Every night before going to bed, Steve Tulk slips off his wedding band and replaces it with his Ōura ring, a $300 titanium sleep-tracker that uses infrared light beams and sensors to measure his sleep quality, heart rate, heart rate variability, breathing rate and skin temperature. And every morning when the 54-year-old executive wakes up, the Ōura ring calculates a score that helps him monitor his overall quality of life. “At my age, I need to be careful with my health,” says Tulk, chief technology officer at Closerlook, a Chicago-based firm recently acquired by the Fishawack Health network.

Ever since the pandemic took hold in early 2020, wearable health-tracking gadgets such as Ōura and Fitbit have exploded in popularity. So, too, have a host of smartphone-based apps that let users do everything from receive mental health counseling to pinpoint their risk of COVID-19 exposure.

“With the pandemic came a tremendous amount of stress. People weren’t even able to get outside,” Tulk says. “All those ways they’d naturally deal with stress, such as going out to exercise, were taken away. So people quickly turned to technology.”

A June 2021 survey of some 40,000 U.S. and British citizens by Piplsay found 30% of Americans have downloaded health apps to their phones since the World Health Organization declared COVID-19 a pandemic in March 2020. Furthermore, 57% have used telemedicine services during the crisis, while 43% have more than three health apps installed on their phones.

In addition, 48% of Americans plan to keep using those services even after the pandemic is over. Yet they’ll do so with a small degree of hesitancy: 65% worry about their data privacy and app security.

By way of example, Tulk points to telehealth, which exploded in popularity in the pandemic’s early months. “Telehealth was a thing before the pandemic, but, like many things, it was fast-forwarded by the pandemic,” Tulk notes. “The wife of our CEO is a doctor and her telehealth practice went through the roof. It was the only way she could properly serve her patients.” 

According to an analysis by McKinsey, overall telehealth utilization for office visits and outpatient care in April 2020 was 78 times higher than it was in February 2020. Since then, the use of telehealth has stabilized at levels 38 times higher than before the pandemic.

According to Klick Health EVP, growth Destry Sulkes, none of this should come as a surprise.

Calm, the subscription-based app for sleep, meditation and relaxation, has had more than 100 million downloads.

“Time spent on these apps has grown significantly, to maybe 10 times more than before the pandemic,” he explains.

All that stay-at-home time has led to weight gain, alcoholism, sleep problems and extreme stress, Sulkes adds, noting the abundance of apps that attempt to address such concerns. 

“[The additional time spent on apps] is because people are seeking more help, not necessarily because they have more time. And they’re seeking it digitally, because many of us are still at home.

“Reaching for our phones was never really an option before,” Sulkes continues. “These services were there, but they were very limited in uptake. Now we’re seeing people reach for healthcare the same way they reach for travel help or online banking.”

That, of course, varies by specialization. While surgery is still very much a hands-on affair, psychiatry lends itself perfectly to remote consultation because few physical exams are involved. Then there are the neurologists, gastroenterologists, rheumatologists and endocrinologists who surprised digital health experts by turning to telehealth easily and with surprising enthusiasm since the pandemic hit.

Sara Holoubek, CEO of consulting firm Luminary Labs, says that, by the time COVID-19 swarmed the country, Americans were already in the midst of a digital transformation.

“It took us two decades to get to the point where an increase in internet penetration, coupled with wireless connectivity and the rise of mobile devices, meant that a very large percentage of Americans now have access to a smartphone,” she explains. “That probably changed a lot about how we moved around and made choices during the pandemic to mitigate risk.”

Early on, right around the time masking and social distancing became a thing, pulse oximeters were in hot demand. The devices, which measure oxygen saturation levels in the blood, are now readily available at most local pharmacies, though their utility in determining if someone has COVID-19-related lung symptoms was questionable from the outset.  

“This became something individuals might have been more willing to buy a smartwatch for. It was data that I never thought I really needed to know about my body,” Holoubek says.

As the pandemic wore on, oximeter apps declined in popularity, while fitness and mental health apps became all the rage. Millions of work-at-home types are now obsessed with the idea of logging at least 10,000 steps a day. 

Those with more money to spend have gobbled up expensive devices such as Lululemon’s Mirror, a $1,495 interactive workout machine that claims to “turn less than two feet of wall space into a personal fitness studio” by streaming on-demand and live workout classes. Also popular are apps that assess exposure to COVID-19 infection, such as MyCOVIDRisk, developed by Brown University physicians Dr. Megan Ranney and Dr. Elizabeth Goldberg.

Then there are mindfulness apps such as Calm and Shine, which aim to reduce stress and improve sleep quality. Calm claims more than 100 million downloads; the subscription-based service has been anointed by the Center for Humane Technology as “the world’s happiest app.”

Yet the past year and a half hasn’t been a particularly happy time for Americans, especially people of color who experienced police brutality and systemic racism in addition to the pandemic. According to the Mayo Clinic, Black and Hispanic Americans are 4.7 times more likely to be hospitalized for COVID-19 than their white counterparts.

All that fear and stress has led to the rise of digital apps such as Hurdle. Its founder and CEO is Kevin Dedner, a critic of the U.S. mental health system, which he says is “designed for middle-class white people” and not the Black Americans who comprise the bulk of Hurdle’s users.

“The pandemic and social unrest we saw following the death of George Floyd pushed people to a tipping point,” Dedner says. “People began seeking out mental health services. That’s why companies like ours have emerged to try to respond to more culturally responsive therapy.”

Hurdle offers daily motivational meditation and messaging, as well as 45-minute remote video sessions with trained therapists. Working directly with employers and payers, it now covers DC, Maryland and Virginia, and will expand to California, Massachusetts, New York and Texas before the year is out.

A final pandemic-era digital health breakout performer is one that predates COVID-19: the now-ubiquitous QR code.

“It’s so flexible, it can be used for anything,” Holoubek says. “Its best application to date is the ability for consumers to do things in a safe way, such as downloading menus at a restaurant for ordering. The QR code found its use during the pandemic and I think it’s here to stay.”

Holoubek adds that, as COVID-19 mutates and new variants such as Delta take hold, risk mitigation will become more important, even for people who have been vaccinated. That will likely lead to even more advances in digital health.

“In places like New York, you have to be vaccinated in order to eat indoors at restaurants or go to Broadway. Every individual entity has its own screening app, but there really needs to be one screening app — a standardized screener similar to a vaccine passport,” she says. 

“A lot of innovation remains to be done.”