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Wearable technology will not bring about a health revolution

The health benefits of wearable technology may have been oversold, just a tad. Technology image via www.shutterstock.com

Rumours are surfacing that Microsoft will launch its own smartwatch in the next few weeks. Given that Microsoft Windows Phone accounts for just 2.5% of the world smartphone market, the watch will work with Apple and Android devices as well as Microsoft’s own platform.

What is interesting about this move is that the commentary about the device is focusing on its role in tracking heart rate rather than its other features.

The focus on the health aspects of wearables is part of a general trend amongst technology journalists who predict a “coming revolution in healthcare” as a result of these devices.

This is not surprising given that when Apple CEO Tim Cook announced Apple’s smart watch he described it as a “comprehensive health and fitness companion.”

The future of wearables as health devices is easy to imagine. Sensors will collect a range of data, software guided by artificial intelligence algorithms will make sense of this data and both the wearer and the wearer’s physician will be updated with a real-time analysis of the wearer’s health status.

Couple this with the terrifying statistic that in 2012, 50% of all US adults, that is 117 million people, had a chronic disease. In 2006, 84% of the total health budget was spent looking after this 50% of the population. The situation in the rest of the world is not that far behind the US.

Unfortunately, there are many problems with this picture that make the impact of wearables on health outcomes extremely limited.

The first of these is the limited number of people who currently use any sort of fitness tracker or smartwatch. Somewhere between 5% and 15% of Americans wear fitness trackers of any sort.

Of these, 35% will stop wearing their devices after six months. It is not known what proportion of people with smartwatches actually use the fitness tracking capabilities of these watches on an ongoing basis.

There is little information about the demographics of people who purchase fitness trackers and smartwatches; however, given the cost, consumers are likely to be the “wealthy well”.

People suffering from chronic disease on the other hand are more likely to come from the less educated and lower income population.

And then there is the issue of what data these devices collect and what we can actually do with that data. Fitness trackers and smartwatches currently report activity through steps and heart rate.

This is useful information to measure exercise intensity and duration, but not very useful as a diagnostic for health. Even if sensors could deliver information that was useful in actual diagnosing or managing health conditions, there would always be an issue with doctors reluctance to rely on information they haven’t themselves collected and on equipment that was not medically certified.

Acting on unverified information could leave medical personnel legally if that information later turned out to be incorrect. None of the smartwatch manufacturers is currently interested in taking their watches through a medical certification process and so the data that comes from them is always going to be couched in legal disclaimers.

Finally, there is the issue of privacy. Storing step counts on Fitbit.com’s website may be acceptable to most people but the idea of storing more sensitive health-related information with companies like Apple and Google will prove another major barrier to adoption.

It was privacy fears that stalled the adoption of Google’s and Microsoft’s previous attempts at providing a cloud-based health record services.

Doctors and health services wanting to interact directly with data provided by patients’ wearables would have to be extremely confident that they could do this without that data being accessed by hackers.
Fundamentally however, wearables do not address the central issue of the burgeoning chronic disease problem which is caused by poor diet, drinking alcohol, smoking and lack of exercise.

The root cause of these behaviours are social and economic. While the tech companies may try to market wearables on the basis of health benefits, these devices will never be a revolutionary cure.

Digital death and the digital afterlife. How to have one and how to avoid it

Digital Death.

In 2012, the UK’s Sunday Times reported that actor Bruce Willis was going to sue Apple because he was not legally allowed to bequeath his iTunes collection of music to his children. The story turned out to be false (and shockingly bad journalism) but it did start a conversation about what we can, and can’t, do with our digital possessions.

It turns out that “possessions” is actually a misnomer. We actually don’t own the music, books and movies we “buy” from Apple and Amazon. As Amazon puts it in its license terms, “Kindle Content is licensed, not sold, to you by the Content Provider”. In other words, we are allowed to read the content but we are not allowed to pass it on.

It comes as no surprise then that 93% of Americans surveyed were unaware or misinformed when asked about what digital assets they were able to pass on in the event of their death.

But the problems don’t stop there. Relatives of the recently deceased are frequently left with a range of decisions and challenges when it comes to dealing with their online accounts, especially social media. This is not made easier by the fact that every company implements different strategies in dealing with accounts belonging to a deceased user, coupled with the fact that in the UK in 2012 at least, the average user had 26 accounts. In most cases, getting an account shut down requires close family to produce a range of documentation to prove that they have the right to request that the account is terminated. This doesn’t allow for those relatives to get access to the content of the accounts however.

Taking a lead in making the process of handling accounts of the deceased simpler, Google has implemented their Inactive Account Manager. This allows anyone to specify what should happen in the event that an account has not been accessed for at least 3 months. Up to 10 people can be notified and the contents of the accounts, including services such as YouTube and Google+, shared with them. Alternatively, the accounts can simply be automatically deleted.

Facebook will, on request, “memorialise” a person’s Facebook page. This freezes the page with the same permissions as it had when it was last accessed by the user but will stop the page from being discovered in a search and will not actively promote the page to others.

The role of social media in the bereavement process has been the focus of an increasing amount of research. Generally, it is thought that social media can help in the bereavement process, although the persistence of a person’s profile online may make final acceptance of the passing more difficult. An interesting finding has been that when people post on a memorial page, they frequently do so in the present tense as if the person was still alive.

In the UK, a survey has found that 36% of people would like their profiles to continue being available online after they die, with a larger proportion of 18-24 year olds preferring this option than over 55s.

It doesn’t have to stop there. There are now services which allow you to continue Tweeting after you die using a bot that has studied your tweeting style. Other services allow users to send final messages via Facebook and LinkedIn.

Digital estate planning is starting to become more of the norm and people are being prompted to think about what they want done with their digital assets and accounts after they die. This is going to be a significant issue for social media companies in the future. Since Facebook started, about 10-20 million users will have died. This number will increase and eventually overtake the number of living users on the site, by one estimate, in 2060.

In one humorous envisioning of the future, Tom Scott has produced a disturbing possibility in his video “Welcome To Life: the singularity, ruined by lawyers”. In it, he describes a corporate sponsored network as a resting place for the digital version of your consciousness, that is, of course, ad sponsored. In this case as with the question today, it is perhaps best for all if your online social presence ends when you do.

Welcome To Life

Should Microsoft CEO Nadella step down over his poor advice to women?

nadella.

Microsoft CEO Satya Nadella’s excruciating gaffe that women should not ask for a raise but trust in “karma” that they would be rewarded eventually has been met with widespread condemnation. He made the statement, ironically enough, during an interview at the Grace Hopper Celebration of Women in Computing conference. The conference , dedicated to women in technology, had a largely female audience who were confounded when Nadella gave his advice. The statement was met with an instant reaction on social media and Nadella, realising the seriousness of his mistake, issued a retraction saying that his answer to the question on whether women should ask for a pay raise was “completely wrong”.

Nadella’s statement is completely wrong for a whole host of reasons but in particular, it highlighted the fact that he seemed completely unaware of the context of the question given that Microsoft’s workforce is made up of just 29% women. When looking at the high status tech jobs at Microsoft, that number drops to 17%.

Nadella also seemed unaware that the 17% of the female tech work force at Microsoft are likely to be paid salaries of around 87% the salaries of men.

Of course, when you take merit-based bonuses into account, the gender pay gap is even greater, as women receive bonuses that are half the size of men’s.

He must have been unaware of these facts, because if he was aware of them, how could he possibly have thought that a woman’s silence would result in the “right thing” happening?

For Nadella, a 22 year veteran of Microsoft it is perhaps not surprising that he would have been unaware of the reality of being female and working at the company. The truth of the matter is that he may rarely have encountered women in his day-to-day job other than those employed in non-technical roles.

As CEO of the company however, it is particularly revealing that he would have been insensitive to the challenges women face in that working environment. His statements perhaps point to the limitations of his abilities and will now remain as the “elephant in the room” when he is trying to navigate Microsoft from being relegated into irrelevance by its stronger rivals, Apple and Google.

At the very least, Nadella joins the ranks of other CEOs who have made similarly public missteps, three of whom lost their jobs as a result:

Mozilla’s CEO, Brendan Eich eventually was forced to step down over his support of anti-gay marriage legislation

Lululemon’s CEO Dennis “Chip” Wilson also stepped down after blaming the fact that some of their yoga pants became see-through on overweight women saying that “Some women’s bodies “just don’t actually work” for Lululemon trousers”

BP CEO Tony Hayward was forced to resign after a series of PR bombs in dealing with the 2010 Gulf of Mexico oil spill that included his famous quote “There’s no one who wants this over more than I do. I would like my life back.”

The fact that a CEO can lose their job over a single statement reflects the nature of the job. The perceived importance of the CEO to a company’s performance is highly debated, especially when it is framed in terms of how much pay they are worth. However, the consensus is that CEOs have little impact on the overall performance of a company.

Nadella comes as a novice to the job of CEO and his turn in this position follows on from a long reign of the founders running the company. The decision to put him in charge reflected the difficulty the board had in finding an acceptable, rather than a necessarily suitable, replacement for Steve Ballmer.

A CEO’s main role however is to present the public face of the company and to inspire the market and their customers as a visionary. Perhaps we should have expected less of Nadella given that his first email to Microsoft employees encapsulated this vision as Microsoft enabling people to “do more” and that staff should “believe in the impossible”. Presumably the latter was aimed at female staff wanting equal representation and pay at the company.