Who watches the Watch men? Wearable computing and the battle for your health data.

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The Apple Watch isn’t just another gadget. It’s part of a wave of wearable devices that could transform the way we look after ourselves. If Apple can popularise wearable computing like it did digital music and touch-screen mobile phones, the Watch could be world-changing.

Inside the Apple Watch is a collection of sensors, and that means it can record the kind of data your doctor can only dream of. The data it gathers could revolutionise the way we treat chronic conditions and help people with all kinds of complaints. It might even help to prevent DVT and ward off obesity.

If you’re thinking we’ve been here before, you’re right: Google launched its Google Health system back in 2008, offering to provide personal medical advice in exchange for access to people’s medical records. Amazingly, people weren’t too keen on sharing that data with a giant advertising company, and Google Health got a Do Not Resuscitate in 2012.

Google hasn’t given up, though. Its Android Wear smartwatches can monitor a range of health information, but so far sales have been slow. That’s partly because the smartwatches haven’t been much cop, and partly because Google is concentrating on fitness tracking, a market that’s already pretty crowded.

Apple is doing something quite different, and potentially much more important.

Better by design

Apple’s Watch is part of a much bigger picture. Wearable computing and health apps could change lives.

The Apple Watch is just one way of getting information into HealthKit, Apple’s platform for tracking health data. Google and Samsung have similar platforms, called Google Fit and SAMI respectively, but it’s Apple’s platform that’s getting the most attention: when Reuters contacted the top 23 US hospitals in February 2015, 14 of them had already rolled out HealthKit to better monitor patients with chronic conditions such as diabetes and hypertension.

HealthKit can track as much or as little as you like. It can record your heart rate (the Apple Watch checks it every 10 minutes, or more often if you’re exercising) and the steps you’ve taken, what you’ve eaten and how long you’ve exercised, and it can connect to a range of specialist monitors too. It can collect data from sleep trackers and blood pressure monitors, blood oxygen sensors and blood pressure bands, bathroom scales and thermometers, and the list of available apps is growing quickly.
 
That data could be very valuable to doctors, but it could be just as valuable to you: the more information HealthKit has, the more it can be used to detect patterns, identify triggers and so on.

You don’t need to be plugged into a monitor or wear an Apple Watch to benefit from wearable computing, though. Apps for conditions such as anxiety and depression can use self-reporting to help people identify potential problems and to develop ways to cope with them, while apps that record fertility cycles can be of real benefit to couples trying to conceive. Inevitably there are lots of crystal-healing new-age nonsense apps around, but there are some genuinely useful ones too. Our own Health Mapper is a good example.

The health monitoring we’ve seen so far hasn’t exactly changed the world, but Apple has something much bigger in mind: it wants to help medical research too. Its tools are iPhones, Apple Watches and something it calls ResearchKit.

There’s not such thing as too much information

There are hundreds of millions of iPhones - and soon, stacks of Apple Watches - in circulation. Imagine what researchers could do with the health data those devices can record. Instead of studying tens or hundreds of people, researchers could study thousands - and with automatic recording of data, they can access data that’s much more detailed and accurate than even the most diligent self-reporting.

That’s what ResearchKit delivers. It’s currently being used for research into Asthma, Parkinson’s Disease, Diabetes, Breast Cancer and Cardiovascular Disease, and Apple plans to widen its scope over time.

It’s early days for ResearchKit, but the potential is enormous: within 24 hours of launching its ResearchKit app for heart health, Stanford University has recruited more participants than it would normally manage in a year.

Why Apple’s approach is different

Apple’s move into health isn’t entirely altruistic - it’s a potentially massive market worth $3 trillion a year in the US alone - but while its motives may be similar to Google, Apple may find it easier to win users’ trust. That’s because Google makes money from user data and advertising, but Apple makes the majority of its money from selling devices. With Google there’s always the sneaking suspicion that it only wants to monitor your blood sugar so it can show you an ad for Snickers.

That’s not all, though. Apple is moving into health at a time when technology is making previously impossible things possible. The Watch is a good example of that: a smartwatch that people will actually want to wear, that won’t run out of puff at lunchtime and that can track all kinds of health and fitness data, if you want it to. Future versions will be better still as battery technology improves - think sensors with batteries that last for decades, not days - and developers find new things to connect to platforms such as HealthKit and ResearchKit.

It all sounds wonderful, but ResearchKit isn’t without its critics. While Apple says it will open source the platform so other manufacturers can use it, it’s currently Apple-only - and that means it doesn’t cover 85% of smartphone users. As a result, ResearchKit is drawing from a limited demographic, as Apple users tend to be among the more affluent members of society. ResearchKit may also be considerably less effective for conditions with fewer sufferers than cancers, diabetes and heart disease.

There are ethical considerations too. Does scrolling quickly through legalese and ticking a few boxes count as “informed consent”? Will all ResearchKit apps have to pass Institution Review Board (IRB) approvals prior to release to ensure that they meet ethical and safety standards? The first five ResearchKit apps are IRB-approved, but it’s unclear whether that will be mandatory.

Brave New World, or Big Brother’s little helper?

As you might expect, there are serious implications to wearable technology and health monitoring in particular. Will employers, particularly in the US where firms pay for healthcare, demand that employees wear such devices and share the information with its healthcare provider or even the HR department? The UK’s Data Protection Act suggests not, but we’re moving into uncharted territory here. It certainly isn’t hard to imagine insurance firms wanting access to health data in much the same way some of them demand teenage drivers fit black box recorders in their cars.

Data security matters too. We’re used to ignoring 35-page user agreements when we install new apps or buy new devices, but that could be a problem when those agreements cover the use of our most personal data. We wouldn’t expect Apple to play fast and loose with people’s private information, but can you say the same for Google? Samsung? Facebook? If you’ve got an Android phone, just look at the permissions apps ask for when you install them. In many cases you’re sharing an awful lot more than you might expect or want. Wearable technology is exciting, but the devil may well lie in the detail.