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. 2019 Sep 5;21(9):e14017.
doi: 10.2196/14017.

Literature on Wearable Technology for Connected Health: Scoping Review of Research Trends, Advances, and Barriers

Tatjana Loncar-Turukalo  1 , Eftim Zdravevski  2 , José Machado da Silva  3 , Ioanna Chouvarda  4 , Vladimir Trajkovik  2
Affiliations

Literature on Wearable Technology for Connected Health: Scoping Review of Research Trends, Advances, and Barriers

Tatjana Loncar-Turukalo et al. J Med Internet Res. .

Abstract

Background: Wearable sensing and information and communication technologies are key enablers driving the transformation of health care delivery toward a new model of connected health (CH) care. The advances in wearable technologies in the last decade are evidenced in a plethora of original articles, patent documentation, and focused systematic reviews. Although technological innovations continuously respond to emerging challenges and technology availability further supports the evolution of CH solutions, the widespread adoption of wearables remains hindered.

Objective: This study aimed to scope the scientific literature in the field of pervasive wearable health monitoring in the time interval from January 2010 to February 2019 with respect to four important pillars: technology, safety and security, prescriptive insight, and user-related concerns. The purpose of this study was multifold: identification of (1) trends and milestones that have driven research in wearable technology in the last decade, (2) concerns and barriers from technology and user perspective, and (3) trends in the research literature addressing these issues.

Methods: This study followed the scoping review methodology to identify and process the available literature. As the scope surpasses the possibilities of manual search, we relied on the natural language processing tool kit to ensure an efficient and exhaustive search of the literature corpus in three large digital libraries: Institute of Electrical and Electronics Engineers, PubMed, and Springer. The search was based on the keywords and properties to be found in articles using the search engines of the digital libraries.

Results: The annual number of publications in all segments of research on wearable technology shows an increasing trend from 2010 to February 2019. The technology-related topics dominated in the number of contributions, followed by research on information delivery, safety, and security, whereas user-related concerns were the topic least addressed. The literature corpus evidences milestones in sensor technology (miniaturization and placement), communication architectures and fifth generation (5G) cellular network technology, data analytics, and evolution of cloud and edge computing architectures. The research lag in battery technology makes energy efficiency a relevant consideration in the design of both sensors and network architectures with computational offloading. The most addressed user-related concerns were (technology) acceptance and privacy, whereas research gaps indicate that more efforts should be invested into formalizing clear use cases with timely and valuable feedback and prescriptive recommendations.

Conclusions: This study confirms that applications of wearable technology in the CH domain are becoming mature and established as a scientific domain. The current research should bring progress to sustainable delivery of valuable recommendations, enforcement of privacy by design, energy-efficient pervasive sensing, seamless monitoring, and low-latency 5G communications. To complement technology achievements, future work involving all stakeholders providing research evidence on improved care pathways and cost-effectiveness of the CH model is needed.

Keywords: assisted living facilities; review; telemedicine; wearable technology.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
The review workflow reflecting the number of articles identified, screened, processed and removed in each step. The remaining articles were used for aggregating and summarizing the results.
Figure 2
Figure 2
Statistics on the number of articles in the identification and study selection (screening and eligibility assessment) phase for each digital library. IEEE: Institute of Electrical and Electronics Engineers.
Figure 3
Figure 3
The number of analyzed articles versus the number of selected relevant articles on wearable technologies per year from January 2010 to February 2019.
Figure 4
Figure 4
The number of identified relevant articles per year from January 2010 to February 2019, sorted by the originated digital library (Institute of Electrical and Electronics Engineers [IEEE], PubMed, and Springer).
Figure 5
Figure 5
The number of relevant research papers per country and collaboration links with the annotated number of joint articles. For clarity, only 25 countries (nodes) with significant research contribution and minimum 7 joint collaborations (edges) are presented.
Figure 6
Figure 6
Distribution of the number of relevant articles with each of the defined keywords on an annual basis from January 2010 to February 2019.
Figure 7
Figure 7
The number of relevant articles containing each one of the keywords per digital library. The data are aggregated within the defined period. IEEE: Institute of Electrical and Electronics Engineers.
Figure 8
Figure 8
The number of relevant articles related to each property group per year within the predefined time frame from January 2010 to February 2019.
Figure 9
Figure 9
The property graph indicates the number of relevant articles with each property and the co-occurrences of properties in those.
Figure 10
Figure 10
The number of relevant articles containing each property grouped primarily into the technological domain in the period from January 2010 to February 2019.
Figure 11
Figure 11
The number of relevant articles related to recommendations and feedback on health monitoring solutions from January 2010 to February 2019.
Figure 12
Figure 12
User-related properties and concerns addressed in the relevant literature corpus from January 2010 to February 2019.
Figure 13
Figure 13
Safety- and security-related properties: protection, reliability, safety, and security. The trends in the period from January 2010 to February 2019 evidence their increasing presence (ie, relevance) as the wearable technology matures.
See this image and copyright information in PMC

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