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Wearable devices are unlocking a personalized version of health care

Wearable devices like the Apple Watch can collect valuable health data, particularly for people with chronic illnesses, but they are not subject to the same privacy rules as traditional medical devices, experts say. (Photo by Paige Gross/States Newsroom)

Wearable devices like the Apple Watch can collect valuable health data, particularly for people with chronic illnesses, but they are not subject to the same privacy rules as traditional medical devices, experts say. (Photo by Paige Gross/States Newsroom)

For 27-year-old Amanda Lien, the decision to start wearing popular wearable tech devices, like her Apple Watch and Oura Ring, didn’t come lightly.

The Chesapeake, Virginia-based content marketing specialist works for a healthcare company, and probably knows more about healthcare data privacy issues than most, she said. She’s also not inclined to wear jewelry on a daily basis, but an official diagnosis of Mast Cell Activation Syndrome — a chronic disease she’d experienced symptoms of her whole life — in 2024 made her reconsider. 

“I was like, ‘okay, if I could have a quantitative numbers-based way to check my gut on is this aspect of my health really getting worse, or am I just, am I reading too much into it?’ Or is something else going on?” she said. “It’s what finally got me to cave and get an Oura ring.”

Though the concept of fitness tracking through wearable devices has been around for decades, the ability to track biometric features like heart rate, sleep quality and stress response has become more ubiquitous in recent years. Consumers who are interested in a device they can wear 24/7 that collects data points on varying aspects of their health have no shortage of options, and new devices roll out every year.

The devices have become popular for those looking to track athletic goals and energy levels, but for some wearers, like Lien, they also provide a view into their own health they haven’t had access to before. 

Lien holds some concerns about data privacy with the devices, choosing carefully which aspects of her biometrics she allows the devices to track, and which she does not. She sees her devices as tools — one piece of how she manages long-distance medical care in a complex, and often inaccessible healthcare system. 

“I can go from a completely healthy-presenting, normal-presenting human to being in bed for two weeks in the span of, it has been as quick as under 12 hours,” Lien said. “And there are warning signs that my body is being run down leading up to this. … But having the ring warn me that my body is showing signs of decline, and that I might be getting sick has enabled me to not only get in touch with my doctors, but also try to proactively get an appointment if that’s needed.”

Healthcare interventions

Wearable devices use sensors to collect constant data about heart rate, blood oxygen levels, temperature and motion, and other measurable factors. Users can view the data directly, sync it with other apps and collect a report that tracks trends over time. 

Because she’s managing an ongoing condition, and can only see her doctors every so often, Lien said her Oura Ring functions as a record keeper for all the data that may help her answer the question, “how are you feeling?” or “how have you been sleeping lately?”

“In front of my doctor, I can look up my sleep score, which helps jog my memory about what the heck is going on,” she said. “But it also pays attention to things that I don’t, like how long I was asleep or how long I was in REM sleep.” 

With data collected by her ring and through talks with her doctors, Lien has also learned to adjust parts of her routine, like when to eat in relation to taking medication, or by taking time off from work to rest when the ring warns her that she may be getting ill. 

Houston-based Stacee Hawkins, a 57-year-old with Parkinson’s disease, has been using her Apple Watch in combination with an app called StrivePD to track the condition’s affect on her motion. The watch and app combo tracks her eating, medication and movement and has offered a lot more insight than trying to document it on her own. 

“Almost within maybe two weeks of looking at the information that I was getting back on when my tremors happened, I could see kind of when my medication kicked in,” Hawkins said. “And one thing I noticed was that on days when I exercised, my medication kicked in about 50% earlier.” 

Her doctor also saw through the data collection that Hawkins’ medication wasn’t lasting as long as it should through the day, and adjusted accordingly. 

Brianna Hood, a physical therapist and clinical specialist at Rune Labs, the company that produced the StrivePD app, works with the company’s product and design team and clinicians to best utilize the data they receive. 

The effects of Parkinson’s disease fluctuate day by day, she said, and ongoing data helps the patient’s doctors adjust their physical therapy exercises or alert neurologists and movement disorder specialists when the device tracks decline. The wearables help keep management of the disease from being too much of a “guessing game,” Hood said. 

“Parkinson’s has its ups and downs. I’ll have … a string of a couple of weeks where I’m doing really well, and then I’ll have a string of days, maybe even a week or two, where I’m really struggling with it,” Hawkins said. “Having all that information gives me some objective information to pair with my subjective observations of myself.” 

Physician Lucienne Ide often works with information from wearable devices for her digital healthcare company Rimidi, a platform that helps with remote patient monitoring and chronic disease management. 

She sees how the devices are helping to fill gaps in an overwhelmed and often understaffed healthcare system by helping patients advocate for themselves during visits. Ide even has personal experience with an emergency intervention — after her husband underwent open heart surgery a few years ago, Ide tracked his heart rhythms on two smart watches, and spotted atrial flutter, a heart rhythm disorder, which she alerted doctors about. Because of her monitoring, he was able to receive care in enough time. 

But Ide thinks officially integrating smart wearable devices into healthcare systems is a tricky move. She also pushed back on the idea that every American should have a wearable — a statement Health and Human Services Secretary Robert F. Kennedy Jr. made in a House subcommittee in June

“I don’t think we have the workflows built out around where that data goes, who it goes to, how it gets reviewed,” Ide said. “You know, clinicians have concerns around liability, right? If this data is shared with me, especially if it’s sort of continuously streamed to me, you know — if a tree falls in the forest, am I liable for it?”

Data collection and privacy concerns

Despite wearables acting a tool for both patients and doctors, the companies that produce them do not need to follow the same levels of privacy and safety regulations that FDA-approved medical devices would, and information does not need to be protected under the Health Insurance Portability and Accountability Act (HIPAA), said Andrew Crawford, senior council with the Center for Democracy and Technology’s Privacy and Data team. 

“There’s potential for discriminatory treatment when it comes to insurance rates or possible profiling by data brokers, creating profiles of people based on either direct or inferred health conditions,” Crawford said. “That then affects not only the type of ads people see, but maybe the types of opportunities that are presented to them when they seek things like insurance.”

It can be a daunting task to stay on top of the privacy policies of each device and app, Crawford said. The U.S. doesn’t currently have federal data privacy protections, but such legislation might bring more transparency to industries like these, that deal with sensitive personal data but aren’t regulated under healthcare laws. 

“Because of that, it’s on each consumer to do their homework, to read those policies, hopefully try to understand them and then make a decision based on how comfortable or not they are with the data practices associated with that product,” Crawford said. 

Oura’s data collection and privacy policy were recently called into question when the company said it was partnering with the Department of Defense and data mining company Palantir, which is used by law enforcement agencies, Immigration and Customs Enforcement and the Centers for Disease Control and Prevention. Droves of users took to social media to announce they were ditching their rings in response, some spreading misinformation that the military now had access to all of their health data. 

“For the record, we will never share your data with anyone unless you direct us to do it,” Oura CEO Tom Hale said at a Fortune event in early September. “We will never sell your data to anyone ever.” 

But both Lien and Hawkins said they have their reservations about how data is stored and who has access to it. A few years ago, Hawkins said she wouldn’t be as worried, but “with the current administration, that is a deep concern,” she said. 

“Five years ago, I would say, ‘Oh you know, of course, our governmental entities recognize that this is our private information. There’s no way the government would, you know, pressure companies to provide that,” Hawkins said. “I can’t say that anymore.”

Lien doesn’t worry about privacy for heart rate data, stress, exercise or sleep — the primary data points she collects. But she’s very aware of how certain healthcare information, like menstrual cycle and other reproductive information, could be vulnerable and potentially dangerous to track digitally after the fall of the constitutional right to abortion in 2022.

“My reproductive cycle is a whole other beast to me, and if the app were to start tracking my location, that would be a big no for me,” Lien said. “I understand that right now, especially, human-generated data in particular, is often for sale. And also that sometimes to use a tool, you have to decide if you are willing to, knowing that, still use that tool. And for me, the trade off is worth it.”

But both women say they continue to make the choice to use their devices as a key role in managing their health. Maybe the healthcare industry will evolve to regulate the devices more and give them more peace of mind, they said, but for now, their concerns are outweighed by the agency they’ve gained. 

“Using a wearable and the information that it gives you can be very empowering. With something like Parkinson’s, it’s hard not to feel like a victim sometimes, because there’s so much you don’t control, but having that information gives you power,” Hawkins said. “You know, knowledge is power, and knowledge dispels fear. And empowerment and courage are two things you really need when you’re facing something like this.”

Editor’s note: This item has been modified to correct Stacee Hawkins’ age. She is 57.

This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.

Trump’s $100K fee for H-1B visas could have ‘huge’ effect on tech industry

President Donald Trump signs an executive order on Sept. 19, 2025, introducing a $100,000 fee for H-1B visas that allows foreign nationals permanent residency and a pathway to U.S. citizenship. (Photo by Andrew Harnik/Getty Images)

President Donald Trump signs an executive order on Sept. 19, 2025, introducing a $100,000 fee for H-1B visas that allows foreign nationals permanent residency and a pathway to U.S. citizenship. (Photo by Andrew Harnik/Getty Images)

proclamation signed by President Donald Trump last week seeking to restrict entry of non-immigrant workers to the U.S. and apply a $100,000 fee to H-1B visa applications created confusion and concern within the tech industry over the weekend. 

Immediately after Friday’s announcement, companies of all sizes, including tech giants Microsoft and Amazon and smaller startups, began calling any workers with H-1B visas who were traveling outside the U.S. to return to the country by the proclamation’s deadline of midnight Sunday. 

“It’s been seismic, to say the least,” said Nicole Gunara, a principal immigration lawyer with Manifest Law. “People are trying to fight to get out of planes, cancel flights, fly back as quickly as possible, privately chartering boats and planes in the night.”

The Trump administration has since clarified that only new H-1B visa applications would be subject to the fee. Officials also said the proclamation would not impact the ability of visa holders to travel to and from the U.S., but the announcement sent many companies and their foreign workers into a “panic,” Gunara said.

H-1B visas are given to non-immigrant foreign candidates with college degrees who fill highly skilled positions that U.S. companies struggle to hire for. Each year, the U.S. caps the number of new visas to about 85,000, and there were about 730,000 H-1B workers in the U.S. at the start of 2025. 

The visas have traditionally cost between just under $1,000 to a few thousand dollars a year, and are paid by the companies. Companies must pay their H-1B workers at least an average wage for their geographical area, to not undercut the cost of wages for other workers. In 2023, the median wage for H-1B workers was $118,000, on par with the 90th percentile ($121,000) of all U.S. wages.

Many of these roles are in information technology, with Amazon, Microsoft and Meta leading the top Fortune 500 companies with the most H-1B visa workers, with 12,391 workers, 5,189 workers and 5,123 workers respectively. About 70% of H-1B visas went to Indian workers and nearly 12% went to Chinese workers last year. 

Trump’s proclamation calls for American companies to rely on American workers for these roles, saying there is “abuse” of the H-1B program. But domestic educational institutions just aren’t preparing Americans for the type of skilled labor that many of the tech companies are seeking, said Elizabeth Ricci, immigration attorney and partner at Rambana & Ricci.

Trump has cut science funding to its lowest level in at least 35 years, and his cuts to the National Science Foundation and other research organizations are having direct effects on K-12 and college tech education. 

“It’ll have a huge effect,” Ricci said of the cost of fees on the industry. “We can’t have it both ways, where we’re not educating the people we need and also having such an incredibly high fee to be able to get a visa to bring someone in to do work for places like Apple and Google.”

U.S. companies have faced a shortage of skilled tech workers for years. Recruiting and talent firm Robert Half reported 87% of tech leaders said they faced challenges finding skilled talent earlier this year. And Silicon Valley tech giants have long sought global talent to help build American companies.  

“There is a dire shortage of extremely talented and motivated engineers in America,” X CEO Elon Musk posted on the platform, earlier this year. He compared tech companies to a pro sports team scouting players. 

“If you force the world’s best talent to play for the other side, America will LOSE,” he wrote.

But large tech companies will not be the only ones to feel the effects of the change if it is upheld. Startup companies, many of whom are responsible for new technology advances, also rely on H-1B visa workers. 

Pedro David Espinoza, a Peruvian-American entrepreneur and investor, said that many of the startups he works with in the Bay Area have hired H-1B workers to their small teams of 20 or 30 people. 

“We probably are going to skip on many foreign hires altogether, because it’s really expensive, and this will definitely, to a certain degree, stifle innovation,” he said.

Ricci said she thinks the $100,000 fee will result in fewer jobs, and may make America’s global competitors more attractive to these highly-skilled workers. 

“People aren’t going to want to come here if the rules are changing day by day, and they’re going to be put in jeopardy just by going home for a vacation or to see a loved one and not know if they’re going to be able to come back. It’s too tenuous,” she said. “And if they can have promises of continuity in places like the UK, they’re going to go there, and they’re going to make those countries better.”

Gunara said she’s unsure that Trump’s proclamation will have the desired effect of hiring more American workers. In the last few days, she’s heard from clients that they’re considering offshoring tech teams, or setting up entities outside of the U.S., maybe in Canada or somewhere with similar time zones. Companies may also pursue alternative plans for these foreign workers, like a J1 visa, which allows people to research in the U.S. for a temporary period of time. 

Gunara said she believes many people are aligned on the idea that America needs the “best and brightest” talent, but that we could be more mindful of cultivating domestic talent where possible. She suspects there will be legal challenges to the action, but that it speaks to the larger Trump administration attitude toward immigration. 

“Innovation moves immediately, right? Innovation doesn’t wait for that talent to already be trained,” Gunara said. “And I think that that’s going to be the inflection point between the initiatives of the government versus what companies are going to be able to do.”

This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.

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