2014: the year of reckoning for the ‘better mousetraps’

Or, the Incredible Immutability of the Gartner Hype Cycle

From Editor Donna, her take on the ‘mega-trend’ of 2014

This Editor expected that her ‘trends for next year’ article would be filled with Sensors, Wearables, Glasses, Smartwatches, 3D Printing, Tablets and Other Whiz-Bang Gizmos, with splashes of color from Continuing Crises like Healthcare.gov in the US, the NHS’ 3million lives plus ‘whither UK telecare’, various Corporate ‘Oops-ses’, IP/Patent Trolls and Assaults on Privacy. While these will continue to spread like storm debris on the beach, providing continuing fodder for your Editors (and The Gimlet Eye) to pick through, speculate and opine on, what in my view rises above–or is under it all–for 2014?

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech…

…diving into the Trough of Disillusionment in 2014. Crystallizing this certainty (more…)

The Quantified Selfer’s Christmas form letter

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]  APPROVED by The Gimlet Eye, on assignment directing Air Traffic Control for Mr. Claus.

Dear ______,

I can see from my ______ wrist device that it’s once again time for my annual Christmas letter to update you on a number of personal facts about the past year! Lucky for you, I’ve been able to view my daily data on a variety of self-tracking devices using interactive graphs to spot trends and patterns so far.  The year raced off to a great start because I got a new ______ from Santa last Christmas. (Continued…)

Our final pre-Christmas post is from the ‘♥ Sister’ herself, Carolyn Thomas, who has written this most witty communication that you may well receive from your favorite (?) Quantified Selfer. If not, reading this you will be forearmed at holiday tables and gatherings. You will view your QS nephew or friend in a new, more tolerant light. Wearing their Google Glass, tracking the cookies and egg nog on their Fitbit or Jawbone UP, passing around the Misfit Shine, obsessing on what workout will most efficiently balance the caloric intake…. To the rescue? Spot the Dog. Fitbit, Jawbone and Shine make great chew toys, and Glass…will Spot get to it before the video hits the cloud?

We wish all of our readers a marvelous Christmas Holiday, Festive Season and Happy New Year! (and thank Carolyn for the reference!–Ed. Donna)

Wearables on the hype cycle: a ‘Fitbit for babies’

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/12/3019806-poster-1280-sprouting.jpg” thumb_width=”175″ /]Is nothing sacred? Certainly not when you want a high-performing infant! FastCompany Design goes ga-ga over the Sproutling, an anklet activity monitor for the bassinet set. It tracks heart rate, skin temperature, and movement plus the room’s ambient temperature, humidity and light levels via a camera and sensors in a base station, sending data to parental smartphones. Target price not disclosed. More measurements here than our late summer baby rave, the Owlet smart sock sleep monitor which primarily alerts for dangerous baby rollover onto the stomach and trends in sleep quality, plus blood oxygen and skin temperature. There’s quite a bit in the article (more…)

Much ado about Airo: the denouement

Like the Maltese Falcon, ‘the stuff that dreams are made of’?

The madly touted Airo fitness band, with its claimed mini-spectrometer built into the band to detect nutritional blood metabolites for passive sensing of food consumption [TTA 30 Oct], has, after a firestorm in the industry press, conceded it lacked proof that it would ‘work as advertised’ and refunded money to its early backers. Very rarely have we seen mass disparagement in health tech, but the fact that the developers ginned up a lot of breathless publicity over a device without a working prototype and no studies to back a future design made it all too easy. (more…)

Staples: a new market for health tech? (US)

Staples is following Amazon’s lead and getting into lines of business–including home health care and personal care–totally unrelated to its core merchandise of office supplies. E-commerce blog GetElastic takes a critical look at their business goals in driving towards over a million SKUs, bringing in third-party sellers (“marketplace”) and drop-shipping, plus sourcing and stocking an extended inventory. The news for us is that one of those marketplaces could be fitness tech/wearable items that employees use in wellness programs such as Fitbits, Jawbones and FuelBands, sensors for Samsung’s S Health program–or glucose meters and blood pressure cuffs. (Already Staples stocks DME, personal care, ostomy and respiratory supplies.) And since Staples already sells smartphones, the potential for cross-selling fitness add-ons and apps is excellent. Can Staples Succeed as an Everything Store?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/11/Staples-home-page.jpg” thumb_width=”400″ /]

Much ado about Airo

A flurry of publicity has descended like early snow in the Rockies promoting the AIRO fitness band. Developed by three graduates of Canada’s University of Waterloo, it is building pre-delivery excitement (and pre-orders) around the band’s claimed unique capability to analyze post-eating effects and make recommendations. A mini-spectrometer built into the band uses light wavelengths to look into a person’s blood stream and detect the metabolites released during and after eating. Their program then analyzes the information and makes nutritional recommendations on your smartphone without any separate input of foods or calories. As far as this Editor knows, this is a first, along with using heart rate and caloric burn to measure exercise intensity and recovery. The ‘only health tracker you’ll ever need’ cuff also measures and reports on stress and sleep. The company is taking pre-orders at $149 in advance of the full DTC price of $200 (not sure if in Canadian or US dollars), but according to the FAQs delivery will not be until Fall 2014. For iPhones and Android.

Could Fitbit and Jawbone Up be getting the treatment they meted out to Zeo within a year? Will the spectrometer and blood analysis mean that the device will need FDA and Health Canada clearance? Inquiring minds want to know. Website, video, Business Insider article, CBS-TV Cleveland. (Editor Donna note that the pre-sale over a year in advance is essentially a crowdfunding strategy, but standalone it feels ‘take the money and run’ dodgy.)  Hat tip to reader Lois Drapin of The Drapin Group, New York.

Update 31 October: The somewhat sketchy credibility of this device has increased exponentially, in this Editor’s opinion, since the revelation that there is not a working prototype (due in December, according to the founder) and the spectrometer’s capability and accuracy of detecting blood metabolites non-invasively at the wrist may resemble junk science (MedCityNews). Brian Dolan concludes that as of this point, Airo cannot be what it’s cracked up to be in Mobihealthnews.

In smartwatch 2014 deluge news, Google is also nearing its smartwatch launch within months, according to The Wall Street Journal. The watch will incorporate the Google Now personal assistant.

Body computing, sensors and all that data

This past week’s Body Computing Conference at University of Southern California (USC) had three sessions focusing on wearable sensors and the big names such as the well-financed Fitbit, Jawbone, BodyMedia, the ingestible sensor Proteus and Zephyr. The panels were split between the medical-grade and the consumer oriented with this report indicating some friction between the two. The notion of the Quantified Self died hard, even with Basis Science’s Marco Della Torre noting that 80% of health app users abandon them within two weeks, so the discussion moved to form factor and the ‘holy grail’ of getting the 90% of never-ever QSers to pay some attention. Of course, it’s the flood of data that has to somehow be processed (one of the FBQs) even though the doctors appear to be unconvinced of the evidence…but the ‘big data’ may be proving it after the fact. The future of wearable sensors in healthcare (iMedicalApps)

Jawbone jawbones $100 million in financing

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/band1.jpg” thumb_width=”150″ /]Fortune, no usual hangout for health tech news, headlined late last week that Jawbone, which recently relaunched its UP fitness tracker after the earlier version developed glitches, obtained $93 million in debt financing and is rumored to be lining up another $20 million in equity financing from its four largest existing VC backers: Andreessen Horowitz, JPMorgan Digital Growth Fund, Khosla Ventures and Sequoia Capital. Reportedly they are wildly back-ordered for the colorful and stylish UP fitness tracker (now a fashionista item, a sure sign of scarcity). Their founder/CEO Hosain Rahman told Fortune “We’ve been experiencing crazy sell-through demand, particularly since the relaunch of Up. It’s been faster than anything we’d had before, and equity is not the most efficient way to scale all that.” We’ve previously noted Jawbone’s aggressive acquisition warpath with BodyMedia [30 April] and Massive Health [11 Feb]. Competitors have hardly been sleeping: Fitbit just raised an additional $43 million to add to their previous $23 million [15 Aug] and Withings a fresh $30 million [22 July], so fitness trackers are all going one way–up. Exclusive: Jawbone raises more than $100 million (Fortune). Also Mobihealthnews.

Quantified selfing: elitist and privacy invading

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The last place you’d expect to see a populist view of Quantified Selfing, outside of the retrograde publications perused by The Gimlet Eye, is Wired. All these Fitbits, Jawbone UPs, Misfit Shines, baby monitors and of course Google Glass cost, cost, cost–upfront and especially for the ongoing subscription services. Even wearables, at this point, are nowhere near cheap and cheerful nor will be for some time. Is QS a luxury of the residents of Elysium? Wired’s Quantified Man, Chris Dancy, toting up his five-sensor/system cost, pays $400-$1,000 per month. The Eye tears up at the effect on the exchequer. But the most painful point for the article’s writer is less elitism than privacy: all the data churned out, existing somewhere to be mined, and all those ad messages waiting to be served up on Glass. PPG–pay per gaze–indeed. Your ‘Quantified-Self’: Are Wearable Technologies Just a Luxury for the Upper-Class? 

Now an app to track circulation and metabolism

How are you really doing? is the question that the developer of One Aura, developed by Ryan Archdeacon, is trying to answer by designing an app that reports metabolism (body fat and carbs) and circulation (heart strength, endurance, life expectancy). According to Mashable, he is using “analytical computation, algorithms and data visualization to derive higher-level meaning of the data.” The outputs are certainly interesting, but the interpretation methodology seems to have missed both the article and website. How metabolism and circulation are arrived at from data inputs from simple heart monitors such as the Zephyr HxM, Polar H7 and others (not Fitbit or Jawbone)–one wonders. Less than what it seems?

Fitbit as clinical assessment tool: Mayo Clinic

Not unexpected, but sooner than one would think given the relative newness of fitness trackers. A Mayo Clinic study published in the September issue of the Journal of Thoracic Surgery (abstract) monitored a group of elderly patients who had elective major surgery, were older than 50 (that’s elderly?) and were expected to be in the hospital from 5 – 7 days. The Fitbit was worn on a disposable ankle strap given their limited mobility. Data went first to the Fitbit website then over to a dashboard for clinical use. Patients were also tracked when they went home, home with home health assistance or to skilled nursing/rehab. Day 2 seemed to be a critical breaking point (more…)

Signs of a home monitoring bubble?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/Ambio-health.jpg” thumb_width=”175″ /]Suddenly home-based remote monitoring is very warm, if not hot. The news of investments at all levels–from Medtronic’s purchase of Cardiocom [TTA 12 Aug] to a $525,000 third angel round investment in AmbioHealth (which this Editor doubts would have been on MedCityNews’ radar a year ago)–sounds like home telehealth is finally, finally gaining traction with investors, which have been more attracted to hospital-based and fitness monitoring. But is it the right type of traction based on reasonable expectations? We were among the first to point out in 2010 in positing the FBQs* that where the data goes, how it’s being used and who’s taking action on it was critical. Now Robert Pearl MD in Forbes is also examining the new song of home RPM and finding a few off notes (or to mix metaphors, finding a pan of fool’s gold):

That’s because some promoters of home monitoring technology believe doctors will carefully scrutinize each EKG or blood sugar reading and use the information to tailor perfect regimens for their patients. This is not how medicine works.

and

Looking at thousands of EKG tracings won’t add much value either. In fact, putting all that information into an electronic medical record (EMR) only makes it more difficult for doctors to identify other, more vital pieces of information. Instead, doctors need to understand which of a few possible patterns are happening to determine the appropriate course of action.

Dr. Pearl’s prescription is for smartphones to embed telehealth monitoring capabilities at a price point slightly above the current cost, but less expensive than stand-alone devices (more…)

Fast funding and sale roundup for Thursday/Friday

A quick summary of news on both recent funding, another recently released funding analysis to add to the pile and sales–one completed, one potential:

  • The StartUp Health accelerator is now producing its independent analysis of health tech funding deals, presumably to catch the fire of RockHealth’s recognized quarterly report [TTA 9 July]. The July 2013 Digital Health Insights Funding Report is available in Slideshare format on their website with the most reported news being the 47 percent year-over-year growth to date, contrasting to RockHealth’s 12 percent, though the difference in all three may be the sampling. Practice management, big data and body computing/sensors lead the trends, according to their summary.
  • What is intriguing in the July deals is the whopping $40 million Series A funding of Oscar, which will integrate telemedicine (presumably consults) and free generic medications to its members in New York State, where they’ve stated they will be integrated into the Health Exchange in NY State. One wonders how they plan to do so on insurance exchanges which haven’t even started yet and which will be having their own challenges being a retail platform for health plans. Not unexpectedly you’ll find Khosla Ventures and Thrive Capital on the roster. MedSynergies led with a $65 million Series A for their software which will facilitate hospital networks performance monitoring of practices and provider referrals/scheduling. Internationally, Withings raised a $30 million Series A in July. MedCityNews also delves deeper into what they see as trends.
  • Fitbit just raised an additional $43 million to add to their previous $23 million. While they are still lagging fitness monitoring rival Jawbone UP by $84 million, rumors abound on what Fitbit plans to do with it: a more fully featured smartwatch? Additional apps to keep their user base engaged?–at the risk of overcomplication?   Fortune, TechCrunch
  • Toronto-based Diversinet closed their sale to New Jersey-based IMS Health for what seems like a small amount: (US)$3.5 million. Its MobiSecure technology provides government-security level mobile app security to customers such as AirStrip and the US Army. However, they were embroiled in early days in a breakup with a mobile provider, AllOne Health, and despite all their high-level tech clearances, the income realized, according to Mobihealthnews, was only in the $1 million range per year and declining and losses increasing. IMS Health is best known for its healthcare informatics, but has been involved with Ford’s in-car SYNC in development of the Allergy Alert app [TTA 7 Aug 12].
  • The ‘For Sale’ sign is also up at BlackBerry, with a corporate committee now officially exploring alliances and a sale, in the usual depressing drill. In a company once ubiquitous enough for smartphone usage to be dubbed ‘Crackberry’, and which still enjoys major worldwide market share and enterprise favor, they cannot get traction with new models. This Editor never used or liked BB, but it’s still kind of sad. ZDNet.

Apple-ologists discern ‘new’ interest in health tech and telehealth

With the same obsession that Kremlinologists had during the Cold War, the Apple-ologists at 9to5Mac divine that Apple is now suddenly interested in the sensor-based fitness sector of telehealth. Recent remarks by their CEO have been examined like the mutterings of the Oracles at Delphi. Their SVP of Technologies has been spotted wearing a Nike FuelBand, just like the CEO–and by looking at his picture, he does need it! Apple Marketing folks have been examining wearables like the Jawbone UP! (naturally as competition, duh!) Far more indicative from their sources: An all-star team from semiconductors to batteries to sensors is working in secrecy on the long-awaited iWatch. Talent’s been snatched from telehealth sensor companies AccuVein (vein mapping), the recently defunct C8 MediSensors (blood monitoring), and Senseonics (embedded sensor for blood glucose).  And they are most interested in sleep tracking. iWatch’s novelty emerges as Apple taps sensor and fitness experts

Apple’s been interested all along in healthcare–and others have been interested in Apple

No surprise to TTA readers, as you’ve been tracking Apple’s and competition’s healthcare moves along with us from the start.

  • the iPad in hospitals and their preliminary tests starting in early 2011 when tablets were new and untried [TTA 8 Feb 2011]
  • Editor Steve on the Apple Smart Shoe US Patent application back in January
  • Samsung’s hype on healthcare devices and software on the new Galaxy S4–fitness tracking disruptor?
  • 5.5 million plus of health app downloads (US) from the App Store (May)
  • the development of many devices that are based on the iPhone (Misfit ShineAliveCor‘s ECG, the Ozcan microscope and food testers only a few)
  • …though Microsoft’s Surface for healthcare back in February is likely a dud–MS just wrote off $900 million with the Surface RT, lowered its price (though only a fool with money to burn would buy it) and the Pro continues to struggle (ZDNet)

Smartwatches as the 2013-2014 tablet…and will they knock out fitness bands?

But this press focus on ‘Apple for Health’ does disguise that Apple is behind the curve, not leading it, on the watch form factor. Just like the Soviets, Apple better get a move-on or lose the race that gets serious next year. Smartwatches are fast becoming the new tablet [TTA 2 July]. One rosy industry estimate has 5 million units sold by end of 2014 (Canalys Research in Gigaom). Sony’s been there for awhile. Pebble sold 275,000 pre-orders through Kickstarter, their web store and now retail through Best Buy. This week the rumor broke among the Microsoft-ologists that they are working on an aluminum smartwatch with a 1.5-inch screen and a band out of Star Trek IV. (The comments below the TechCrunch article on the very thought of smartwatches are a good chuckle!) And undoubtedly looking over their shoulder because they’re gaining on you, contrary to Satchel Paige’s advice, are Fitbit, Jawbone and Nike, wondering if they’ll be the next Zeo.

Misfit Shine debut delayed, minus Android

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/leather-band21-1024×682.jpg” thumb_width=”150″ /]Announced to Misfit Shiners on the Saturday of the Memorial Day holiday weekend, of all times, was the further delay of their wearable tracker-sensor to mid-July from early June. The five to six week delay due to waterproofing was less aggravating to many pledgers than the dropping of Android compatibility for iOS only.  To those early birds who enthusiastically pledged their money to buy 10,000 units as part of the $846,000 incredibly oversubscribed placement on Indiegogo, the squishily worded justification on their blog from founder Sonny Vu, ” iOS allows us to roll out the features we want and give you the best user experience out of the box” did not satisfy–and the date of Android’s debut was not addressed. Comments on Indiegogo are not complimentary. With not only the kickstarter funding but a healthy jolt of Series A funds ($7.6 million), it is a mystery to most why Android is not supported from the start. Refund requests are a-go-go. So Misfit is sleek, waterproof….and has to overcome bad word-of-mouth from its funders just before its official debut. And directly competitive Fitbit and Jawbone UP support Android.  Crowdfund Insider, Mobihealthnews

Samsung Galaxy S4’s S Health: fitness tracker disruptor?

The much-heralded second quarter intro of the Samsung Galaxy S4 mobile phone is, according to multiple reviewers, a sustaining innovation (improvement). But embedded in it is a disruptive innovation to the fitness app sector dominated by Fitbit, Jawbone Up, Nike FuelBand and a raft of low-cost/free tracking apps.  It’s S Health, which according to Gizmodo’s incredibly detailed review monitors key activities and sleep (Editor emphasis):

Holy crap, Samsung put a health tracker in its phone! Which is actually a great idea. S Health is an app that will track your steps, stairs climbed, and the ambient temperature and humidity, plus track your food intake and estimate calories consumed/burned. You can even track sleep with an optional accessory (see below). Fitbit and co. should be nervous, although I’m curious to see what kind of ding this puts on your battery life.

and

There are also a bevy of accessories that complement the S Health app. There’s a wristband you can wear independently of the phone (in case you prefer running without it), which will track your steps and monitor the quality of your sleep. It will then sync wirelessly with the app. There’s also a connected scale and heart rate monitor. Again, this isn’t good news for smaller fitness tracking companies.

The Verge has the S Health slide (grainy photo) presumably from the Samsung debut presentation. (Better photos over at CNet; photo here is courtesy of 3G Doctor–see below)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/03/s-health-via-device-foused-message1.png” thumb_width=”250″ /]If the implementation is high quality (and some commenters have issues with Samsung), Fitbit et al. could themselves be disrupted straight out of their (current) business model and consumer market, just like they did to Zeo.  S Health integrates–it’s already on your phone, it largely does what they do and gets the fitness tracking job done (‘Total Reports’) for most who are interested for free, even without the few available accessories. No downloading and going to Amazon or Best Buy to buy a raft of expensive accessories to make it work with your phone. No annual $49 membership so you can access your data.  Worst of all for the current crop of fitness trackers, not one–not even Nike–can beat the Samsung international distribution network and only Nike beats Samsung on brand recognition. Is it a deal-maker for consumers? Probably not, but it gets much much closer to the customer. Also a few things that Samsung has introduced–the Air View/Air Gesture eye tracking and gesture control–have great potential for app designers in other aspects of fitness and health.

We’ll have to wait and see–not too long– if other smartphones (HTC, Apple, LG, even BlackBerry) add fitness tracking. If I were Fitbit or Nike, this Editor would be hopping like an Easter Bunny to cut a licensing/partnership deal with them. BlackBerry with Nike FuelBand….

Related articles: Dan Munro over at Forbes cheers Samsung on in Latest Samsung Smartphone Adds Health Functions, Sky News adds the international perspective. CNet reports accessory pricing: S Band and Body Scale at $99.99 each, Heart Rate Monitor at $69.99. Update 18 March: Lt. Dan opines at HISTalk on What it means for healthcare and mHealth [WARNING 31 Aug 2014: linked page may now be infected with malware] –the market pushing for bigger smartphones that blur the line between phones and tablets, the navigation capabilities of Air View for EMR. A cold-waterish review/comments at iMedicalApps doesn’t think much of the native temp/humidity feature (your Editor begs to disagree); again a commenter brings up Samsung’s track record of weak software, but agrees that Era of mobile health tracking definitively arrives. Hat tip on these two updates to the 3G Doctor, David Doherty, via LinkedIn’s mHealth group. ZDNet notes Samsung’s Knox software to separate personal and business use on one phone, along with SAFE for enterprises.

And do read David Doherty, the 3G Doctor for a further dissection and projection of the S4’s capabilities in features like its camera, the humidity/temperature sensor, the aforementioned Air View/Gesture, the dual video, Smart Scroll for eye testing and even the recharging pad as particularly friendly to healthcare use — and users. Samsung takes S Health centre stage at Galaxy S4 launch and Will Samsung’s Smart Scroll turn the world upside down for mHealth Regulators? (mHealth Insight)