Smart watches, intelligent bands and other gadgets that will calculate the frequency of our heart beat, the number of exercised steps and the quantity of consumed or burned calories are sweeping the market.

The predominant objective of such tools is to collect personal data coming from various sensors storing them in the cloud platforms such as Google Fit, Microsoft Health or Apple Health Kit. This can provide individuals with an insight into their daily physiological activities including nutrition, work, fitness and rest. In this respect such devices could be branded under the so-called mHealth (Mobile Health) domain defined as a “practice of medicine and public health supported by mobile devices [1]. There are some reservations though: current commercial technologies are predominately covering fitness and wellness areas. The tracking of such records may require a good deal of energy and motivation from the user. Not only one has to accept running, jumping and dieting as a way of life, but also has to obsessively think about these activities. In a word, you have to be quite fit to enjoy new mobile appliances.

But what about the rest who are not that vigorous and technically savvy? Various recent researches are pointing that the majority of people are not yet ready to embrace the brave new world of “quantify self” mHealth technologies.

The recent study by Technology Advice Research showed that nearly 74.9% of the US population were not using fitness apps or devices. Not everybody seems to be “fit and healthy”: there is a growing population of aging as well as younger people worried about their health and chronic conditions more than just about wellness. This is perhaps the reason why according to the Research2Guidance Study the consumer wearable devices related to chronic diseases will outpace the ones in the fitness and wellness areas.

The notion of Mobile Health (mHealth) is much wider than just the usage of wearables such as, e.g., 24-hours heart rates or calories assessment. The expectations are that new biosensors embedded in commercial devices will enable one to monitor physiological reactions of the whole organism under natural real-life conditions, such as stress, psychic overload, allergens, parasites, etc. with no additional stress or health perturbations typical of, e.g., exercise-electrocardiogram (stress ECG or cardiac stress treadmills) or glucose tolerance test favored by doctors but occasionally detrimental for the patients.

Fostering the development of non-intrusive sensor-based techniques of picking up parallel information from multiple body areas in real time, mHealth devices and applications can let one to measure the distributed state of human health.

Intuitively consumers seem to expect a shift from the tools that are “nice to have” towards the ones that are addressing the real problems of their health. If this is the case we may soon witness the boost of the second wave of commercial wearable devices and applications that will consume the power of existing cloud infrastructures such as Microsoft Health Vault, Microsoft Health, Samsung S.A.M.I., Google Fit or Apple Health Kit.

The majority of wearable non-obtrusive technologies are developed within the medical environment for preventive or post-rehabilitation purposes. Considering the consumers’ demand, the scope of such technologies will increase to encompass broader population layers and boost the development of the new way of commercially available mobile health diagnostic applications.

There are four basic requirements that can ensure the broad adoption of such technologies:

1.Addressing vital health problems

Diabetes is one of the widest spread chronic diseases hitting 347 million people worldwide irrespective of their age. Having to draw blood from a finger to test for glucose levels is the primary reason many diabetics fail to keep a close eye on their sugar that can lead to dangerous conditions such as hypoglycemia. NovioSense, from Nijmegen, Holland, has developed and just received a European patent for a tiny device that is placed near the eye to continuously measure sugar levels in tears. The NovioSense device is initially expected to be worn continuously for two week, thanks to a soft coating around the unit that absorbs and swells from tears, helping to keep it comfortably next to the eye. The fabric of a device is flexible and can conform to the contour of the environment into which it is placed such as the curvature of the eye. It is wirelessly powered and can be connected to any NFC enabled smart phone. Similar devices designed by Google are now piloted by Novartis. Besides measuring a glucose level, this “smart lens” is aimed to address other ocular conditions such as myopia or presbyopia by helping to accommodative vision correction and restore the eye’s natural autofocus on near objects.

2. Non-invasive easy use

For citizens and patients to fully embrace wearable technologies for preventive care it is important that such technologies are not only clinically approved, but are non-invasive, thus presenting no risk (e.g., of infection or injury) when used outside of clinical environment. An automatic atrial fibrillation detector called Heart Monitor AliveCor recently approved by FDA was intended to bridge the gap between patients, doctors and consumers. The Heart Monitor snaps onto the back of smartphones and functions as a one-lead ECG, with recordings instantaneously displayed on the phone’s screen. Previously the app was sharing the recordings with specialists who can interpret the charts. The new version, however, is able to notice irregular heartbeats and immediately notify a patient with clear and understandable alerts. Users of the Heart Monitor can take notes regarding medication, food intake, and physical activity and pass everything to the physician.

3.Fashionable design.  

Beauty and elegance have a strong power. If we relish bio food, why not to enjoy bio-clothing such as HealthWatch that has been debuted at the recent annual meeting of the American Telemedicine Association? This 15-lead ECG-sensing T-shirt can read heart rate and blood pressure, detect cardiac irregularities and other vital signs that could be the key to preventing heart attacks. Data is generated in real time, reaching doctors immediately – no need to wait until the next scheduled appointment. The design is quite practical: one can throw this special T-shirt in the laundry with the rest of your clothes. This sensing garment allows medical workers to keep track of a heart condition remotely, without having to hook the patient up to a heart-measuring device in a doctor’s office.

A similar example is Niturit developed by the University of Aveiro in Portugal and the Israeli “Moked Enosh” center (also known for the development of the emergency button twenty years ago). This seemingly ordinary T-shirt made of fabric does not absorb sweat. Electrodes are embedded in the shirt that can transmit a record of heart activity over a number of hours and for up to four consecutive days. The examination captures irregularities in heart rate and other disorders that may point to heart disease or arterial blockages. The T-shirt is being offered as a part of examinations by the Moked Enosh center, at the cost of $ 117. Doctors from the center come to the patients’ homes and guide them through the examination. The Niturit is already being marketed in Portugal, Spain and Brazil and is available in various sizes.

4. Knowledge vs. Data.

People, including patients and physicians, need to understand issues pertain to their health. Heaps of unconnected data can only create an informational stress. From this perspective, one of the most important features in the recent Microsoft announcement is not the wrist Band, but the Intelligence Engine of its Health platform. After combining the data generated from different devices and services – steps, calories, heart rate and more – the Intelligence Engine analyzes correlations between those data to provide an insight such as the recommended recovery time based on the intensity of exercises or workload, the amount of restful vs. restless sleep. In the nearest future, the user would be able to combine her/his health data and fitness metrics with calendar and email information from Microsoft Office, thus being able to detect if, e.g., the number of meetings during the day or an unpleasant discussion with a boss impact sleep quality and overall productivity. If such intelligent engines are applied to health indicators in connection with the external factors such as medication or nutrition, stress or exercises, one can get a much deeper insight on the overall health status.

Conclusion

The current wave of commercial wearable fitness and wellness devices have made a good start. They have demonstrated the possibility of collecting personal data with the help of small and trendy gadgets. But we are just scratching the surface. The consumers’ demands are much more extensive. The challenge now is to provide technologies and related mobile applications with valid and accurate data supply that both physicians and consumers can use to make decisions on vital issues of their health.

With biosensors that constantly scan vital health parameters of individual organism, store data in the cloud platforms empowered by analytical engines that big IT vendors can offer, one can imagine a “personal cloud Avatar” that could be monitored by relevant physicians. The physician of the future should be able to track the data coming from multiple wearable devices noticing the slightest changes in physiological parameters on an early stage, intelligently guiding patients through the care process. In this case mHealth tools capable of ubiquitous healthcare delivery will turn medicine into health maintenance and the notion of Mobile Health into the Measurable Health.