Remember the Quantified Selfer’s fascination with sleep tracking and all those sleep-specific devices that went away, taking their investors’ millions with them? Fitbit and many smartwatches work with apps to give the wearer feedback on their sleep hygiene, but the devices and apps themselves can deliver faulty information. This is according to a study published in the Journal of Clinical Sleep Medicine called “Orthosomnia: Are Some Patients Taking the Quantified Self Too Far?” (abstract) by Kelly Glazer Baron, MD with researchers from the Feinberg School of Medicine at Northwestern University. “The patients’ inferred correlation between sleep tracker data and daytime fatigue may become a perfectionistic quest for the ideal sleep in order to optimize daytime function. To the patients, sleep tracker data often feels more consistent with their experience of sleep than validated techniques, such as polysomnography or actigraphy.” (more…)
While most industry observers are perceiving Jawbone’s abandoning the consumer fitness tracker market, repositioning into the clinical B2B2C vitals market, and seeking fresh financing as a last-ditch effort to save the company, Jawbone continues to be highly active in one place–court. Last week, Jawbone filed a lawsuit against Fitbit and five former employees in California state court for theft of trade secrets and has rebutted Fitbit’s motion to dismiss in a 27-page filing. According to Fortune’s account of the lawsuit, Jawbone’s filing states: “Each of the defendants has been, for more than five months, the subject of a criminal grand jury investigation regarding theft of Jawbone’s trade secrets that is being conducted by the Department of Justice and the Department of Homeland Security,” a charge that Fitbit calls ‘fictional’ and false. The court hearing in San Francisco is 15 February.
The legal skirmishing, which largely has gone Fitbit’s way [TTA 27 July] in the US International Trade Commission, indicates that Jawbone is still spending money to protect what is left of value in the company–its patents and intellectual property (whatever hasn’t been voided). Jawbone $100 million ‘gem’: the BodyMedia patents acquired in 2013 [TTA 30 Apr 13]. BodyMedia had FDA Class II clearance but a clunky form factor. This IP is a critical save if they want to go clinical. Fitbit’s shares continue to go down, an indicator that the mud is rising. Also Bloomberg with video.
Jawbone out of the consumer fitness tracker business, going to clinical model, raising funds: report
Confirming reports from various sources last year [TTA 21 Dec] and prior (July) is a report in TechCrunch confirming what we already guessed: Jawbone is out of the consumer fitness tracker market, is aiming at a B2B2C market of health providers, and needs to raise a lot more money.
Key points in the article:
- It intends to market a “health product and accompanying set of services sold primarily to clinicians and health providers working with patients”
- It’s seeking additional funding from investors. TechCrunch‘s sources claim that is at an advanced stage, but no closings as of yet.
We noted in December that research/analytics company CB Insights calculated that 2015 wearable computing (a broader category that includes smartwatches) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment. TechCrunch’s end of year report from eMarketer and other sources also noted that 2016 sales growth of the wearables sector, forecast at 60 percent, only achieved 25 percent growth and will be equally weak in 2017. Lack of demand, lack of loyalty (most fitness bands are discarded after 3-6 months), unreliable (TechCrunch makes much of customer displeasure), their looks and generally useless (in a clinical sense) data and the greater versatility (and appearance) of smartwatches for those who want them, are all factors. There’s a disenchantment here (‘who needs ’em?’) that mass marketing can’t overcome.
It is worthwhile reflecting that Jawbone, which started off in 1997 as an audio technology company, has burned through over $980 million in 14 funding rounds, generously provided by various VC luminaries of Silicon Valley. (One wonders how much equity is even left in the company, a la ‘The Producers’) (more…)
The first in a series of brief projections for 2017. Fitness wearables aren’t even lukewarm anymore, and it’s visible in consolidation and the nay-saying articles. In late November, Fitbit bought one of the pioneers, Pebble, for a cut price of $40 million (TechCrunch). Fitbit shares are also cut price at below $7.50, whereas the 2015 IPO debuted at $50. Editor Charles’ favorite, Jawbone, is moribund; the springtime rumors of company sale and shutdown of the fitness band line have not been contradicted since [TTA 27 July]. Research/analytics company CB Insights calculated that 2015 wearable computing (a broader category) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment.
A sure sign that fitness bands have chilled is negative play in the consumer press. ‘My fitness band has made me fat’, spun off the JAMA article [TTA 28 Sep], is now the theme of hilarious ‘dieters gone wild’ articles like this from the New York Post (warning, eye bleach photos!). But The Sun (UK) waves a warning flag that the information could be sold, sent to your employer or insurance company to profile and/or discriminate against you, or cyberhacked. All this can knock a pricey band off the Christmas shopping list. And no, it hasn’t shifted to smartwatches as most insiders predicted, as smartwatch sales have leveled off–as expected–until their functionality and appearance improve to justify their high price.
What’s in our crystal ball? Clinical-quality and specialized wearables will rise from these ashes.
- Doctors are simply not interested in the current poor quality of data generated by current wearables–‘it’s worthless, Jim!’ ZDNet’s much-discussed article on this subject paradoxically stresses this, then focuses in on the clinical quality data generated by startup VivaLnk’s eSkin for temperature and stress. Clinical quality data is what is required for a health and wellness research partnership like the one recently announced by RTI and Validic.
- Industry buzz is that Fitbit bought Pebble for its better IP, apps and stable of developers, not its smartwatch hardware, and that IP includes clinical quality measurement. Other biosensor companies on the rise according to CB Insights are Thync, Thalmic Labs, YBrain and mCube.
- In specialty wearables, there’s the recent funding success of Owlet, the High Cute Factor baby monitor sock. Lifebeam transfers multiple sensing technology to helmets and hats for richer data.
And if sensor patches develop with speed, in two to three years they may eliminate all of these!
The shock waves are reverberating through the wearables industry, but it is likely less than it seems. The JAMA study being cited was testing the hypothesis that technology could assist a weight loss program, and also what type of technology did best. The subject group of 471 at the University of Pittsburgh was young–18-35, prime for a wearable–overweight to moderately obese, and tracked for 24 months between 2010 and 2012 (!) The participants were started on a group weight loss program supported with calls and texts for the first six months, then randomized into two groups that monitored their diet and fitness either through a fitness tracker plus website (enhanced intervention group), or those using a website only (standard intervention). Both groups lost weight but the enhanced/fitness tracker group lost 5.29 pounds less than the website-only group.
The caveats: According to Mobihealthnews, the fitness band used was BodyMedia SenseWear, which was acquired by Jawbone and as they noted, put out of business. Fitness bands now also look and feel different than this early generation. Mobile tracking apps are now the standard versus going online which was necessary four years ago–a huge jump in convenience. But tracking itself may change behavior. The authors speculate that tracking data might actually demotivate people, or that activity ‘congratulations’ may lead to a bit of cheating. But they should try it with up to date trackers. Also Healthcare Dive and Reuters
Fitbit may succeed in blocking Jawbone from selling in US? The Jawbone wins [TTA 27 July] in the US International Trade Commission court was apparently reversed due to a judge’s error for two Fitbit patents, and this may open the way for Fitbit to further block Jawbone. An additional California court action on infringement and misappropriation on trade secrets by Jawbone is headed for court in 2017. Mobihealthnews…..Maybe texting is enough? Dr Joseph Kvedar seems to think so for simple medication adherence and reminders, with reasons like the easy scaling of text messaging in EHRs, but prefers installing an app to deliver them due to the downsides of plain text messaging such as HIPAA and security. Thus we return to the logic of the desktop unit days (e.g. Health Buddy, Viterion) but delivered via smartphone. CHealthBlog….550 US primary care docs say no reimbursement, no telehealth (actually telemedicine). Usage in the past year was a scant 15 percent, with higher usage in Federally designated ‘safety net’ clinics (FQHCs) and HMOs versus PCMHs and ACOs where reimbursement by Medicare, Medicaid and private payers is far chancier. The survey was conducted by their association, the American Association of Family Physicians (AAFP). mHealthIntelligence….iHealth Andon Group buys France’s eDevice for $106 million. The aim seems to be integration of eDevice’s backend infrastructure to iHealth’s RPM devices. Mobihealthnews….A analysis of what went wrong at HealthSpot is in the new publication Telehealth & Medicine Today. A summary is that they had a business model that started out on point quite a while ago (2010) but then competitors and fresh technology ate their lunch (Editor’s term). They didn’t pivot to fit, moved too slowly and were overly wedded to their business model. A big problem was scaling costly kiosks and not finding the right places for them. While initially impressive, there was something all too elephantine about HealthSpot from the start. Our Readers interested in a Trip Down Memory Lane may read our collection of articles from 2013 here which pointed out most of the above….In the industry moves department, Peter Radsliff, whom this Editor worked with briefly on AgeTek-The Aging Technology Alliance (apparently defunct), has joined Arrayent, an IoT developer, as VP Marketing. Now that tells us something! Congrats to Peter!
And finally for a good long, but not light, read, this article in The Atlantic will give you a chilling glimpse of front-line medicine attempting to heal the carnage in Syria, using WhatsApp, texts and the simplest forms of telemedicine. A dedicated group of primarily Syrian-American doctors on a WhatsApp volunteer group called Madaya Medical Consultants uses it to perform consults with the minimal medical resources available in Syria. And yes, they know what Aleppo is.
Mobihealthnews provides a recap of the past four years of patent actions pitting company against company in the hushed but deadly rings of the US Patent and Trademark Office (USPTO) and the US International Trade Commission. On the fight card: the never-ending American Well-Teladoc bout (Teladoc winning every decision so far by a knockout [TTA 18 June]–a second American Well patent being invalidated on 25 August); CardioNet vs MedTel, which the former won but has had to chase the latter out of the arena and down the street to collect; Fitbit-Jawbone which has gone both ways [TTA 27 July]; and the long trail of blood, sweat and Unintended Consequences around Bosch Healthcare’s heavyweight IP pursuit against mainly flyweight early-stage companies (not noting, as we did, their apparent ‘draws’ vs Philips and Viterion, then owned by Bayer).
The Reader will note our tracking Bosch’s activities go back to 2012 (here, here and here). Moreover, with Mr Tim Rowan of Home Care Technology, we broke the news of Bosch’s demise in June 2015, drawing the conclusion that their offense versus Cardiocom’s patents (now in Medtronic’s cardiac division) directly led to the invalidation of their key patents, IP–and the very basis of the company’s existence. See the 19 June 2015 article and our recap one year later in reviewing AW-Teladoc. (Any similar phrasing or conclusions within the Mobihealthnews article, we will leave to our Readers to decide!)
The wearables war continues, and the Law of Unintended Consequences seems unbreakable. This one was decided in a US International Trade Commission court, with the judge ruling that the three patents in question “don’t cover ideas eligible for protection” and dismissed the August trial between Fitbit and Jawbone. This is a reversal of fortune for the two competitors as a similar patent challenge to Jawbone was won by Fitbit back in April in the same court. In the new ruling, the judge said that Fitbit “seek(s) a monopoly on the abstract ideas of collecting and monitoring sleep and other health-related data.”
The skirmishing has a deeper context. Jawbone has accused Fitbit of hiring former employees and purloining trade secrets like product design and marketing plans, and alleges that the suits were “brought improperly by Fitbit in an attempt to burden Jawbone with having to defend invalid patents in multiple venues.” Fitbit reportedly has 300 patents, so that is a lot of defending for a company that has issues of its own. Jawbone has struggled in past months with its products, with various (and contradictory) reports indicating it’s exiting the wearable business, working on a new wearable and selling its audio business (which has also been crushed by competition.) Undoubtedly this will continue as Fitbit plans to challenge the ruling. Your Editor suspects that their legal and IP offense/defense activity is a substantial budget line for them. Bloomberg (20 July and April), The Verge
Update: Jawbone is rumored to be up for sale, with reports that they have approached at least one hardware manufacturer about a purchase. Reportedly they missed an August payment to a business partner. Investor BlackRock has marked down their shares, formerly valued at $5.97 a share, to less than a single penny. Since 1999, Jawbone has had funding of over $900 million. 9to5Mac, The Verge Even the much-publicized hiring of high-profile exec Adam Pellegrini from Walgreens to Fitbit to lead digital health has a Jawbone twist, as both the former and latter were partners. MedCityNews
Funding’s up, but the digital darlings have changed. The stock market and tech sector may have been uncertain kicking off 2016, but digital health wasn’t. Rock Health’s first report for 2016 exudes optimism. Compared to the same quarter in 2015, funding increased nearly 50 percent to $981.3 million, the highest amount since 2011. But the devil may be in the details:
- Five deals accounted for 56 percent of the volume (in descending order: Flatiron Health (clinical intel for cancer care), Jawbone, HealthLine (consumer health info), Health Catalyst (data warehousing) and Higi, an odd little kiosk + consumer engagement program nationally placed in Rite Aid stores–odd enough to gain $40 million in its first venture round
- Seed and Series A raises were still well over half–54 percent, over the 50 percent in 2015
- Later stage deals (Series D and above) shrank to 13 percent in 2016 from 35 percent
- Top categories also demonstrated the fickleness of funding favorites. Only two categories in the top six were carry-overs from 2015: wearables (driven by Jawbone) and consumer engagement. New favorites: analytics/big data, population health management, consumer health information and EHR/clinical workflow.
- There were no venture-backed IPOs in the quarter, and public company performance was down (9 percent y/y)
The new picture favors what to do with the data–finding trends and putting them to use both consumer and clinical sides. And exits were popular as well: 187 was the Rock Health count, with fitness wear Asics‘ acquisition of the Runkeeper fitness wearable and provider One Medical acquiring the Rise app. Will the trend continue in 2nd quarter? Stay tuned….Rock Health Q1 Update
This editor’s recent blogs on Jawbone’s UPs do not make pleasant reading so now I’ve reached my “lemonade point” – ie I am on my 7UP (or should that be seventh UP?) – it seemed only fair to advise readers that I have had my second UP3 for over a month and it still works! As I took my previous one in the shower – as is recommended – and it packed up very quickly, for this one I’m avoiding all water contact. Perhaps that’s the secret?
I was reminded of this by this recent piece in ZD-net grumbling about tracker data loss – Jawbone, alongside Misfit, were the two quoted. That is an experience I have yet to have, although at present if anything I have the reverse with my sleep times being doubled resulting in 14+ hour daily sleeps.
Apart from this relatively minor glitch (compared to previous rather more terminal ones), I am almost at the point of being impressed. The new software automatically detects sleep, so no need to remember to tell it when you are going to bed, and the heart rate monitor produces some very interesting results. Once you work out how to put it on so it doesn’t keep falling off, it’s much less obtrusive that the original UP open bracelet, too. If it keeps going like this for another eleven months, I fear I might even start recommending it!
The interest in fitness bands has quantifiably and substantially diminished since January, according to Argus Insights’ survey of online consumer reviews (!)–and since the debut of Apple Watch. And while Fitbit maintains its leadership in the band category (sorry Jawbone, though Editor Charles won’t be), the rising preference is for smartwatches like the Apple Watch and Android wear such as the Moto 360 and the LG Watch Urbane (pictured). While there’s a substantial price difference between smartwatches (~$350 versus under $150), and both Apple Watch and LG’s watches (versus LG bands) have limited fitness capability, there’s few new developments in fitness bands to create excitement. There have been enough problems with fitness band reliability, breakage, rising prices and a boredom with design to diminish interest while new brands enter the market, and smartwatch prices come down slightly. For the price, users also want more out of their watches. Neil Versel in MedCityNews.
Updated: Apple Watch, with 3.6 million units sold in 2nd quarter was immediately behind Fitbit with 4.4 million, according to IDC’s Worldwide Quarterly Wearable Device Tracker. 2 of every 3 smart wearables (capable of running third-party apps) was an Apple Watch. Another sign of the coming divide between fitness bands (which will be sold on price and fitness focus) and smartwatches (which will be sold on versatility as well as fitness justifying the higher price). IDC release
Also by Mr Versel is a memorial to telemedicine pioneer Dr ‘Red’ Duke. As a surgical resident at Parkland Hospital, he was on the team which saved the life of Texas Governor John Connally, shot with President John Kennedy in November 1963.
Trying at least temporarily to distract this editor’s attention from his recent unfortunate experience with Jawbone technology, here are some interesting app and wearables snippets received over the summer.
We begin with news of the first CE certified mole checking app, SkinVision which rates moles using a simple traffic light system (using a red, orange or green risk rating). The app lets users store photos in multiple folders so they can track different moles over time. It aims to detect changing moles (color, size, symmetry etc.) that are a clear sign that something is wrong and that the person should visit a doctor immediately.
This contrasts with the findings of a paper published in June examining 46 insulin calculator apps, 45 of which were found to contain material problems, resulting in the conclusion that :”The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control.”, which to say the least of matters is worrying. (more…)
But does the average person even care? This Editor senses a groundswell of concern among HIT and health tech regarding the highly touted Internet of Things (IoT) and the dangers it might present. Our previous article reviewed the possibilities of hacking, system vulnerabilities in IoT networks and software bugs ‘bricking’ everyday objects such as refrigerators and cars. But what about wearables and the unimaginable amount of data they generate? Is it as unidentifiable as wearables makers claim? Columbia University computer science student Matthew Piccolella focuses in his article on healthcare ‘things’, primarily fitness trackers like Editor Charles’ favorite, Jawbone, but also clothing and even headsets that measure brain waves (Imec). Their volumes of data are changing the definition of healthcare privacy, which in the US has been synonymous with HIPAA. The problem is that health metadata are increasingly identifiable in a ‘big data’ world. (more…)
Readers may recall this editor’s most recent blast against Jawbone in which I complained about being emailed by them about a product I couldn’t buy. Well in due course I got a nice email from Jawbone, explaining the error and extolling the UP3, that I could buy. So nice that I relented and bought one.
Big mistake: my three UP bracelets that failed have lasted an average of some seven months each. The UP3 lasted just eight days before it stopped recording sleep correctly (an even shorter time than the two weeks the preproduction UP3 took to stop working when on trial by re/code).
Initial problem handling by Jawbone support has always been good – I can only assume they get lots of practice – and indeed I got an email straight back telling me how to do a ‘soft reset’ (These have never worked for me for any of the problems I’ve had, with either UP type of bracelet; perhaps it gets some people to give up.). When I told them it hadn’t worked, this was followed quickly by an email 10 working days ago telling me that they were referring my problem to colleagues and to expect a response within 2-3 working days.
Since when nothing: my emails have gone unresponded to, and I have heard nothing further. If this poor quality is the experience of others too (certainly some), then it’s clearly no wonder why FierceMobileHealthcare refer to Jawbone as one of six companies collectively making up 15 percent of the market with Apple & Fitbit way ahead.
It’s such a shame too, because in spite of the problems, my Jawbones, when they have worked, have been great motivators that have helped me lose over 12 kilos now – unlike the suggestions in the recent Guardian artcle, I’m sold on being nudged. I just need something I can rely on to nudge me!
The just-published AARP study of 50+ consumers and design of sleep and activity trackers has found that a near-or majority surveyed found activity and sleep trackers useful in maintaining health. 71 percent found they increased awareness of habits; 67 percent found them useful and beneficial. Four user personas emerged: sticklers, achievers, enthusiasts and the ‘why not’-ers. Yet these mostly enthusiastic users experienced difficulties. During the six-week trial, many discontinued use of the trackers due to data inaccuracy, finding and using instructions, perceived device malfunctions, difficulty in syncing, difficulty in putting on the device and comfort in wearing. The seven trackers used by the 92 participants were from Misfit, Spire, Jawbone, Lumo and Withings. Conducted by Georgia Tech Research Institute’s HomeLab with AARP’s Project Catalyst: The Power of We initiative which encourages good product and service design for the 50+ demographic. Coming up: med management tools. iHealthBeat. AARP release. AARP’s Building a Better Tracker research paper