Bridging the Regulatory Divide: Ensuring Safety and Equity in Wearable Health Technologies
Akshay Kelshiker (1), Susan Cheng (2), Jivan Achar (3), Leo Anthony Celi (4,5,6), Divya Jain (7,8), Thinh Nguyen (9), Harsh Patel (10), Nina Prakash (11), Alice Wong (11), Barbara Evans (9) ((1) Albert Einstein College of Medicine, (2) Independent Researcher

TL;DR
This paper discusses the regulatory challenges of wearable health technologies, highlighting safety, equity, and oversight issues, and proposes a flexible framework to address risks and improve public trust.
Contribution
It introduces a novel, adaptable regulatory approach emphasizing distributed risk and patient-centered outcomes to better oversee wearable health devices.
Findings
Current regulations are insufficient for new wearable tech complexities.
Reusing wellness devices for medical purposes poses safety risks.
A flexible, iterative regulatory framework can enhance safety and equity.
Abstract
As wearable health technologies have grown more sophisticated, the distinction between "wellness" and "medical" devices has become increasingly blurred. While some features undergo formal U.S. Food and Drug Administration (FDA) review, many over-the-counter tools operate in a regulatory grey zone, leveraging health-related data and outputs without clinical validation. Further complicating the issue is the widespread repurposing of wellness devices for medical uses, which can introduce safety risks beyond the reach of current oversight. Drawing on legal analysis, case studies, and ethical considerations, we propose an approach emphasizing distributed risk, patient-centered outcomes, and iterative reform. Without a more pluralistic and evolving framework, the promise of wearable health technology risks being undermined by growing inequities, misuse, and eroded public trust.
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