The Wearables Evolution

This year marks my three decades of work in Digital Health and, more specifically, Wearables. I promoted my first "wearable" as a business service in the late 1990s. It was part of a corporate wellness program sold through Providence Health Services, under the mentorship of Barbara Greatwood, as part of a steps program. To be clear, there was no digital component to either the device or any companion app—there were no apps. The "king" of corporate wellness wearable programs at that time was a program called 10kADay (it is still offered today). To me, it made sense as it was positioned as a way to motivate healthy behaviors using a set step goal (originally more a marketing campaign out of Japan to sell pedometers), but the logic was sound.

I have never lost passion for wearables since those early days. Fast forward to 2013-2014 when I came to Walgreens as its first Vice President of Digital Health. The team had already been working with the Biggest Loser on a program to give reward points for setting and achieving step goals. It was totally a no-brainer idea. We transformed and launched the program Balance Rewards for Healthy Choices, which launched with Apigee (dating myself) as an API aggregation engine to allow multiple apps and devices to work with the program, and we rewarded millions of Walgreens customers for achieving daily goals. It was, and still is in my opinion, the best use case for wearables in retail healthcare ever created. It also had a real health outcome impact.

This exciting initiative was one of many innovative things the Walgreens Digital team championed during that time period but was the fuel for my passion to dive deeper into healthcare wearable strategy and led me to Fitbit. Some of the smartest people I have ever met in technology were (and are) at Fitbit. James and Eric are true pioneers in taking concepts that were non-digital and making them digital. From a Wii bowling experience, they evolved wearables to sell over 80 million devices (just think of the behavior change that one innovation created). And they were the nicest people you could ever work with. My partner in crime, Amy, and I worked to weave these wearables into healthcare even deeper by buying Twine Health and creating a B2B solution that leveraged coaching enablement with wearables to drive outcomes via shared action plans. To this day, the team is still successful in launching these programs for payors.

All of these experiences bring us really to today and tomorrow. What I have never had access to is the power of AI in the context of wearables; it just wasn't mature. Now imagine what all of these experiences could be with a layer of AI powering both the consumer and professional side of the business? What would these tech stacks look like if their DNA was built with AI and LLMs? It's easy to see the AI intersection on the device and in the consumer experience providing personalized guidance, prompts, nudges, and content. But imagine the healthcare professional side being built Ai-first, driving risk stratification, workflow, coaching, and truly smart nudges? Imagine the efficiencies gained from a hybrid, virtual experience that drives behavior change for diabetes and other chronic conditions while still providing the "fun" for the consumers where they are looking to achieve daily lifestyle goals but with a clinically validated, FDA-approved layer beneath making them healthier even when they do not know it.

The future of wearables is about the intersection of AI, consumers, healthcare professionals, and holistic health powered by intrinsic and extrinsic reward models that drive behavior change. I can't wait to see the first organization that pulls it off as it will change the health of the world.