Smart and smarter. The battle for the "smartest" watch

Following on from a blog post I wrote at the beginning of January the media attention around smart watches seems to have reached fever pitch. Thanks to @Paul_Sonnier's Digital Health Group on LinkedIn I came across this article about how Samsung are already launching their second generation smart watch. From what I can gather it does pretty much what the original Samsung Gear did, but has been redesigned to be more ergonomically sound.

As the article appears on a site called 9 to 5 Mac it's hardly surprising that the majority of the discussion is around when Apple are going to launch their smart watch. This article from a few days ago is quite fascinating, suggesting that Apple's new smart watch (note no-one is saying that Apple won't go down this route) is going to have way more health data functionality that just movement sensing.

As mentioned previously, although valuable, there has to be more to wearable devices that purely movement tracking to make them truly useful health management adjuncts for the masses. Jawbone, Nike and Fitbit have all done great jobs of taking the humble pedometer and transforming it into a piece of tech that can be integrated seamlessly into daily life (albeit with a slight bump in the road for the Fitbit Force), but this surely is just a first step.

For most of us our wristwatch is the only item we wear every day. It therefore makes sense to use it as the conduit to capture health related data. It doesn't seem beyond the realms of possibility to have a wristwatch continuously monitor heart rate, body temperature and movement throughout the day. Add to this an inference on how much sleep one is getting at night time (I say "inference" as all of the sleep monitoring apps and devices rely on interpreting movement, or lack of movement, at night time to crudely quantify sleep duration and quality) and you have a data stream that would be extremely useful in monitoring individuals with a number of chronic diseases.

Take for example someone with COPD (chronic obstructive pulmonary disease), a condition affecting 6.8% of US adults. Individuals with COPD are prone to "exacerbations" where a simple viral respiratory infection can lead to severe shortness of breath, copious mucus production and sometimes a super-imposed bacterial infection. If left unchecked an exacerbation can be life threatening and invariably requires hospital admission, however, if caught early and treated with antibiotics and steroids hospitalization can often be avoided. Now imagine someone with COPD wearing a smartwatch continuously transmitting data back to their provider. Their heart rate will increase a day or two before they start to feel unwell, their temperature may also increase. In addition, as the infection starts to take hold they'll probably feel more breathless and so won't be moving around as much as they normally do. The combination of these three data streams should be enough to identify an exacerbation at an early stage. With this early identification comes the ability to treat and the real possibility of avoiding a hospital admission. Now that to anyone's mind has to be a victory for health tech!

Prevalence of COPD in the United States. Image from CDC website: http://www.cdc.gov/features/copdadults/copdadults_a600px.jpg

 

    

Wearable and Cool

I've spent a lot of the last week reading reviews and watching videos from the Consumer Electronics Show (CES) in Las Vegas. Unfortunately I wasn't able to make it out west, but that didn't actually matter too much with the amount of commentary that was coming out of the show in pretty much real time. This was the first time that I can remember that I really felt like I was immersed in a "real world" event while physically being more than a thousand miles away. Now clearly it's not going to be quite the same as being there in person (canapés and a cocktail on your own isn't that much fun!), but the sheer depth and breadth of the commentary coming out of the event from people who were there was astounding.

It seemed from the outside that healthtech and wearable tech were big items at this years show, with companies big and small previewing their new offerings. This infographic from the organizers seems to confirm this, with these two areas coming in first and fourth in terms of volume of mentions on social media.

As an organization that harnesses data from wearable devices and apps, and makes this data usable for healthcare providers, this is obviously great news for us. It appears that there is growing interest in self-monitoring and quantification and it seems unlikely that the large tech companies would be putting in so much time and effort into creating new and improved devices if they didn't see a real market for them.

Having said this I have got he impression that the majority of the devices are variations on a theme; physical activity, sleep and nutrition.This discussion thread on the Digital Health group on LinkedIn started by @BillVick calls for more diverse offerings. I do tend to agree. Although the data from continuous monitoring of activity and sleep patterns is extremely valuable there are so many other parameters that would augment this data and provide real insight to both the individual and their provider of care.

Of course there is the gray area between what constitutes a medical device and what is a consumer product. Falling foul of the FDA is not something anyone wants to do, especially in the light of the recent 23AndMe episode. However, with the pace of change in the industry seemingly accelerating to "warp speed" I am sure it is not going to be long before a consumer will be able to measure and monitor pretty much any parameter that their physician can. With this I truly believe there will come great opportunities to improve the health of the population, reduce the cost of delivering healthcare and make sure our patients (read clients) are satisfied.

Example of how the nGage Health platform presents data from a population using different devices to track physical activity.