Rethinking Wellness in the Wearable?Age

This past week I had the privilege of joining ~30 or so people from around the country in Los Angeles to hear about the work Aetna and Apple have been doing as part of their partnership announced last Fall (Aetna to Transform Members’ Consumer Health Experience Using iPhone, iPad and Apple Watch) focusing on creating simple, intuitive and personalized solutions to transform the health and wellness experience for their employees and members. Aetna included their employees and have been challenging them to expand the use cases and maximize the experience for themselves and their colleagues as they test the concepts and “eat their own dog food” as they say.

Since sharing some of the details of this trip with my friends I heard from one of them who is an Aetna member and participant and his wife, Joan Ahier, Owner, Glimpses of Heaven Photography (wife of Brian Ahier), who is a participant in this initiative said:

The Apple Watch has been great, especially for tracking my exercise/activity. Love the breathing and need to stand reminders too. Of course, it’s great for sending texts too!

In the first phase of the experience, Aetna focused on providing guidance to patients to help them navigate the complexities of healthcare offering tools to help manage their prescriptions, track their activities and food and connect with their doctor. They developed a section the App store of Apps recommended for use on the Apple Watch for health and wellness. For Apple’s part – they have declared a clear interest in the wellness space and consider one of the most important things they can do is “Embrace a culture of wellness”

Frictionless Experiences

Humans and society have been pushing towards frictionless experiences going back to Roman Times and beyond as Monty Python captured in its classic form:

Many of the frictionless experiences were historically reserved for the rich and while that remains a challenge today the continued march towards automation and the steady decline in costs of technology, processing power and increasing access to data for decision making will help drive down costs and increase access for everyone.

Hilton understands this and I was on stage this past spring with Nathalie Corredor, SVP of Corporate Strategy for Hilton at the HIMSS (The Best Exotic Marigold Hospital – details in this Beckers piece and the follow-up webcast here) concept talking about these concepts and how we could learn from the hospitality industry. Hilton focuses on the customer experience and how to improve for economic reasons but also for the desire to deliver memorable experiences to their customers as Nathalie pointed out:

“People may not remember exactly what you did or what you said, but they will always remember how you made them feel”

Maya Angelou

Focusing on Details

Achieving a frictionless experience requires a razor sharp focus on design and functionality and Apple has excelled in this area with their other products and the Watch is no exception.

Their research centered on their fitness lab in Cupertino includes many clinical experts and fitness resources that test hypotheses and gather data on test subjects who wear customized face masks that track the use of oxygen in a wide range of circumstances including a fully portable configuration and an incredible set up that dangled above a swimmer. They found solutions to problems for water based watch tracking capabilities (the GPS system does not work underwater) that included the odd sensation of the watch vibrating after your exit and finish your swim (hint – it’s designed to clear the speaker grill full of small holes filled with micro droplets of water)

Mindfulness in the Digital Age

It may seem something of an enigma to talk about mindfulness and digital in the same sentence but this was of special interest to me – a definite Type A personality who struggles to switch off and relax. I’ve been taking Yoga classes for some years now and love the experience both mental and physical – but my struggle has been continuing my practice while on the road. Aside from the occasional location where I find a yoga class on the road I have not had much success. The next best option might be using technology to access a yoga instructor and class such as Yoga Glow that offers classes and instructors and integration with the apple watch for tracking.

I personally use one of the mindful relaxation apps, Calm but suffer from inconsistency as I forget to use it on a daily basis – something that could be helped by the inclusion of a breath app built into the watch that reminds you to relax and I was certainly excited to hear of upcoming partnerships with fitness equipment manufacturers and health clubs like Equinox that is capitalizing on the integration to provide more customized classes and team based competitive bike classes.

Even if you attend the same gym on a regular basis setting up equipment for my personal preferences and recording my activity is a manual process. With new data sharing an integration with the watch – your data is shared with the fitness equipment (temporarily and deleted afterward we were told) so that your settings can automatically be configured and the effort from the workout recorded in your personal health record. We saw connectivity with Schwinn and   but were told there are partnerships with 7 other gym equipment manufacturers

Home Fitness

From the home fitness perspective and for those who travel and try to keep up with their fitness regime on the road presenting the guide videos on the watch resonated with many in my group whom all complained of the need to stop mid work out to see how an exercise should be done. Kayla Itsines is well known in the home fitness workout space and her workouts come with Apple Watch integration so the guidance can appear conveniently on your watch while you are working out. For other sports, sensors can be attached to equipment offering more data and insights into performance – something my families soccer coach has been asking for a long time. I saw the concepts presented by Adidas back in 2014 – fresh off their experience with the triumphant German world cup soccer team and now 3 years on we are starting to see examples of this for tennis, baseball and surfing with Trace

We were treated to the new wave of competitive fitness experience that is sweeping Europe from Prama by Pavigym. It reminded me of Orange Theory but unlike these gyms none of the usual equipment, large screens, sound system and pressure sensitive walls and floors with built in lighting systems. A complete body workout from a giant game and all controlled by the instructor with an Apple Watch.

With Apple’s acquisition of Beddit – the popular apple watch enabled tracking app they rounded out the areas of health with the all important but oft forgotten sleep.

Form Factor

Many of the guests were wearing the Apple Watch but not all had or owned this device. Not everyone wears a watch and not everyone is comfortable with a device hanging off their wrist – having tried a range of these devices I was uncertain how I would fair. The device did fade into the background and given 30+ years of not wearing a watch I failed on several occasions to lift my wrist as I searched for the time, defaulting instead to pulling my phone from my pocket to see the time there! But interestingly when I challenged one Apple Executive on this issue he made an interesting point:

We clearly need to give you more reasons to wear a watch

Perhaps part of the problem is the labeling of the device. I understand the underlying concept from Apple – associate this with something that people know and use and offer that same feature and function out of the box – a watch. But perhaps this is not a “watch” but rather a digital wellness tracker

But there is still the challenge for many who have a wide selection of custom watches for fashion vs function and there is a big industry (1.2 Billion wristwatches sold in 2016 of which Switzerland holds over 50% of the market share) competing for that space on your wrist. The industry can certainly be disrupted but there is a lot of fashion and money tied up with this “Haute couture”.

Costs and Access

Aetna has taken some early steps towards offering wider access to devices, in this case, the Apple watch, to the spectrum of people not all of whom can afford the ~$350 entry price for the device. But this remains an expensive choice to many that are challenged with making the rent or even paying for prescriptions. This is not an easy problem to solve but is an essential part of the solution given the large segment of society in desperate need of help to become fitter and healthier. If they are to have any hope of avoiding costly medical treatments and interventions and staying healthier and fitter we have to find ways to help provide incremental steps to that are achievable and affordable.

Digital Future

There are costs to this approach and as in most cases, the positive needs to out weigh the negative. Being tracked with your every action and move (or inaction) recorded for time immemorial comes with a price. Ida Auken wrote a discussion piece for the World Economic Forum titled: “Welcome to 2030. I own nothing, have no privacy, and life has never been better“. It describes the world where there is no privacy and people own nothing – everything has become a service

First communication became digitized and free to everyone….clean energy became free..transportation dropped dramatically in price….we could call a driverless vehicle or a flying car for longer journeys within minutes….we don’t pay any rent, because someone else is using our free space whenever we do not need it…my living room is used for business meetings when I am not there.

These are interesting thoughts and worthy of discussion as we march towards a new age of continuous tracking

Digital Health Partnerships

It was a fun event and a great opportunity to hear deep insights into the thinking and strategies for two leading companies in the space of wellness and healthcare – Apple and Aetna. I got to spend time with some leaders in the space as captured in Mandi Bishop‘s post on LinkedIn.

Having a personal fitness coach on your wrist could help and certainly has shown results in Apple’s own employees where tens of thousands of employees participated in challenges to effect we were told. Cerner had a similar program “KC Slimdown Challenge” – 10 weeks in 2011 that included 10,000 people who lost 38,000 pounds (an average of 3.8 lbs per person) and a 15% improvement in BMI.

There is real gold to be had in them thar hills!

Starting with small steps and changes that offer a path to success and including everyone will be critical to an effective program 

Incremental Steps to Digital Health

Ultimately this is not about the technology – as Michael Dell has said and I have quoted him on many occasions.

Technology has always been about enabling human potential, Michael Dell

Digitally enabling wellness I suggest starts with the following

• Coach, engage and encourage activity at every opportunity
• If you have a Device – use that and capture and action the data produced
• Wellness is made up of Nutrition, Activity, Relaxation, and Sleep – start with one
• Find a Partner to Walk the Path with You as encouragement, accountability, and support
• Finding solutions and interventions that work for you

Conflict of Interest Declaration: Aetna paid for my travel, room, and board to this event. I was not asked to or compensated for writing this piece nor was I asked for anything in return.

This post previously appeared on Incrementalhealth.com