Wearables: Hope or Hype?

I've been thinking about this question a lot in 2014. I'm seeing more articles proclaiming that wearable technology is a 'fad', has no 'practical' value, and in the context of health are often viewed as inferior to officially certified & regulated medical devices.

"Technology is beyond good or bad", said Tamara Sword, at yesterday's Wearable Horizons event. Now, a very common piece of technology in our kitchen, the knife, is a classic example. Used for it's purpose, it speeds up the food preparation process by slicing carrots. However, it can also be used for harm, if used to slice a finger off.

The same goes with wearable technology like Google Glass. It can do immense good, such as saving someone's life. However, it could also be used to harm, if someone wearing Glass takes a picture of your 5 year old child in Starbucks without obtaining consent from your child or yourself [credit to the visionary John Havens for making me think about the Starbucks scenario]

We all have to start somewhere

We have to remember that the market for wearables is embryonic, it's not mature in any shape or size. Every innovation I see & test is crude & clumsy, with many flaws. Thinking back to 1903, wasn't the first airplane crude & clumsy?  Wearables WILL evolve, just like the the airplane [Hopefully, it won't take 111 years like the airplane] 

I salute those willing to take a risk and develop wearable technology. From the lone entrepreneurs to Nike, what unites them is that they took a risk. They experimented. Experiments don't always turn out to be successful, noting Nike's recent withdrawal from Wearables. That's entirely normal, we can't expect everyone to succeed at their first attempt. What would our world look like today, if Steve Jobs had given up after his first attempt? 

How many of you failed your driving test the first time? Instead of dismissing the brave efforts of those willing to take a risk into the unknown, we should be encouraging & supporting them. It's those willing to take those chances, to explore unknown waters, to imagine a better world, that have helped humanity make so much progress. 

Courageous conversations

There are many questions around wearables that remain unanswered. There are uncomfortable, awkward & terrifying conversations surrounding the use of wearable technology that are sorely needed, not just within society, but within our political, legal and regulatory framework too. If we place a piece of wearable tech on a patient with dementia, how do we obtain informed consent from the patient?

When I saw the recent headline that a hospital in Boston is equipping everyone in the ER room with Google Glass, my first reaction was one of excitement, with my second reaction being one one of curiosity. What happens to the face & voice data? At 3am, when the ambulance rushes you & your sick child to the hospital, will you really stop to ask the hospital staff, what the privacy policy is, regarding the images captured using Google Glass of your child in the hospital?

I observe that many, including those in the business of creating or using regulated medical devices, look down upon some wearable technologies. Activity trackers are frequently viewed as fun toys, not 'proper' medical devices.

Let me ask you something. If an overweight & inactive person aged 40, uses a $99 Fitbit to track their activity & sleep, leading to insights that trigger behaviour change over the long term, is it still a toy? For example, what if developing the habit of walking 10,000 steps a day (versus 1,000 today), reduces their risk of a heart attack, delays the onset of Diabetes or even prevents high blood pressure? Still just a 'glorified' pedometer?

Imagining a better tomorrow

I believe wearable technology, particularly for health, is just one step on the journey in today's digital world. There will continue to be failures, and whilst there is significant froth & hype, there is also significant hope. Our ability to imagine a better future is what has gotten us to where we are today. Imagination could be one of the most useful attributes for any organisation wishing to meet the challenges facing human health in the 21st century.

It appears likely that firms which don't have roots in health could be helping us realise this new world. Perhaps this shift frightens those firms that have got their roots in health? I'm intrigued to note that Samsung, are holding an event in San Francisco later this month, promising that a new conversation about health is about to begin. Having visited South Korea a few years ago, and learning so much about Samsung's history & vision, I'm going to be watching what they do very closely. 

Is it a bad thing if wearable technology (and the resulting data, insights & education) empowers patients and makes them less dependent on doctors & the healthcare system?

Is it wrong to dream of 'smart fabrics' where our health could be monitored 24 hours a day?

Is it silly to want to develop sensors that could one day transmit data directly from our internal organs to our doctors?

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The dark side of wearable technology

An update on my talk in Boston, Will advancing technology make doctors unemployed?. 

It's confirmed for Fri April 11th at 12pm. The format will be a lunchtime session, with time for questions, and tickets are free. I believe there are still a few tickets available. Big thanks to Maggie Delano, Joshua Kotfila & Hack Reduce for helping me make this event a reality!

So, Wearable Technology, we are hearing more and more about it in 2014. New research is forecasting that wearable tech will become even more popular than tablets. Our lives will change, our health will improve, and generally it's simply amazing, right? The use of Google Glass in Houston to allow sick kids to virtually visit the zoo is one of the wonderful applications I've seen. Today, the headline in the local newspaper in Boston was about a local hospital that is the 1st hospital in the USA to employ Google Glass in everyday medical care, expanding it's use across the entire Emergency department.

However, my views on wearable technology have been challenged recently, which prompted me to write this blog. There is a dark side to this technology, and it's fascinating to see the headlines touting the benefits but not always mentioning the risks.

I was invited to speak at an event in London, hosted by NESTA in March 2014. The event was titled, Data, health and me: the future of people-powered healthcare , and I shared my research on the emergence of personal data marketplaces & the future scenario where patients can profit from selling their health data which has been collected using wearable technology. My research has also been cited in the recent report, Refilling the Innovator's Prescription: The new wave of medtech, produced by NESTA & Silicon Valley comes to UK,  

There is a great Storify summarising my talk, as well as the talks by the other 3 speakers.

One of the exercises we were set, was to examine a possible future in the year 2024, where it's so lucrative for patients to sell their health data, that they can use wearable technology to 'amplify' their illness or even perhaps give themselves an ilness? It sounds preposterous, but look at what happens today in India. Deliberately maiming children to increase profit from begging. As healthcare costs continue to spiral, OUR personal health data, will only become MORE valuable in the future.  

The discussion in our group was thought provoking, as our small group discussed the moral, social, legal, & cultural implications. How would a doctor know that your illness occurred naturally or you used wearable technology to give yourself the illness? What circumstances would compel healthy people to do this? Would it be the poorest sections of society who realised one of the few assets they have is their health data? Would there a black market in 'patches' that when applied to the skin would give you diabetes? All of this really made me think again about the concept of selling our health data to governments, pharmaceuticals & health insurers. It's not that simple as I originally anticipated, and I'd welcome comments from readers on the intersection of wearable tech, personal health data and these new marketplaces. Kudos to Jessica Bland & Cassie Robinson for hosting & curating this event. There is a great video with soundbites from participants, definitely worth watching. Incidentally, on the same day, there was an event in New York, on the Social, Cultural & Ethical Dimensions of “Big Data." I'm proud that the UK is not lagging behind the US when it comes to thinking about the future.

I came across a Google Hangout from an event in New York, discussing Augmented Reality & Privacy in the future. Featuring John C Havens, Dawn Jutla, and Jules Polonetsky, it was an inspiring 1 hour. Again, speakers who made me rethink my beliefs, assumptions and attitudes towards wearable technology with their sharp insights.

Think about the use of Google Glass in the Boston hospital. When rushed out of the ambulance into the ER room, are you really going to be in a position to ask where your face or voice data may be going, and who has access to it?

It's scary enough to consider these questions when thinking of our own privacy & security, but even more frightening when thinking how wearable technology could be used to do harm to our children? Fast forward 5 or 10 years, and if most kids are given wearable technology so that their parents, teachers & doctors can monitor their health and movements in real-time, are we considering that these data are also of interest to criminals? Children may be warned not just to avoid talking to strangers, but to avoid strangers with laptops sitting next to them on a train as their personal data may be being hacked!

An article this week reports how "Companies are ignoring serious security issues in their rush to release next-generation wearable devices, according to Symantec."

There are other risks associated with the expansion of wearable tech in our lives, but I've highlighted just a couple of scenarios that warrant further thought. It's important that we find a balance between creating conditions that encourage entrepreneurs to take the risks to experiment with these new ideas, but at the same time, we can't let our enthusiasm for new shiny gadgets blind us from discussing how we govern use of this (or any) technology in society.

I don't know if we have the answers, as we are not even confident in defining the questions. However, the wearable technology market is evolving at such a rapid pace, it's critical that we take time out to both, ask those questions, and answer them. Without that pause, we run the risk of society eagerly adopting and evangelising these products without pausing to consider the ramifications on different members of our communities.

If you are in Boston this week, and can't attend my talk on Friday, I'd definitely like to connect, especially if you're a wearable tech startup.  

[Disclosure: I have no commercial ties with the companies/individuals mentioned]

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I'm a geek, not a terrorist

So, I was travelling by 'tube' in London yesterday (subway for my American readers), and I was wearing a biosensor strapped to my forehead.  If you've been to London, you'll know that people shy away from making eye contact on the tube. As the doors to the carriage were closing, I heard the announcement over the PA system, something about 'report any signs of suspicious behaviour'.

It's then that I became aware that other passengers were looking at me with a mix of curiosity, apprehension and bewilderment. Now, for those in the Digital Health arena that know me well, me walking around with some kind of gadget strapped to my head is 'normal'. I certainly don't even think twice about it.

Wearing my  Truesense  biosensor

Wearing my Truesense biosensor

Wearing my  Neurosky Mindwave  headset

Wearing my Neurosky Mindwave headset

Fear of the Unknown

Maybe I need to do what photographers did a few years back and wear a t-shirt that says 'I'm a GEEK, not a terrorist"? Or should I be wearing my biosensor under a headband?

Misuse of 'wearable computing'?

In the future, what if technology such as Google Glass is 'misused' by someone who wishes to harm society? Will it cause the public to be suspicious of wearable computing? Will it lead to a knee jerk reaction from governments and legislators? What if manufacturers design products that integrate with how we currently dress?

Yesterday, I was also wearing a MeCam.

Taken with a pen to show you just how small the MeCam is

Taken with a pen to show you just how small the MeCam is

It was switched on, I simply wanted to see if anyone noticed that I was wearing a video camera capable of recording 2 hours of HD video. Not one person I met realised what it was. One person thought it was something to do with my headphones. They were surprised when I told them what it was. [Note: I deleted any footage I captured in this experiment]



How will society respond? 

Now I'm thinking, as these technologies become cheaper and potentially integrated into our everyday clothing, how will we know who is wearing a jacket that contains a wearable computer and who doesn't?

If someone is wearing a sensor that is monitoring their own body, could that sensor also monitor other people's bodies without their consent? Who owns that data? Do we get the chance to practice 'informed consent'? [Note: A video also counts as data] 

From a moral standpoint, should I be walking around with a note on my shirt saying, "Warning: You are being recorded on video"? 

However, it got me thinking, how do others (who are not in the Digital Health arena) perceive me?

It was a hot and humid day, a brown skinned man walks into the carriage, with what looks like a microchip on his forehead, and he's perspiring heavily [Note: the 'tube' in London has no air conditioning]. Would people stop to ask me, so "Recording your EEG brain waves again are you, mate?" or would they assume it's some kind of trigger for an explosive device, and possibly report me to the authorities as a potential terrorist?

Reflecting on the wider issue here, with the rise of wearable computing (not just in Digital Health), how will the general public perceive early adopters who are wearing all sorts of gadgets, sensors and devices? 

What are the implications for our security and privacy? 

[Disclosure: The author has no financial relationships with any of the companies mentioned in this blog post.] Thanks to Pritpal S Tamber for taking the picture of me and for taking part in my experiment.