• Adam Tilton

What is Healthy? The Future of Healthtech As I See It

How do you live a happy, healthy life? I have no idea. What makes me feel happy and healthy is eating well, exercising regularly, and sleeping consistently. If I want to really feel great, then completely removing alcohol does the trick, and that is what I intend to do for 2022. As for my health—I have no idea how to measure it. I would guess that I'm probably healthy. Nothing hurts, I have no obvious signs of disease, and all of my teeth are in place. Every few years I go in for a regular check-up, and so far they've always given me good news. So, I guess I'm healthy.

But guessing isn't good enough for me anymore. As a country, we spend more on healthcare as a percent of GDP than other countries, but are an outlier on key health metrics like life expectancy. A complex issue, but, as this article explains, “many of the important factors – smoking, obesity, violence, poverty – are not about providing better healthcare for those that need it, but about preventing poor health outcomes in the first place.” I have a growing sense of responsibility to my family, and building confidence in the status of my health and doing my best to prevent my own poor health outcomes is a priority. I want to be able to keep up with my boys as long as possible, and ensure that I will know immediately if (or when) my health changes. The questions I want to answer are: How do I build monitoring and logging into my life so that I can benefit from diagnostics and debugging? How do we scale this to provide preventative health care to everyone? And is this even the right approach?

I should have a strong opinion, given my experience with building wearable activity and health trackers, but I don't know that what I'm looking for exists. Most of the work I’ve done has focused on solving technical problems related to on-body sensing, like how to better analyze the sensor data for more useful insights. When I look around at the other commercially available wearable and connected health devices (e.g., Apple Watch, Withings, Oura, Levels), the experiences are still basic metric tracking, e.g. glucose, sleep, activity. If I’m honest, it wasn’t until recently that I thought about the long-term vision of wearable technology—what are wearables doing for humanity? Is there a future where the answer to that is meaningful? I don’t see these devices as that future.

I’m even less impressed by my experience at the doctor’s office than I am by consumer wearables. Every visit I've had to the doctor begins with an introduction to a physician I’ve never met before, a cold stethoscope placed against my chest and back, and a series of standard questions. When I was a kid I really liked it when they hit my knee with the hammer and it made my leg jump. Since then, nothing a doctor has done during a routine visit has left much of an impression. If I don't take notes leading up to the meeting then I forget the questions I have, and even when I do remember I'm not sure the conversation results in lifelong changes to my health.

Here's the vision for the future I have in my head: I'm in the doctor's office meeting my physician. It’s not our first meeting—she knows more about me and my life than anyone else. She is reading over the latest report of my key biometrics provided from my various connected health devices, commenting as she reads. "Keeping up with running since we last spoke, and your recovery looks good too... I see your sleep schedule was inconsistent for a while. How old are your kids now?" she asks. "My oldest just turned three," I reply, knowing she's wondering what I was doing in the middle of the night all of last year. "Looks like you might have had a temperature for a few days back in August, but overall, your heart, respiratory, blood pressure, and temperature reports look consistent with what the models predict. Just routine tests today and a quick exam," she says as she sets down my report. This is the experience I want. Informed by data, enriched with insights from the population, reviewed and interpreted by an expert, and provided to me with empathy and hope. And if I can’t have it, then I want it for my kids.

While this experience is possible today, it requires a considerable amount of tracking and piecing together on the patient end. We have most of the biomarker measurement technology and, across a variety of devices, can track temperature, blood pressure, breathing rate, heart rate, sleep quality, glucose levels, blood oxygen levels, cognitive abilities and more. What we don’t have, we will soon enough (I plan to write about the future of the wearable technology market soon). Building a delightful experience for both the patient and the clinician across mobile, tablet, and PC is also possible, as is connecting it all up over the IP network while protecting the patient’s privacy and mining population-level insights with machine-learning techniques. While there are glimpses of this future if you go looking (I’m going to write more about the companies and products building the future of healthtech soon, too) there’s still a significant amount of work to do to help people more proactively answer “Am I healthy?”

I look forward to a future where no one has to ask themselves that question, but instead take it for granted that someone else is asking that question on their behalf. I hope my kids joke about how we used to go to the doctor for a regular check-up. Mostly, I hope there’s a more connected infrastructure to help them understand how the decisions they make each day impact their health outcomes in the future.