Abstract 11436: Trends in Consumer Wearable Devices in a Primary Care Cohort

Introduction: Consumer wearable devices that record data relevant to cardiac health are widely available. However, whether providers find these devices relevant to clinical care, and in which patients, is unknown. Methods: We identified mention of wearable devices in provider notes between 2005 and 2020 in an EHR cohort of primary care patients in the Mass General Brigham healthcare system. Outpatient notes containing >250 characters were included. Search terms included “AliveCor,” “Apple Watch,” “Fitbit,” “Garmin,” “smartwatch,” “fitness tracker,” and alternative spellings. Demographics and cardiovascular comorbidities were compared between patients with and without device mentions. Notes with and without device mention were compared with respect to clinic type and diagnosis codes occurring on the same date. Incidence rates for device mention were calculated for each year. Results: The final sample comprised 494,254 patients and 27,221,019 notes. The mean age was 49.1 ± 17.0 years, and median follow-up was 6.9 (Q1 2.7, Q3 11.9) years. A total of 8,955 (1.8%) patients had ≥1 note mentioning a device. The proportion of notes mentioning devices increased over time (Figure), with increased incidence of device mention from 0.006 to 7.5 per 1000 person-years between 2005 and 2019. Most patients with device mentions were female (69.4%) and white (86.7%). At the time of first device mention, the mean age was 55.3 ± 14.0 years and 1,183 (13.2%) patients had prevalent atrial fibrillation (AF). Cardiology clinic notes comprised a greater proportion of notes with device mentions versus notes without device mentions (15.7% [5,336] vs 3.7% [996,971], p<0.001). A total of 9.3% (3,160) of notes with device mentions had same-day diagnosis codes for AF, versus 2.7% (730,614) of notes without device mentions (p < 0.001). Conclusion: Provider mention of consumer wearable devices in EHR notes has increased over time, and is associated with cardiology clinic notes and diagnosis codes for AF.