Many people agree that wearable Health Tech devices will have a huge impact on the health and wellness of millions of people, both in terms of individual data and of aggregated information about larger populations that can lead to new insights about prevention and treatment of a variety of illnesses. But as with any technology, the Law of Unintended Consequences is waiting in the shadows to bite you in the butt.
For example, take an interesting essay written by Michael Ellison, president of a strategic marketing and consulting firm. In “Wearables Poised to Reshape Insurer-Insured Relationship,” he points to some of the existing joint projects between technology companies and health insurance or healthcare companies. He makes the case that wearables will be able to reward good behavior with lower premiums for the individuals (or their employers). As he puts it “UBI (usage based insurance), both rewards healthy behavior and motivates users to continue healthy diet and exercise habits.”
As much as I want to believe in this pot of gold at the end of the wearable Health Tech rainbow, we need to accept more than a couple leaps of faith to get there. First, there is the question of whether or not the devices make accurate measurements. We’ve already seen plenty of reports on how inaccurate many of the popular products are when it comes to simply counting steps. And even if they are accurate, can “gaming” the system be detected? Will the information generated by strapping your smartphone to your puppy and then playing fetch for half an hour be recognized as bogus data? If people are offered a financial incentive, there are always going to be some who seek a shortcut to the payoff.
Then we get to the question of whether they are measuring what you think they’re measuring. New devices claim to record data on everything from glucose levels to blood pressure to electrocardiogram traces. Extensive independent testing will be required in order to determine if there is a close-enough correlation between the data produced by an accepted clinical measuring device and the wearable, and this has to be shown for all potential usage applications such as swimming or being outdoors in sub-freezing temperatures or at high altitudes.
But perhaps the most difficult hurdle is the term “healthy behavior.” Pop quiz: is eating eggs healthy or not? That one food has yo-yo’ed in and out of favor in the health and medical community in recent decades, so who is to be the arbiter of what constitutes healthy behavior? Is running good for everyone, or just certain people? Is any amount of running good, or is there a threshold for too much or too little to be effective?
Rewarding people with lower healthcare insurance premiums is certainly a good idea, but if we reward them based on inaccurate data that doesn’t measure the intended metrics, and then that data is compared with flawed conclusions about what is healthy behavior, then we could do more harm than good. Especially since not everyone can be above average (except in Lake Woebegone), so we may well end up penalizing some people who are actually doing the right thing to stay healthy.
I believe that we will get to the point where all this aggregated Big Data will give us a much better idea of what “healthy behavior” truly is, but I don’t expect that this revolution in healthcare insurance will come about any time soon.
Regarding accuracy of wearable sensors, there are already small, discreet, and comfortable wearable biosensors that have been validated and cleared by the FDA to provide biometric data that is equivalent to gold standard medical equipment (HealthPatch by Vital Connect, http://www.vitalconnect.com). What’s more, these devices provide multiple biometric data streams (ECG, HR, respiratory rate, steps, body posture, etc.) that would make it impossible to “game the system”, as a person’s ECG trace is as unique as a finger print (so putting it on your dog or even a friend could be easily detectable).
One issue that will inevitably arise is the opposite effect of more personal health information in the hands of the insurance companies, where instead of decreasing your rates based on your activity, the insurance company could use this data against you to increase rates or even deny coverage. It will not be long before we will be able to do diagnostic and predictive analysis of your health based on the data captured from a single wireless clinical grade biosensor. A particularly dark scenario would be if an insurance company employed this technology to discover existing conditions (or predisposition to develop) based on monitoring multiple vital sign data streams, and then used that information to deny coverage based on an existing condition that you didn’t even know you had.
As an optimist, I believe in and focus on the positive potential for these technologies to make massive beneficial impacts on peoples’ health and wellbeing. However, I’m also a realist, and so I must also consider and maintain vigilance of how this (and any new technology) could be used against both the individual and the common good.
Well said, Eric. I am also a vigilant optimist, and hope that eventually we will get more good than harm from some of these new technologies. I expect that we’re going to have to burn our collective fingers a few times, however, before we get it right.