Want to check snow conditions on the mountain, how many calories are in your lunch, or where you parked your car? “There’s an app for that,” as Apple memorably advertised its iPhone in 2009. In the years since, developers have introduced apps for more than 2 million other things.
But what about…saving lives? Yes, apparently there’s an app for that, too.
In fall 2015, ABC News reported the viral story of Massachusetts teen Paul Houle, Jr., who was experiencing some back and chest pain after football practice. He thought to check his Apple Watch; its sensors registered his heart was beating at twice its normal rate. Houle alerted his family and health professionals, who then discovered he had rhabdomyolysis, a very serious condition in which muscle fibers break down and enter the bloodstream, potentially damaging major organs.
After his diagnosis, Houle spent a few days recovering in the hospital, which is much preferable to what could have happened if he'd suffered from kidney failure on the football field, which may well have happened had he gone to the next practice.
Parents are constantly struggling to get their kids (not to mention themselves) to put down the technology. In Houle’s case, it’s a good thing he didn’t. And Apple Watch’s heart-rate monitor is just the beginning of the many ways smart devices are improving our health—and even saving lives.
First Aid Kit 2.0
When a tech giant like Apple unveils its latest products, we tend to geek out over all the shiny new bells and whistles. This year, for instance, the company showcased its amusing Animoji and flashy Face ID. Garnering less attention, however, are its ambitious—if less glamorous—health initiatives.
In a project it calls ResearchKit, Apple has been teaming up with some top U.S. university medical centers and institutes, including Duke and Johns Hopkins, to develop apps for Apple products that target a battery of illnesses and disorders: Parkinson’s disease, autism, concussions, and melanoma, to name just a few.
EpiWatch, for instance, is an Apple Watch app that helps track seizures, which is particularly useful for people with epilepsy, hence the name.
Although the app can’t currently detect seizures outright, it uses Apple Watch technology to collect real-time data before and during a seizure event, including the option for the wearer to send an alert to a family member or caregiver. Johns Hopkins is analyzing the data to get a better understanding of epilepsy and improve its treatment, with an eye toward device detection and automatic notification of seizures in the future.
At Apple’s 2017 event, it debuted a new partnership with Stanford University to harness the Apple Watch for the detection of atrial fibrillation, an irregular and rapid heart rate associated with a variety of cardiac diseases.
What’s key to these efforts isn’t just Apple’s whiz-bang hardware—the sensors, gyroscopes, GPS, and accelerometers it packs into a wrist-sized bundle. It’s the data.
While we may take it for granted, internet-based technologies have already transformed our health and lives by bringing previously unavailable or inaccessible data right to our fingertips.
Consider how we can learn more about our symptoms if we are feeling sick with a search on WebMD, how we can consult with our doctor across the globe thanks to Skype, or how we can navigate the world like never before using mapping programs like BlindSquare if we have a visual impairment.
But with wearable devices like Apple Watch, we—our very bodies—are the data. And we are lots and lots of data.
With Apple’s ResearchKit, for example, app users agree to essentially become study participants, allowing researchers to collect a volume and depth of data previously unavailable in traditional, in-person studies. These data will provide a potentially massive database no one laboratory could ever summon, given that Apple had sold over a billion devices by 2016.
In its new study with Apple, Stanford aims to analyze all the heart data from its participating Apple Watch users to fashion an algorithm that spots heart arrhythmia with the flick of wrist, so to speak.
Now that’s not your grandma’s country doctor.
One Step at a Time
Fancy stuff, Apple. But sometimes it’s the simpler features of our technology that prove transformative.
“Those little notifications just reminded me I needed to move,” says Felicia Bolton of her Fitbit, a wireless health and fitness tracker worn on the wrist. The device had over 22 million active users in 2016.
A disabilities support worker in British Columbia, Bolton sank into a deep postpartum depression following the birth of her third child. On top of that, she was still recovering from a very difficult pregnancy and surviving the trauma of an earlier abusive relationship. “I didn’t think there was a way out,” she says of the time right after her daughter was born.
Then she turned to her Fitbit, which her boyfriend had given her for Christmas. The device can be programmed to give reminders for such activities as moving regularly.
“After [the] baby was born, I would basically sleep all day in bed, barely get up to eat. Getting those notifications made me get up to get something eat and walk around with her,” Bolton says, adding that this activity helped keep her mind “off all the bad stuff.”
Bolton’s Fitbit didn’t just nudge her to get out of bed. “The app kept me connected,” she says. Around this time, she was new to her town and her boyfriend was working long hours. She felt isolated in addition to her tendency to isolate herself post-trauma. “I didn’t realize how many of my friends and family have them.”
Fitbit allows fellow trackers to engage in encouraging challenges, such as the “Daily Showdown,” or “Who can get the most steps today?” These friendly competitions helped prevent from Bolton disappearing further into isolation with her newborn.
“The more steps I took, I got braver,” Bolton continues. “I would walk around the neighborhood. That was a big thing. [My former partner] was so controlling I couldn’t leave the house without him knowing.”
As Bolton later noted in a message, Fitbit’s sleep and calorie trackers also helped her with her struggles with insomnia and an eating disorder. But its greatest impact was clearly psychological. “It got me thinking. I have my baby to care for. I have myself to care for,” she says.
“There’s still a long way to go, but I’m so grateful my partner got me that Fitbit. I don’t know where I’d be today, but I’d probably still be in bed crying.”
Opter-ing for a Better Lifestyle
Chalisa Prarasri knows the importance of changing behaviors one step at a time.
After Prarasri studied neuroscience and biomedicine at the University of California, Los Angeles, she and her CalTech-trained physicist husband have just launched Opter Pose. Opter Pose is a unisex smart necklace/clip that tracks posture, sleep, and exposure to ultraviolet (UV) and blue light, which Prarasri says no other wearable is currently monitoring.
Blue light, a high-energy wavelength of light emitted from the many screens we use throughout the day, has a major effect on our biological clock and overall health.
Unlike other popular wearables, Opter Pose is taking a “more behavioral approach,” Prarasri says. “It’s about how can you change your behavior to change your health as opposed to how can we give you numbers and graphs and you can figure it out on your own.”
“We will track when you sleep and tell you these are the more efficient hours you could sleep,” Prarasri continues. “We will track your posture and that’s sort of real-time information about what you could be changing. Or will we track UV exposure,” prompting users to apply more sunscreen.
With Opter Pose, Prarasri wants to build a “smart lifestyle.” As with smart, lifestyle is a bit of a buzzword in today’s health and wellness zeitgeist, but Prarasri has very clear, science-backed vision for it.
“There are all these tiny choices we make every single day that have an impact on our health because we do it every single day. Slouching for one hour is probably not going to give you chronic back pain,” she says. “But if you are in an awkward position every day… If you get sun burnt once? Probably not a big deal, but if you are exposed all the time,” then you can develop serious problems.
The technology that makes a product like Opter Pose work is quite complicated. But Prarasri’s underlying theory for it is pretty simple: “Slight behavior change can really impact our health.”
And it’s all packaged in a sleek, stylish accessory designed to seamlessly integrate into your look—and lifestyle.
Brave New Wearables
Bolton’s story and Prarasri’s vision are nothing short of inspiring. But what if you have have diabetes, are at risk of breast cancer, or—well, you name it? There’s probably a wearable for that.
In recent years, the so-called “internet of things” has been booming in health and medicine; in the case of Clarius’ handheld, wireless ultrasound machine, for instance, doctors can use smartphones to display ultrasound images.
Slated for mass introduction in 2018, K’Watch Glucose is a specialized watch that allows people with diabetes to measure glucose levels with just the touch of a finger. Since 2014, Google has been testing prototypes of a smart contact lens that will continuously monitor glucose levels in tears.
iTBra can help take the time, costs, and pain out of breast examinations with its “intelligent breast patches,” which detect changes in breast tissue temperature, instantly sending off the data for clinical analysis.
And while iTBra may not be an actual everyday brassiere, smart clothing—yes, full-fledged wearable wearables—are taking off. Much of this technology is targeted at athletes, but the Owlet Smart Sock is a veritable baby monitor 2.0: Strap this soft half-bootie onto your infant, and it will notify you if there are any concerning changes in your baby’s heart rate and oxygen levels.
They’re smart, but are they safe and secure?
This all sounds too good to be true, doesn’t it? Wearables and other personal smart technologies are profoundly changing—or disrupting, to use the buzzword—our fitness, health education, symptom tracking, and health communication and management. But it has its limitations.
Lukasz Piwek, MA, MSc, PhD, led a 2016 study, published in the Public Library of Science Medicine, assessing the state of consumer health wearables. He and his team found that wearables hold great and exciting promises in “providing patients with personalized health data, which could assist with self-diagnosis and behaviour change interventions.” They also raised serious concerns about its barriers, including:
Users can become overly dependent on their devices, leading to a false sense of security, self-misdiagnosis, or using their device as a substitute for doctor visits. Plus, the constant availability of data can compel some to check their devices compulsively, causing needless anxiety. And people can widely differ in how faithfully or accurately they use a device, which could cause harm.
Reliability and Validity
Walk the same distances using Fitbit’s pedometer and Apple Watch’s pedometer and you may well get different results. Such margins of error raise red flags about product effectiveness. And some products don’t work 100 percent of the time, such as a melanoma app that was found to fail up to 30 percent of the time.
And then there’s all that data. In many instances, users own the device—but not their own data. That becomes the property of the manufacturer, which they might sell at the risk of exposing your personal information, as even anonymous data can potentially reveal identifying information.
Finally, as devices, they can be hacked, which can compromise the very health data that makes wearables and other smart technologies so attractive in the first place.
And none of this is to mention cost. The Smart Sock costs $300, and most of the newest Apple Watches come in at $400. Not that we aren’t shelling out; the overall wearables market is forecasted to crack $6 billion in 2018.
A computer is only as smart as the person using it.
In the meantime, as doctors and engineers work out the challenges to smart tech—and as they forge ever smarter devices that we willingly integrate into our lives—maybe we can take a cue from our conscientious football player, Paul Houle.
He patiently saved up for his expensive Apple Watch, for one thing. And he used it just as that: technology. Not as healthcare and not as a substitute for seeing a physician, but as a tool that helped him get to a doctor when he needed it most.
Now that’s pretty smart.