopedics, affiliated with Legacy Meridian Park Medical Center; OrthoBethesda; OrthoArizona; Midwest Center for Joint Replacement; Hartzband Center for Hip & Knee Replacement; New Mexico Orthopaedic Associates; The DeClaire LaMacchia Orthopaedic Institute, affiliated with Michigan Institute for Advanced Surgery; Joint Implant Surgeons; Orthopedic and Fracture Clinic; Panorama Orthopedic and Spine Center.
The study — which for now will be US-only — comes after two years of Zimmer Biomet working with Apple behind the scenes, Spooner said, on not just making sure the parameters of what Zimmer Biomet hoped to achieve in a connected app would be possible, but also for Apple to understand what stakeholders in the health industry would want to see out of a health service built around a smartwatch and smartphone. Zimmer Biomet was a key target because today it accounts for one in every four knee replacements globally, and it has similarly strong market positions in hip, shoulder, foot, dental and spine products.
A measure of where Apple is placing the importance of this study is who they have commenting on its launch.
“We believe one of the best ways to empower consumers is by giving them the ability to use their health and activity information to improve their own care,” said Jeff Williams, Chief Operating Officer, Apple, in a statement. “We are proud to enable knee and hip replacement patients to use their own data and share it with their doctors seamlessly, so that they can participate in their care and recovery in a way not previously possible through traditional in-person visits. This solution will connect consumers with their doctors continuously, before and after surgery.”
Hip and knee replacements are the most common “replacement” procedures that take place, accounting for one million operations each year in the US, according to Deloitte, a figure that will grow to 3.5 million by 2035 as our population grows, stays alive for longer, and includes more people who were much more active in their earlier years in a wider upswing for fitness.
You might assume that it would be an uphill challenge to sell the idea of connected health services to older people — who are the typical recipients of these operations — but Spooner said that the opposite is the case.
“It turns out that the fastest adoption group for smartphones is 55-64 right now,” he said, saying that they are currently buying smartphones and other connected devices three times as fast as the next group down. Some of that of course might be because older people have been slower to adopt, but nevertheless, he points out, the stats “are really staggering, considering that other groups are at less than a two percent compound annual growth rate.” Smart watches, he said, have a similarly high growth rate among the elderly. “When they use it, the utility they get is higher than in younger populations, and people have such sensitivity to their health as they get older, that we thought this is the right time to do what we are doing.”
The core problems that Zimmer Biomet and Apple are hoping to address are around making sure that patients are able to be more engaged with their course of treatment, and in cases when something has not gone to plan, people are able to identify this and act on it. Part of the system will involve a larger dashboard and analytics for doctors and caregivers to help assess how people are doing in between in-person appointments.
On the patient side, they will be getting alerts leading up to their operations, suggesting activities that they should be doing to keep themselves active ahead of surgery. And doctors will be able to monitor just how well they are actually doing them, by looking at things like movement, heart rate, and specifically how much they are doing basic things like standing during the day. The same will continue after the operation. Throughout, a patient will also be able to contact their medical team if, for example, they are worried about how a scar is looking, although Spooner said that he is not sure that this has been conceived as the primary use case as much as monitoring and education.
Zimmer Biomet’s move into collaborating and working more closely with Apple comes at a time when medical companies — like those across so many other industries — are realising that they have to jump on the innovations afforded by the rise in digital services, lest they be cut out of whatever the future holds for medicine and healthcare. Spooner says that he came to Zimmer Biomet by way of RespondWell, a startup he founded focused specifically on this challenge.
“We were in the marketplace trying to understand what kind of biometric data collection was available so that we could measure patients continuously to use that data to drive more insight into conditions and how to work with caregivers,” he said. The startup was using Microsoft Connect, “but at the same time Zimmer Biomet was having preliminary conversations with Apple. We went to Cupertino with the idea of a common vision, and that is what led to this collaboration.”