Tech companies are betting billions they can predict disease from your wearable device
Halle Billie purchased an Ora Ring to track her fertility. This came on the day she found out she was pregnant. He slipped the $450 titanium band on anyway.
Months of worrying readings on energy and stress measurements, levels of which she initially attributed to pregnancy, led her to seek a professional opinion. The ultimate cause: Hashimoto’s disease, an autoimmune disorder.
“The ring can’t diagnose you,” said Billy, 31, manager of the National Park Friends Alliance in Ann Arbor, Michigan. “I can look at the data and take it to my doctor.” But she wants the ring to do more.
So she is now handing over personal data to Oura Health Oy, the ring maker, to help it detect symptoms of high blood pressure. It will eventually be incorporated into a new artificial intelligence model the company is building to predict events like heart attacks and strokes years before they occur.
Tom Hale, Ora’s chief executive, said, “Real success is not knowing you have a problem.” “It’s about knowing before you do it, so you can change the behavior and stop it.”
Getting there will mean pushing the boundaries of data collection and personal information sharing. Billy is totally involved. “I’m glad they’re using the data they get from me to build stronger algorithms,” he said.
It’s a trend that has been around for years and is entering a new phase around active health. Companies around the world, including Samsung Electronics Co. and Apple Inc., are studying how the technology can predict health events.
It’s an “elusive unicorn,” said Ramon Lamas, who directs mobile-device research at the International Data Corporation. To find this out would require governments to rewrite the rules regarding what exactly is a medical device.
Rings, smartwatches and other such devices are seen as reliable biometric monitors, capturing information about respiratory rate, blood oxygen levels, sleep duration and more. They are becoming increasingly common, with the market size estimated at more than $90 billion last year.
Tennis players will be allowed to wear gadgets in Grand Slam matches this year. Golfer Rory McIlroy allowed Whoop Inc. – in which he is an investor – to release data collected by his wristband during the Masters Tournament. US Health Secretary Robert F. Kennedy Jr. told Congress that he wants every American to wear a wellness tracker.
Collecting and analyzing data is one thing. “The bar for prediction is very high,” said Joseph Schwab, director of surgical innovation and engineering at Cedars-Sinai Medical Center in Los Angeles.
Inventors keep trying to enhance it, as seen at the Consumer Electronics Show in January. One product that caught attention was NuraLogix’s “Longevity Mirror,” which aims to predict health risks by measuring blood flow from selfies. Earlier this year, Death Clock, which uses AI trained on longevity data, went viral for promising to “predict when you’ll die.”
The wearables industry is focusing on risk factors like blood sugar, high blood pressure and pulse that have established links to heart health. The plan is to connect dots throughout the body, from reproduction to cognition, and leverage artificial intelligence to make it happen.
“Just like a big language model predicts the next word, we’re building models that can predict the next heartbeat,” said Whoop chief executive Will Ahmed. The Boston-based company was valued at $10.1 billion in March after raising $575 million in a funding round.
Its goal is to warn of heart attacks at least 15 minutes earlier, and in some cases years earlier — a reality that Ahmed said is “coming much sooner than people expect.”
Alphabet Inc.’s Google, which owns Fitbit, recently launched a screenless band to compete with the Whoop. Fitbit has also added a feature that integrates a user’s medical records and readings from a continuous glucose monitor. It then asks the AI to flag situations and suggest how to address them.
Finnish ring-maker Ora has a women’s health chatbot to answer questions about the menstrual cycle. In May, it introduced a new feature for monitoring birth control and certain signs of aging, part of an effort to predict ovulation, hormonal shifts and menopause. Premium smartwatch maker Garmin Ltd. has partnered with birth-control app Natural Cycles to help pinpoint ovulation using skin temperature.
At the other end of the life cycle, Samsung Health is working to detect dementia using indicators such as speech and gait. Hon Pak, head of digital health at the Samsung unit, said it plans to introduce an AI “personal health companion” over the next several months that will provide Galaxy Watch wearers with advice and “nuances” about risks, such as those raised by its recently launched blood-pressure monitoring feature.
Although no one has been able to show how variation in the vast data sets the companies are building can affect a person’s risk of chronic diseases, “that’s what we’re aiming to do,” said Pak, an Army physician and former chief medical information officer.
The shortcomings of currently existing health-monitoring devices are well documented, with heavy use sometimes associated with obsessive tracking and doctor shopping. The Internet is full of accounts of so-called wearable anxiety, where people cancel plans because a sensor detects possible symptoms of flu or congestion even though they don’t get sick, or report being gaslighted because of low sleep scores. Frequent alerts could lead to unnecessary testing, said Margaret Lozovtsy, who directs digital health innovations at the American Medical Association. Too much self-monitoring may shift the responsibility for monitoring from experts to individuals with low medical literacy.
“It embodies the argument that ‘I am only as good as the data I produce,'” said James Gilmore, author of “Bringers of Order: Wearable Technologies and the Manufacturing of Everyday Life.” This mentality can encourage dangerous reactions, he said.
The range of concerns about the predictive wearables of the future is wide, beyond the cost barrier for those who cannot afford it. Users today are younger, wealthier, and more health conscious, so the inputs used to train the model may not reflect other high-risk populations. Much of the information collected may fall outside the protections of the Health Insurance Portability and Accountability Act, or HIPAA, which allows broader secondary use rather than under the terms of service. Data breaches are always a concern.
“I’ve always had a dystopia of the influx of healthcare spam,” said Kevin Fu, an expert in emerging sensor technologies at Northeastern University’s College of Engineering. The former acting director of medical device cybersecurity at the Food and Drug Administration worries that “I suddenly started getting more ads saying, ‘Here’s some medicine for high blood pressure’ because they’re somehow using my watch.”
The industry has acknowledged the concerns. The companies have explained what steps they are taking to strengthen safety measures and how they are looking to integrate their products into healthcare systems, which, in their view, will make them accessible to more people. So far the FDA has not relaxed rules preventing wearables from diagnosing diseases or confirming medical conditions. Advocacy continues. One example: Oura Health, valued at about $11 billion after raising $875 million last September, is advocating for a new US classification that would allow wearable devices to alert users to potential health issues without having to go through the lengthy approval process required for medical devices.
One Wearable fan, Thomas Lynch of Florida, said his Ora ring “saved my life” after a major surgery. His ring indicated an increased heart rate, and he was eventually diagnosed with pulmonary embolism. The credit for this goes to what was seen in real time, he said. As far as finding out future events? As a data scientist who works with AI every day, he said he would take it with “a grain of salt.”
For Haley Billie, a participant in the Ora study, the issues raised don’t give her pause. “If a company knows my blood pressure and heart rate and everything, I’m comfortable with that at this point — and it feels silly to say it out loud.” She added, “I hope I don’t mince my words.”
Thornton writes for Bloomberg.
