Three years ago, Kegan Schouwenburg left a comfortable gig at the 3D-printing service Shapeways to go it alone. The 27-year-old Pratt graduate left behind printing jewelry and miniatures for something infinitely less sexy: orthotics. Her nearly lifelong fascination with the space began early on, when foot problems required her mother to spend $500 to purchase a corrective pair for her young daughter.
Schouwenburg cites a confluence of technological breakthroughs that have made it possible for her to launch her New York-based 3D printed orthotics company, SOLS, including computer-aided design (CAD); computer vision; Apple’s mobile operating system, iOS; and, of course, 3D printing.
“[It] has improved the accuracy of patient-specific fit for orthotics, prosthetics, and implants in powerful ways,” she tells Digital Trends. “It’s been a game-changer for creating complex and unique geometries possible to produce.”
The explosive growth of consumer electronics over the past decade has morphed virtually every aspect of our society, from journalism to filmmaking to music to love. Health care is no different. The same devices we use to slingshot birds and ninja swipe flying fruit are now working to improve our health in nearly every aspect, including the way we walk, and are ultimately even saving our lives.
I.T. is power
In 2007, things were dire for Dave deBronkart,. A routine shoulder X-ray uncovered stage IV cancer. It had begun in his kidney and metastasized throughout his body, from his legs to his skull, snapping a thigh bone in the process. Ultimately, deBronkart survived. “I’m all better,” he explains over email, “and I haven’t had a drop of anything since.”
“We didn’t have the information systems that we needed to be able to support the delivery of really good care.”
DeBrokart was one of the lucky ones. He made it through late-stage cancer with little more than a kidney surgery and a broken leg. But no one comes through cancer unchanged, and for the high tech marketer from outside of Boston, the all-clear diagnosis marked the beginning of a new fight.
“[The] treatment was like an atom bomb that they didn’t know how to aim well, and sometimes it kills patients from the severe side effects,” explains deBronkart. “What helped save me was that my doctor recommended a good online patient community, and they had information on how to survive the side effects. Today, my oncologist thinks that helped save my life. What I was doing was called being an engaged, empowered patient – an ‘e-patient.’ At the time I was one — I just didn’t know it had a name.”
DeBronkart has tacked the words “e-patient” onto the front of his name, one small part of his late-career transformation into a patients’ rights advocate, a gig that has found him giving speeches around the world, including a high-profile TEDx speech in the Netherlands, and, most recently, a speaking engagement in Switzerland, where he communicated with us via email. DeBronkart has been an internet user since the CompuServe-dominated days of the late-80s.
The growth of the internet over the past 10 years has expanded the prospect of e-patient empowerment immensely, coinciding, not coincidentally, with an uptick in public distrust toward governmental health institutions. According to a 2006 Wall Street Journal poll, 58 percent of people said they felt the Food and Drug Administration did a fair or poor job.
No wonder Pew discovered, in a study published eight years later, that a majority of internet users have turned online for some manner of health care guidance. Seven in 10 have searched for information on health issues, one in four have read about or watched someone else’s health experiences online, and 16 percent have gone online to find others who share their health concerns.
“The medical industry is frickin’ huge, for those who haven’t noticed,” explains deBronkart. “It has many leading thinkers and many archaic tortoises, with the vast majority in the middle: a classic bell-shaped curve. Ten years ago, the vast majority had no clue that real value can arise from smart, engaged patients, with or without technology.”
Here come the feds
The internet has afforded users instantaneous access to health-related information, in stark contrast to the glacial speed with which hospitals and other bureaucratically run health institutions operate. In 2004, Dr. Jon White left his private practice to join the U.S. government, in hopes of leveraging IT advances to help improve healthcare.
“What became stunningly obvious to me is that we didn’t have the information systems that we needed to be able to support the delivery of really good care,” he explains.
Today, White serves as the Deputy National Coordinator for Health Information Technology for Health and Human Services. His voice still evokes the same sort of passion that landed him a government gig a dozen years back. “As consumers have gotten a lot more savvy and had a lot more data available to us, we see the possibilities in other places,” White explains. “They can look up information on Yelp about where they’re going to eat or where they’re going to get their car fixed. Why isn’t that available in health care? They can get their banking records online, why can’t they get their health data?”
The system is coming around, too, White explains. “Doctors are not Luddites. Do not make that mistake. There was a big differential 10 years ago between the adoption of health IT in small practices, versus large practices. In order for large practices to efficiently run their systems, they needed these IT systems. The business case for IT has definitely driven a lot of adoption and use in healthcare.”
He points to the numbers: Ten years ago, 20 to 30 percent of doctors and hospitals had adopted health IT systems. Today, between 70 and 95 percent have.
“That’s been a huge sea change in the past 10 years,” he explains, pointing to an individual personal empowerment movement that treats patients more like informed consumers. “People say that they really want to be more involved with and more in control of their care.”
Wearables change the game
But knowledge-based health empowerment isn’t exclusively the realm of high-end hospital equipment. DeBronkart attributes some of its rise to the recent explosion of inexpensive wearable technology.
“Today the change is amplified extremely by the rise of self-tracking equipment,” he explains. “In our house, we have a Withings Wi-Fi bathroom scale that records our weight automatically, two different blood pressure [trackers], we have wristbands to track our steps and our sleep, and when I got diagnosed with prediabetes, we used MyFitnessPal to keep track of our eating as well.” Their gadgetry helped deBronkart and his wife lose 40 and 20 pounds, respectively.
Consumer electronics designed to help counter the sedentary lifestyle brought on by consumer electronics.
Mark Gainey, CEO of the fitness-tracking company Strava, is aware of the ironies of using gadgets to battle health maladies. “We were trying to create a software experience and feedback loops that require people to look at a computer, with the hope being that it would get them off the computer and out and being active again.”
It’s a fascinating contradiction at the center of fitness wearables’ meteoric rise over the last decade — they’re consumer electronics designed to help counter the sedentary lifestyle brought on, in no small part, by the rise of consumer electronics. The same technologies that have plopped us down on the couch, sitting for hours on end in front of TVs, gaming consoles, and social media, are now demanding we get up and move at regular intervals, with all the subtlety of a boot camp sergeant.
Of course, fitness trackers existed before the likes of Fitbit — it just took a while for them to trickle from elite athletes to common consumers. Polar, a pioneer in fitness wearables, was founded in 1977 by Seppo Säynäjäkangas after a conversation with the head coach of the Finnish cross-country skiing team, who was attempting to find a way to accurately track the health of his skiers. Three years later, the company filed a patent for a wearable wireless heart rate monitor, and by 1982, it brought the product to market.
“It looked like a digital watch that was providing the heart rate data, and then had the chest strap solution,” explains the company’s global product director, Marco Suvilaakso. “What happened at that point is that all of the top endurance athletes in the world immediately saw the value of this kind of solution and then started to embrace the technology. Over the years, it started to spread to lower tiers of different athletes.”
Over the decades, devices designed to appeal to the upper echelon of athletes have given way to far more populist fare, now baked into fitness bands, smartwatches, and phones. The first came roughly a decade after Polar’s original heart rate monitor came to market.
“In the late ’80s, early ’90s, we started to launch very, very simple, consumer-oriented heart rate monitors,” says Suvilaakso . “We saw a huge explosion of growth. The company’s volume started to double within the year. The devices were much easier to use and the costs came down dramatically.”
But even the devices of the ’90s were of limited appeal to mainstream users, proving at best a novelty, and at worst bulky, functionally limited and prohibitively expensive. It’s only in the past decade that fitness wearables have truly hit their stride.
“For a good 10 or 15 years, they were still treated like a very basic stopwatch,” says Strava’s Gainey. “You have all of this amazing information that you would use when you were out on the road or during a trail run, and then when you hit stop, for all intents and purposes, you would actually be hitting ‘delete.’”
The true watershed moment for fitness technology occurred with the arrival of Nike+
The true watershed moment for the technology occurred in 2006, with the arrival of the original Nike+, a partnership between the world’s largest sneaker company and Apple, the hottest electronics manufacturer, that predated the launch of the first iPhone by nearly a year.
The first-generation product coupled a pair of specialized Nike shoes with built-in sensors, which transmitted wirelessly to an iPod nano. “The result,” Apple’s Steve Jobs said at the time, “is like having a personal coach or training partner motivating you every step of your workout.” Nike’s CEO Mark Parker, naturally, concurred. “Nike+iPod will change the way people run. Nike+iPod creates a better running experience. We see many more such Nike+ innovations in the future.” Both Nike and Apple have since struck out on their own, but their brief marriage helped kick-start the explosive growth of fitness wearables.
Consumer interest in health has also stoked the fire. “It’s important to look at the overall growth in fitness to understand what’s driving trackers,” explains David Ng, product manager, Samsung Electronics America, which entered the space full bore in 2012 with the launch of its S Health fitness platform. “For example, gym memberships and participation in classes like spin and yoga are at an all-time high. More people are running more 5Ks and half marathons than ever before. Fitness trackers help us stay motivated in our goals by providing a bar by which to measure progress. It could be something simple like achieving a daily step target or more advanced goals like improving your mile time splits.”
But it took smartphones to truly feed the flames, both through electronic evolution and consumer engagement. “I’d say sensor improvements have provided the greatest benefit in terms of consumer health tech,” explains Ng. “Today’s sensors are smaller, more accurate, and more battery efficient than ever.”
Suvilaakso agrees. “The last five years have seen a huge leap forward in terms of user interfaces and the display technology on the actual wearable. “ Last year, companies shipped 72.2 million fitness wearables and smartwatches, according to IDC. This year, they’ve already hit 100 million.
Such growth can be attributed to, in part, companies’ success in tying fitness tracking to social media, encouraging users to compete not only against their own previous efforts, but against friends on social media.
“It’s been really fascinating to see our members’ willingness to share data,” says Gainey. “What we’re try to demonstrate at Strava is that the benefit of sharing that kind of data outweighs any of the cost. There really are some great motivational, education and aspirational applications.”
If current indications hold, we’re only seeing the beginning. IDC sees wearables’ already impressive growth continuing for the foreseeable future, more than doubling to 237.1 million shipments by 2020. But in order for that uptick to continue, this nascent technology still has a lot of growing up to do.
The future of fit
Three years after launching SOLS, Schouwenburg believes that her mail-order orthotics business is just the tip of the spear in a forthcoming personalized health care revolution.
“As [3D printing] costs decline and accessibility increases, the technology will become more ubiquitous to end users,” she explains. “Ultimately, consumer products will fundamentally change to leverage the new possibilities that 3DP enables and enable customized fit at a mass scale.”
Gainey, likewise, sees tremendous growth on the horizon. “The bands were phase one,” he explains. “I think what we’re going to see more and more is this integration of the actual connected device built into the equipment itself.” In other words, it will be in your clothing. In your bike. In your shoes.
“Virtual reality is already playing an important role in health care, and its role will only grow.”
Samsung concurs. “In the next 10 years — considering how fast technology moves, expect fitness technologies to expand their presence in areas like fashion and jewelry,” Ng says. “Advanced biometric sensors will provide even more data and insights into what our bodies are doing. Things like resting heart rate improvements over time and during workouts, sleep-stage monitoring, and more precise movement tracking will make big data even more meaningful to our health and overall fitness.”
Dr. Tracy Dennis-Tiwary, a professor of psychology and neuroscience at Hunter College, foresees technology improving our mental health in the future, too. Just as electronics have lured us to our couches, some theorize that an increased reliance on screens may have led to an “empathy deficit” among college students. But tech could potentially provide some solutions, too.
“Technology that will promote health needs to become increasingly invisible, seamless,” says Dennis-Tiwary, echoing the sentiments of the prognosticating wearable manufacturers. “One way is to integrate health treatments into existing tools like health apps, and to focus clinical validation on brief ‘micro-interventions’ that people can use in their daily lives and on the go.”
That fits in nicely with Suvilaakso’s vision for always-on life tracking that goes well beyond just fitness and sleep. For example, he explains, “How well are you sleeping and how will it impact the next day? The 24/7 dimension is a huge evolution from where we were 10 years ago, and we will continue to move forward in the future. And if the smart algorithms are in the background processing, the system can give you good guidance and support.”
White is thinking much larger. His own plans for increasing patient engagement involve a more open system for hospitals and patients alike.
“Right now we’re working superhard on an API access in certified health IT,” he explains. “We recognize that that is the best technological approach … to give people access to their data when they want, where they want it, how they want it. There is a huge change about to come over us once the data is unlocked.”
Data is just the beginning. Surgical robots like the Da Vinci have already been approved by the FDA and are in use by hospitals. Telepresence is on the rise in the medical field, as well, with companies like iRobot developing tablet-based mobile systems that allow doctors to increase the frequency of check-ins through remote visitation.
Dennis-Tiwary also points to the increased application of VR in the medical field.
“Virtual reality is already playing an important role in health care, and its role will only grow,” she explains. “Such as being used in the treatment of PTSD, in which exposure to the traumatizing event is a key factor in treatment, but is impossible for many traumas, such as battle-related trauma. Teaching medical and health profession students in VR environments also holds incredible promise.”
Gadgets can’t fix everything
Despite the promise, Dennis-Tiwary still wants to see many modern digital maladies treated at their source, rather than remedied with more technology. “The digital technology culture in which health care is evolving is consciously and relentlessly designed to brain hack, co-opting our anxious brains, our addicted brains, our bored and restless brains,” she says. “We have to disrupt the digital disruption of our lives.”
DeBronkart agrees that technological innovations don’t amount to much if we ultimately fail to act upon them. “It’s not just the [doctors] who need to change. We, the people, need to realize that it’s up to us,” he explains. “Lots of investor people point to how eBay is flooded with used Fitbits. What we need to realize is that knowledge is power and technology gives us power — but only if we use it. It really is up to us.”
It’s a powerful reminder that all the technology in the world won’t help us if we won’t help ourselves. Taking care of yourself, it turns out, even with your wrist covered in gadgets, is still a task you need to take on yourself.
