health technology


How “Sticky” Are You When It Comes To Health?

When it comes to health and fitness, even the best intentions won’t get you far if you don’t stick with the plan.

That’s the thinking behind a new fitness tracking and motivational nudging service, called Wellocracy, that seeks to get at a person’s “stickiness” quotient. In other words, how likely is he or she to stay engaged with one of the myriad health and fitness apps currently available?

It’s the brainchild of Dr. Joseph Kvedar, founder and director of the Center for Connected Health at Partners Healthcare, the dominant hospital system in the state. I spoke with him recently about the concept of “stickiness” and the new service.

“Part of the reason we launched this effort is because we studied for about 10 years why patients adopt these technologies,” Kvedar says. “We were trying to reach people who could benefit from self-tracking as a health-improvement strategy, but either don’t know about it or find it confusing and frustrating.”

He pointed to an October 2013 survey of 2,014 adults in the U.S. which found the following about fitness-tracking behavior:

• Sixty-eight percent say encouragement from family and friends is important for achieving health goals.
• More than half of respondents aged 35-44 found it difficult to stay motivated to live in a healthier way.
• Sixty-five percent think tracking their health using a device, website or app would be beneficial, including 32% who felt it could keep them motivated in pursuing health and/or fitness. About half of those 18-44 agree that easy-to-use tracking tools are essential to following through with their health goals.
• Eighty-six percent say feeling informed about the status of their health is empowering.

Given the widespread endorsement of fitness tracking, one might think it a fairly common practice. On the contrary; the survey found the following: Continue reading

Esther Dyson: Don’t Blame Fat People

Esther Dyson in a 2011 photo by Frank-Jurgen Richter (via Wikimedia Commons)

I think of Esther Dyson as a Geek Queen. She’s a longtime angel investor and prominent public voice on matters technological. (She’s also a former journalist whose description of our current institutional health system as a “calcified hairball” made me laugh out loud.)

In recent years, she’s added the topic of health care and how technology can help us be healthier to her portfolio, and Slate has just posted a provocative piece she wrote after a Medicine X conference at Stanford. Clearly she touched a nerve, with her “Hate the sin, not the sinner” approach to obesity: The post has already prompted more than 700 comments. She writes in part:

To be sure, it is worthwhile to foster healthy behavior, which will lower costs and improve many people’s lives. But how far do we want to go? Where are the appropriate limits when it comes to encouraging good behavior? Can good behavior be encouraged without ever punishing bad behavior?

I suspect that different societies, cultures, employers, and governments will come up with different answers. In part, we need to feel comfortable with the reality that there is no environment perfect for everyone, and there are no perfect people. In a world of statistics, it is 100 percent likely that fewer than 100 percent of people will be happy. We try to mitigate bad luck, but we cannot eliminate it.

In practical terms, though, we would be wise to listen to Collazo’s plea: “I am not a fat blob, having [unhealthy] English breakfasts, who gave herself diabetes. I AM A HUMAN, AND I HAVE DIGNITY.” Collazo identifies the problem for her—and for all of us: “Is there some diabetes that is preventable? I don’t think anyone FULLY knows the answer to that. BUT SO WHAT? Does it mean I no longer deserve dignity if I do get it? If I ‘fail’ to ‘prevent’ it? Should I now be excommunicated from the population at large? Should I be made an ‘example’ to others? Should I be spoken of as a plague? As an unwanted thing in the world?” Continue reading

If Your Phone Could Warn You When You’re About To Overeat


(paulymer/Flickr Creative Commons)

Here’s my dream of a dieting app: It picks up your brain waves, and when you start to crave chocolate or chips, it instantly hyper-activates your neural receptors for feelings of fullness, so you have that “couldn’t eat another bite” feeling until the cravings pass.

Sigh. Someday. Right now, what we mainly have is app upon app that lets you record what you eat and add up those calories, then record your exercise and subtract those calories. This is not a bad thing. Keeping a food diary is a proven tool for successful dieting. But, as obesity researcher Sherry Pagoto writes on Psychology Today, these apps are somewhat underwhelming, not the game-changers that mobile tech seems to have the promise to deliver.

So Pagoto, a clinical psychologist and an associate professor at the University of Massachusetts Medical School, is aiming to develop a more sophisticated app, one that incorporates “sensing” technology — from GPS for location to heart rate for possible stress. She and University of Massachusetts colleague Deepak Ganesan have just won a $185,000 grant from the university President’s Science & Technology Initiatives Fund to launch that effort.

You drive in to McDonald’s and your phone pings you: ‘Are you sure you want to go in? Last week you ate a 1,200-calorie meal here.’

Imagine: You drive into McDonald’s and your smartphone, picking up your location via GPS, pings you: “Are you sure you want to go in? Last week you ate a 1,200-calorie meal here.” Or it’s 3 p.m., just an hour away from your usual mid-afternoon junk-food foray, and the app suggests: “You often grab candy at 4 p.m. Perhaps you’d like a snack of protein and whole grains now to head that off?” Or it’s a brutal workday, and the app says, “Your body is showing signs of stress. Perhaps you’d like to do some deep breathing rather than self-soothing with food?”

When Pagoto works with weight management clients, she tends to see them weekly, which means they come in and describe the moments when they fell down on their weight-loss efforts only after the fact. “I’m not there; I can’t help them,” she said. “I’d love a mobile phone to be me, but me with you all the time” — even if “I’m putting myself out of business by doing this.”

Similar work is under way on apps for drug and smoking addicts, aiming to detect when a relapse is especially likely based on place or stress levels or other cues. Continue reading