Cardiologist Dr. David Kao is used to patients walking into appointments armed with data from their wearables. One Wednesday morning in late May was no different: a patient showed him stats from her smart band that she was worried about.

"Probably 70% of it, I just don't know what to do with clinically, because it's all been made up by the company," said Kao, an associate professor of cardiology at the University of Colorado School of Medicine. "And then there were like two things that were incredibly useful that we would not have had if she wasn't wearing her [device]."

Scenes like this have been playing out across the country for more than a decade as patients and doctors struggle to handle the glut of metrics produced by wearable technology.

"You just get this fire hose of all this different kind of information," Kao said. "Usually you have to look up some of it to even have a remote idea of how to comment on it, and there's not a way to digitally summarize or support a clinician in understanding what to do with any of that."

More than 30% of adults in the US own a fitness or wellness wearable, according to Statista. Heart rate, blood pressure, sleep patterns, stress, pulse oxygen - the individual human has never been more quantified. Yet the episodic care system isn't structured to accommodate an ongoing stream of health data.

"As much as the physicians do believe in its utility, their systems, their infrastructure, and the resources that they have, including time and staffing, aren't set up to receive and make use of that data," said Ream Shoreibah, teaching associate professor of marketing at the University of Alabama at Birmingham, who co-authored a recent report in The Journal of Consumer Affairs.

One key issue is integrating wearable data into electronic health records (EHRs). Absorbing that data requires two separate clouds owned by two big companies to talk to each other, with guaranteed patient matching. "All of that is just a Wild, Wild West," said Dr. Ida Sim, professor of medicine at the University of San Francisco and co-director of the UCSF and UC Berkeley joint program in Computational Precision Health.

Even when data could be ported in, providers juggle myriad accounts and logins for proprietary platforms, and governance remains murky - does a doctor need your heart rate every five minutes for three months in perpetuity? Meanwhile, metrics like "recovery" and "strain" don't translate neatly into clinical settings, and validity concerns create a "professional dilemma" - dismissing data risks alienating engaged patients, while acting on inaccurate readings risks harm.

Dr. Kenneth Civello, an electrophysiologist at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, recalls 2009 when Fitbit hit the market. An elderly woman loaded data on her iPad showing what looked like atrial fibrillation. "It was at that point that I kind of became a believer in wearables," he said.

Wearables have saved lives - Apple Watch alerts for irregular heart rhythms are well documented. Samsung bought care orchestration platform Xealth in 2025, which integrates with Epic, the largest EHR vendor. Civello hopes AI tools can help synthesize the "digital avalanche" and create personalized care via large language models, though HIPAA doesn't apply to chatbots.

Kao said the University of Colorado is working on solutions: "How do you partner the operational electronic health record with some kind of intelligence support that consumes all that external wearable data and processes it in a way that everybody agrees is useful?" Sim is helping build JupyterHealth, an open-source platform to avoid putting infrastructure in corporate hands. "Health is a public good," she said.

The American Academy of Neurology released guidance in March for neurologists on wearables. As more of us sport devices, Sim hopes people remember that charts aren't a magic key - diagnosing a human isn't like replacing a car's carburetor. For now, Kao guides patients through disappointment when their data trove isn't clinically useful. "Patients, admirably, want to know more about themselves," he said.