The Sleeping Giant: How Wearables Will Revolutionize Healthcare

Wearable tech is in its awkward adolescent phase, but it's about to grow up in a big way.

Credit: Jawbone
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At the Consumer Electronics Show in January, many analysts and news outlets (included us) predicted that 2014 would be a breakout year for wearable tech.

In some ways, that prediction has come true. According to research firm Canalys, wearable band shipments (including smartwatches) soared by 684 percent in the first half of this year, compared to the same period in 2013. That growth is only expected to continue. IDC has predicted that global sales will reach 19 million units by the end of 2014, tripling last year’s figures.

This year we've also seen the unveiling of the Apple Watch, the announcement of Android Wear and its first six devices, the public release of Google Glass, and Facebook’s acquisition of Oculus VR. Wearables are now a rapidly diversifying market, with everyone from Casio to Samsung to Will.i.am jumping in feet first.

But despite runaway growth, there's an argument to be made that the wearables industry is treading water, lacking in innovation and almost exclusively devoted to a single, narrow-minded design paradigm. While wearable shipments have been skyrocketing, most of the volume is attributable to simple fitness bands like the Fitbit and Jawbone Up. And even then, figures pale in comparison to other tech categories.

Global wearable shipments are expected to reach 112 million units by 2018, but that's a drop in the bucket compared to the billion or so smartphones sold last year, or the nearly 2 billion expected to ship in 2018. Even tablets enjoy far higher sales figures. According to Gartner, they are already more than double (229 million) what IDC predicts wearables will be at in four years.

Global Wearable Shipments

But hidden beneath the underwhelming sales figures and uninspiring gizmos is a sleeping giant. Wearable technology isn't a transient fitness fad for quinoa-eating yuppies, and it's not just a market for step-counters, pulse monitors, or a more convenient way to get smartphone notifications. It’s a stepping stone toward an explicitly utopian (and potentially Orwellian) ideal: the quantified self.

Behind the scenes, in labs and research facilities around the world, our brightest minds are building wearable devices that could revolutionize the way we approach our very health and wellbeing.

The question is: How do we get there from here? How do we transition from the clunky, marginally useful smartwatches and fitness bands of today to the invisible yet omnipresent sensory network of tomorrow?


The Curse of Fashion

For many potential buyers, the look of today's wearables makes them a non-starter. The usual tech-obsessed early adopters may be gobbling them up, but regular folks just aren’t sure they want to be seen wearing a smartwatch or AR glasses.

Need an example? Just look at highly visible devices like Google Glass and Bluetooth headsets. Wearers of the former have already earned the unfortunate nickname “glassholes," and Bluetooth headsets, which have been around for nearly 15 years, still evoke a certain "douchiness."

Samsung Galaxy Gear w/ Swarovski
Samsung has dressed up its Galaxy Gear watches with Swarovski crystals, but they can't hide the underwhelming design. [Credit: Samsung via Flickr]

"The wearables market is in its Stone Age right now,” said CCS director of forecasting Marina Koytcheva, in a statement last summer. “There need to be huge improvements to broaden their appeal. Wearables need to quickly move on from black, clunky devices.”

It's easy to see why inconspicuous activity trackers comprise the bulk of the wearables market. Customers and reviewers alike have dismissed today's smartwatches as "horribly ugly, boxy contraptions with boring, rubbery straps," with the possible exception of the Motorola Moto 360 and LG G Watch R. Then there's Google Glass. Though clearly ripe with potential, its aesthetics are questionable at best. And its chances at market success? Well, I’ll let Google fill in the blanks:

Google fail.png

HP seems to have gotten the hint: It has teamed up with fashion designer Michael Bastian to create a watch humans would actually want to be seen wearing. But the company doesn’t have a great track record on this front, and poor distribution and high pricing mean few will wear it.

Then there’s the Apple Watch—a highly anticipated release that failed to generate any appreciable excitement when its awkward design was finally unveiled.

You may disagree with the particulars of these opinions, but the fact remains that poor design is a huge obstacle to mass adoption. A survey conducted last year by Modis found that only 34 percent of Americans who make more than $100,000 a year would consider buying or wearing a smartwatch or smart glasses. The figure rose to 47% when including consumers with an income of $35,000 or more, suggesting that price is far less of a factor than aesthetics.

PwC Wearable Tech Survey
Consumer Interest in Wearable Tech View Larger

According to a separate study recently conducted by PwC, only 42 percent of U.S. consumers say they would actually pay for a smartwatch, and that figure drops to 38 percent for fitness bands.

But these numbers reflect the wearables market as it currently stands—a market filled with oversized watches, plasticky bands, and clumsy glasses. The real promise—the utility that will make wearables commonplace—is in what you can do with the data these devices provide.

The same PwC survey that found most Americans have little interest in wearables also found that all the information consumers most desperately want from wearables is health-related. Roughly three-quarters of respondents concurrently stated they want wearables to help them exercise, collect and track medical data, and help them eat better.

In other words, consumers are saying, "Forget syncing with my phone—I want something that will make me healthier."

Many experts believe the design flaws endemic to wearables today will get smoothed out over time. “Wearables are sort of a novelty right now,” says Rohan Puri, a biomedical engineer and researcher at MIT’s Media Lab. “It’s a big buzzword, up there with Big Data and the Cloud. But I think we’re going to find interesting ways to use these devices, and we’re going to become more and more okay with having devices strapped to us all the time.”

LG's G Watch R
LG's G Watch R is a refreshing standout in a market of hideous smartwatches.

The Promise of Big Data

You've probably heard of "Big Data," but what exactly does it mean? It's a buzzword, and like so many Silicon Valley buzzwords it refers to a nebulous concept that can be confusing to outsiders. But at its core, Big Data simply refers to a vast, cloud-based repository of data on everything that happens in our lives—from location tracking information, to financial transactions, to biometrics and more.

If that sounds pretty creepy, well... it is. But it's also the fuel driving the Internet of Things—the growing web of machine-to-machine communication that will one day lead to mass automation. It's the foundation of information required to build an autonomous, "smart" system—be it a smart home or a smart energy grid.

Today's wearable tech has only a surface-level relationship with Big Data, but that may soon change. Within a few years, wearables could transition from novelty gadgets into essential medical commodities, eventually becoming the brain of the connected, quantified self.

The Scout allows you to "check your health as easily as your email." Tweet It

One of the earliest entrants in this field is the Scanadu Scout—a portable health monitor and diagnostic tool that's set to launch sometime in 2015.

On its website, Scanadu boasts that the Scout allows you to “check your health as easily as your email." The wallet-sized gizmo can monitor your temperature, blood pressure, heart rate, oxygen saturation, ECG (electrocardiography), heart rate variability, and even stress. The company is currently working on a similar device that will provide comprehensive urine analysis.

The implications are profound. As a standalone consumer gadget, the Scout and products like it offer limited functionality—essentially, they provide more personalized information for late-night WebMD sessions. But over time, these devices will compile data from a huge number of users and devices and upload it to the cloud. Like a Wikipedia for medicine, that information could eventually become the largest, most comprehensive sample set of medical data that’s ever been produced.

Scanadu-Scout.jpg

“We are going to amass a wealth of data on ourselves, on our family, on the weather, on everything around us,” says Walter De Brouwer, co-founder and CEO of Scanadu. He believes this data will help us move from what he calls "outcomes"—conclusions like "I am sick"—to complete diagnoses that actually explain what's making us sick, and what we can do to prevent such infections in the future.

"Perhaps our diabetes is in correlation with our biking speed," he suggests. "Perhaps our stress factor goes together with our credit score.”

"We are going to amass a wealth of data on ourselves, on our family, on the weather, on everything around us." Tweet It

In some ways, today's diagnostic methods are hardly more advanced than they were 100 years ago. As MIT’s Puri points out, doctors often rely on extremely limited data to make important diagnoses. For example, they might conduct a single study for a suspected case of sleep apnea—a cumbersome process that requires dozens of sensors and on-location sleep examinations—and then make assessments based on the information produced by just a couple dozen individuals.

“And then they’ll say, okay here’s your diagnosis,” Puri says. His team is trying to create a wearable that can diagnose sleep apnea faster and more accurately than existing methods, but getting such a device approved can be difficult. “If you want to create a device that will be cleared by the FDA, you’ll need to go through hundreds of clinical trials, and you’ll want each one of those patients to give you a few samples.”

mECG.jpg
Rohan Puri, a biomedical researcher at MIT, has also worked with a health tech workshop called ReDx to design the mECG—a wearable heart monitoring system with companion mobile app.

He envisions a future where patients will wear these devices on their own time, passively accumulating a treasure trove of data that doctors can use to not only create individual diagnoses for each wearer, but also to compare each individual's case against the greater pool of sleep apnea cases. “It will give us something much more statistically relevant,” he explains—something superior to a diagnosis based solely on qualitative observations or a doctor's personal experience.

In some ways, today's diagnostic methods are hardly more advanced than they were 100 years ago. Tweet It

But it's not just fringe startups and MIT researchers who are innovating in wearable tech. Philips, perhaps best known in the U.S. for its light bulbs, is another early entrant in the field.

The Dutch multinational recently restructured itself by splitting off its lighting business and merging its healthcare and electronics divisions—a revealing move that signals the growing importance of healthcare in consumer tech. In October, it followed that up by unveiling a wearable digital biosensor designed to record the biometric data of patients suffering from chronic obstructive pulmonary disease (COPD), the third-leading cause of death in the U.S. The device is part of a larger family of biosensors designed for remote patient monitoring.

Philips COPD sensor.jpg
A still from a demo video indicating what the Philips COPD monitor app may look like.

According to Philips’ head of marketing Manu Varma, these types of devices allow patients to transition from a highly monitored, high-care hospital environment to the more comfortable environs of their own homes. As sensors and wearable devices become cheaper and more diverse, the wealth of data that hospitals are already accruing will be contextualized by more casual, consumer-derived health information.

“Depending on the population you’re looking at, all types of devices have a role in the future,” he says. “With wearable technologies we don’t see Big Data there yet. But I think it’s absolutely going to be a component in the future, because it’s rising exponentially.”

"By coordinating care through technology, you can reduce waste and cut healthcare costs." Tweet It

Perhaps most importantly, this automation of medical diagnostics lessens the strain on both physicians and budgets. “By coordinating care through technology, you can reduce waste and cut healthcare costs," Varma said.

Still there's the problem of compatibility. Most of the data produced by these devices—including more well-known ventures like Apple Health and the recently announced Google Fit—are siloed in proprietary apps and programming interfaces. Some data makes its way to the cloud, but a lot is kept behind.

Microsoft wants to change all that. In October, the company launched its own health service, simply called "Health." Unlike most other fitness platforms, Health—and its accompanying Band wearable—is entirely cloud-based and available on Android, Windows Phone, and iOS devices. It's designed to collect data from watches, fitness bands, phones, and any other motion sensor or accelerometer your device may employ.

By uniting this data, Microsoft believes it can become the primary repository for the world's health data, and in the process merge the disparate worlds of medical and consumer wearables.

Microsoft-Health.jpg
Microsoft's Health Band works with iPhone, Android, and Windows Phone.

Wearables and the Home of the Future

On top of compatibility issues, fitness bands and activity trackers have another annoying issue: inconsistency.

There have been several different studies that have measured the uniformity of data across a variety of activity trackers, and each has revealed glaring inconsistencies. A question emerges: What’s the point of a fitness band if the information it records can’t be trusted?

What’s the point of a fitness band if the information it records can’t be trusted? Tweet It

Jonathan Collins, a principal analyst at ABI Research, points out that, unlike medical-grade devices like the Scanadu Scout, fitness bands have virtually no technical guidelines or regulatory oversight to help ensure you'll get accurate results.

But Collins also argues that, at least in some cases, bad data can be better than no data at all. In short, he suggests that there's information now where there previously wasn't, and “the more people understand or care about that information, the more it can be used.” Over time, the metrics will improve and the data will begin to align from device to device.

While personal health is a major driver of wearable tech, it's not the only avenue for innovation. Much of the same data collected for medical purposes can be repurposed to make domestic or even municipal systems more efficient. Eventually, experts say, we'll see fitness bands, smart watches, and even AR glasses that sync with smart home systems, traffic grids, and other aspects of our urban infrastructure.

Jawbone Up.jpg
Activity trackers like the Jawbone UP saturate the market, but they're only the beginning.

“The thing that’s exciting is the interaction between these devices and other systems,” Collins says. “You’ll have the ability to connect popular wearables and activity devices to your home automation system.”

For instance, your wearable could detect when you roll out of bed in the middle of the night and automatically turn on the lights in the bathroom. It could monitor your alarm clock and, over time, learn when to signal your coffee-maker to begin brewing. Or it could notice you're falling asleep in front of the TV, bookmark the point in the program when you dozed off, and then turn the screen off to save power.

Puri notes that some of these capabilities are already emerging. He points to algorithmic personal assistants like Google Now, which is able to parse through all of your online data—including Gmail messages, Google search history, and Google Drive documents—to intelligently provide you with relevant contextual information on the fly.

Many expect the early adopters of medical-grade wearables won't be tech-savvy millennials or even Gen Xers, but rather aging Baby Boomers. Tweet It

Future versions of this virtual personal assistant tech could, for example, note that you’re running and that that you have a meeting in five minutes. It could then autonomously text your colleagues to let them know you’ll be late. If, on the other hand, it notices you've been sitting around an awful lot, it could nag you to stand up and get some exercise.

“If you have a device which is on you 12, 15 hours a day, and the information it’s giving you includes everything from oxygen saturation to blood pressure, then you’ll have a lot more contextual information,” Puri says. “I think contextual awareness is the future of wearables on the consumer side.”


The Heart and Soul

What Puri describes is the premise of the Internet of Things writ large, but it’s made all the more personal and interactive by wearables. In the future, your wearable device may become the brain that informs your automated environment.

In the long run, the internet may be a mere footnote in the larger story of Big Data and the quantified self. Tweet It

It’s a nifty concept, but the heart and soul of the technology still lies in healthcare and personal wellness. For that reason, many expect that the early adopters of medical-grade wearables won't be tech-savvy millennials or even Gen Xers, but rather aging Baby Boomers.

“For that population, being able to quantify how they’re doing could make a big difference in figuring out how much care they need, and enabling the right care at the right time,” says Philips' Varma.

Scanadu’s De Brouwer agrees, even going so far as to suggest that the internet may end up as a mere footnote in the larger story of Big Data, the quantified self, and the healthcare revolution these systems could foster.

“This will be [the Boomers’] last and biggest mission,” De Brouwer says. “Because everyone wants to talk about healthcare, and everyone wants to talk about their health. It’s a very passionate and romantic moment in the 21st century.”

Hero image: Jawbone

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