While The Institute’s June special report describes what is needed to make wearables more accurate, seamless, and better equipped to monitor vital signs—readers had other concerns, including data security and how to make the products simpler to use and wear. Here to answer their questions are four leading experts in the field.
They include IEEE Senior Member Kevin Curran [top left], a professor in computer science at Ulster University, in Northern Ireland, and an IEEE technical expert; Jesse Jur [bottom left], an assistant professor of textile engineering, chemistry, and science at North Carolina State University, in Raleigh; and collaborators Elizabeth Churchill right], a specialist in user experience with a background in experimental psychology, and IEEE Member m.c. Schraefel [center], founder of the WellthLab for Human Systems Interactive Design at the University of Southampton, in England. Here’s what they had to say.
Although companies seem to be more aware of security and privacy for their products, it doesn’t seem that users are worried, conscious, or aware of the need for data privacy and control over their personal data, even when related to their health. How can we make users more committed to protecting their data?
JUR: Companies have a monetary incentive to be concerned about security and privacy of their products. Consumers do not yet have that strong incentive; the key word being yet. As health data goes online and becomes ubiquitous in our society, it will be likely that consumers are going to want to know exactly what is being done with their data. And as medical decisions are made based on that data, such as how government agencies like the U.S. Federal Drug Administration will use the data, these concerns will be even more heightened.
CURRAN: Invasion of privacy is a real concern with the widespread deployment of the Internet of Things and myriad smart devices including wearables, which will lead to an increased collection of information about individuals, such as their habits, location, and interests. Users need to be educated. As the media continue to cover more leaked data breaches, we will start to see people ask for greater protection.
CHURCHILL AND SCHRAEFEL: Research suggests that people do worry about their data, but take little action until there is a breach that forces them to think about it. Several reasons for why we don’t take action include: the terms of service agreements that are typically written in language that makes little sense to us; the fact that most devices, websites, and applications are not transparent about what data they collect and how they are using it; and that such services don’t make it easy for people to access and manage our own data. We will see an even greater need for secure logging and sharing when wearables become part of our clothing and accessories, collecting data about us all the time. A call for transparency and new policies can help change how users manage their data.
Despite privacy concerns, reading of millions of people’s health information from wearables could have a lot of benefits. Can you name some of the most important benefits that could come out of collecting users’ data?
CHURCHILL AND SCHRAEFEL: A common business motto is: “You can’t manage what you can’t measure.” Gathering data on a larger scale has the potential to lead to improved disease prevention as well as symptom identification and potential cures. It can also help establish “new normal” and what normal is for each individual. That is, determining what the ranges should actually be for standard diagnostics as well as determining new measures for what is health and well-being. With that said, it is more important for us to think about whether what we are measuring is what we want to manage.
CURRAN: Wearables are beginning to play a part in preventative health care and can lead to fewer doctor visits. For example, Vital Connect is a wearable patch that monitors your vital signs such as heart rate and temperature and gives doctors access to the data remotely. There are smart contact lenses that can detect glucose levels in tears and notify the wearer when it’s time to take their insulin. The JUNE bracelet measures sun exposure, and its app tells you how much sun protection is needed in order to protect your skin from the sun. These are just some applications that can be beneficial to people, despite having to give up data.
Is there evidence that designers of wearables are mindful of product adaptability necessary for everyday use? What are they doing to make products user-friendly and more accurate?
CURRAN: Manufacturers are constantly refining their products based on feedback from consumers. Earlier trackers provided inaccurate measurements and some required straps to be worn across the chest. Those trackers led to a newer generation of redesigned wearables that use sensors embedded in a wristband, and are said to be more accurate as well.
Given the wide variety of devices available today, there are some that are doing well in terms of designing for utility. However, many devices are not within reach of people who would benefit from them—not because of their usability but because of their cost. The real wins will come when the devices are well-integrated and affordable enough for mass adoption.
Moreover, the idea of a ‘normal’ body type, a set of quantitative measurements that we should all aspire to, is a problem. You can have all the ‘right’ numbers, and still not be experiencing a sense of well-being. That is another aspect that we can improve.
JUR: A primary issue for wearables is their perception that they are a hassle to use. These concerns include battery life and form factor, such as having to clip it somewhere on the body or wear it on one’s wrist. Strategies for reducing power consumption are rapidly developing in the area of low-power communication, which includes low-power Bluetooth, sensing, and data algorithms. The ASSIST Center, funded by the National Science Foundation, is working on the next big step: self-powered devices that use body heat and motion to provide energy for the wearable so that the user never has to charge a battery. There is an opportunity to introduce these technologies into form factors that are commonplace in our lives, like garments!
CHURCHILL AND SCHRAEFEL: We need to ask a fundamental question: What are we trying to do with these devices? Most of the time, it’s to measure something, whether heart rate, steps, and other things we can count easily. If we consider calorie tracking, the most popular approach to food logging is adding up calories from food labels, which are found to be 10 to 40 percent inaccurate. If the goal is to be healthy, that may mean more focus on health and wellness knowledge sharing than measurement alone.
At what point will wearables become synonymous with clothing, and not be seen as gadgets?
JUR: Gadgets are cool to a point, but what people really want is something that is more usable. Cost, comfort, and durability are the biggest prohibiting factors for inclusion of wearables in clothing. R&D needs to approach all three factors simultaneously in order to develop these technologies in mass quantities.
CURRAN: As technology grows smaller, more connected, and more integrated into our environment, it will eventually disappear into our surroundings until only the user interface is visible. This will be likely for wearables in that they will become integrated into our clothing and then communicate via the interfaces with our smartphones. The wearable technology market is a growth area and will ultimately lead to a revolution of our everyday garments, ones that will be powered up as we sleep.
CHURCHILL AND SCHRAEFEL: For many people, wearable devices are already part of their everyday outfits, and we will undoubtedly see more of this. Fashion designers are moving fast into the wearables space with the creation of interactive and interconnected accessories. Artists are playing with concepts such as microelectronic nail art. In the fitness and health spaces, companies like Athos have already received backing for smart fitness clothing that incorporate electromyography sensors to detect muscle activity as well as sensors that monitor heart rate and oxygen levels.
How can wearables help patients be proactive about their own health?
JUR: A real benefit of wearables is that they will be able to change the conversation that occurs between the doctor and patient. Patients will understand that the benefit of using a wearable device will be to help the doctor have an improved historical timeline of their health. Ideally, this leads to better health. In addition, the wearable will be able to provide immediate feedback to the user when their health is at risk. One key to this is data visualization, which can help a user and the doctor to make quick, educated decisions.
CHURCHILL AND SCHRAEFEL: While wearables are important, they are not the only part of well-being and health awareness. For example, the bathroom scale is the most ubiquitous sensor on the planet for personal health monitoring. But does getting on a scale lead to weight loss? If that were a successful intervention on its own, there would be no obesity. So what makes us think that doing the same thing on far more expensive portable devices will be any more successful?
The two of us have developed a concept called Wellth to frame the challenges around developing interactive technology to support health and wellness. We believe that computer science has a huge role to play here. We need to think beyond the current wearable paradigm to what the models of greatest sustainable success are first, and design backwards from there.