Who who who who Remix By DJ Don mp3

By Vince Giuliano with inputs and assistance from Melody Winnig and James P Watson

INTRODUCTION

The consumer electronics industry is giving a tremendous boost to public and individual health – perhaps the most important boost in the first half of this century. The digital health movement could result in a number of important but unforeseen consequences, such as the emergence of powerful personal electronic health biomarkers which were hitherto unavailable.   The movement is already contributing significantly to changing our health paradigm by allowing individuals to document their day-to-day health-related behavior patterns.

2014 has been a huge year for health tech according to digital health incubator , “Digital health funding in the first three quarters of 2014 has already surpassed $5 billion, close to double what was invested in all of 2013 ($2.8 billion). “Digital health funding for the year is on track to double last year’s total,” said Unity Stoakes, co-founder and president of startup health. “Some trends we’re watching include a growing corporate interest in digital health, more global cross-pollination of ideas, as well as increasing health consumerism as people move into the driver’s seat when it comes to their care.  With this kind of capital pouring into the market, the health tech space should be exciting to watch in the coming years.” (from mashable.com .

This Part 1 blog entry provides a panoramic snapshot view of one area of digital health: the rapidly changing landscape of consumer health and fitness smart wearables like smart watches, online and mobile health and wellness applications, and the associated emergence of online and mobile software platforms that can integrate such applications together.  I also discuss a couple of devices I am personally familiar with.

Smart wearables include electronics-infused clothing and body devices that enhance our perceptions and allow us to do things we cannot normally do – such as know our actual heart rate at any time, or experience virtual reality.  Consumer digital health and fitness is a central theme of smart wearables,  The expectation has been  that 90 million SMART wearables would be sold in 2014(),  Accordingly, tremendous capital has been flowing into this area as can be seen from the amazing new array of health-measuring wearables now being sold by leading retailers.

Morgan Stanley has projected that the smart wearables market will soon be worth $1.6 trillion(). “Wearable devices will far surpass market expectations, and become the fastest ramping consumer technology device to date, in our view,” a group of Morgan Stanley analysts wrote in a note on Thursday. The analysts add that wearable devices will have “far-reaching” impacts by creating a new category and disrupting or even accelerating change within industries outside of technology.” (I think one of these industries will be medicine – VG) “The analysts project sales of wearable devices will grow at a 154-percent annual compound rate through 2017, where 248 million devices will be sold. The figure will grow even further where sales of wearable technologies will reach one billion in 2020.”

THE QUEST FOR SIMPLE, SENSITIVE AND EASILY-MEASURABLE GENERAL STRESS BIOMARKERS

Quest for the Holy Grail   I

A key fantasy I and other longevity researchers have long had may soon start becoming reality – the ability for ordinary people to monitor readily accessible biomarkers that will allow us to evaluate the impacts of day-to-day health and longevity interventions and stress events.  Such an intervention could be a simple change in diet, exercise or sleep patterns, or consuming a new supplement or drug.  Stress events could be a disease, of an emotional or traumatic nature, or as simple as disruption of the normal sleep pattern. These biomarkers could conceivably provide easy and very accessible answers in a few days to very basic questions such as “is my new approach (to a new pattern of exercise/taking a new supplement or drug/sleeping longer or differently/etc.) really working?”  “Comparatively speaking, how well am doing now compared to before?”  “What price am I paying for staying up drinking and carousing until 4 AM last night?”  “How long will it take for me after returning fromChina to re-establish my normal circadian rhythms?” “What has been the health impact of my partying for several nights in a row over Christmas, drinking more than usual and eating large late meals?”  “I had to take a strong prescription antibiotic.  How long will it take for my gut biome to recover?” Or “I have added a high intensity 8-minute segment to my daily exercise regimen, designed to send my heart rate above 125.   What is this doing to me or for me?”   I now believe the fantasy of ordinary people being able to answer such questions for themselves without professional help is rapidly becoming real.  It will be realized through a powerful wave of developments in consumer electronics powered by billions of dollars in investment.

In fact, during the period of generating this blog entry I have been doing some initial personal research that leads me to think I may already have discovered reliable metrics of constitutional stress that can be easily computed from measurements made by an existing smartwatch device.     I have initially reported on that personal research in a

I have helped Jim Watson prepare and publish a .  This is concerned with heart rate variability (HRV), a well-studied constitutional stress biomarker.  That blog entry looks at both at the science of HRV and practical wearables technology to measure it.

Because new improved products are coming on the market at an incredible rate, it is likely that some devices described here will be becoming obsolete in six months or even less.  That is why I expect to continue reporting on health and fitness wearables on an ongoing basis in this blog.

What is exciting from the viewpoint of this longevity science blog is not that the existing or even the latest generation of consumer devices and software can measure traditionally-identified  biomarkers, such as those identified in the previous blog entry . Rather what exciting to me is the extremely massive public scale and rapidity of adoption of consumer health wearables and apps, the deep pocket companies investing in them, the variety of physiologic biomarkers that are turning out to be electronically measurable by wearables, the possibilities inherent in 24-7 gathering of personal health data, and the extremely low cost to consumers of starting to participate in this movement.

• Integrated health and fitness display software platforms
• A couple of wearables that I have personal experience with

The consumer wearables area of digital health we discussed here is very large but the entire field of digital health is even larger. According to a recent .  “The top 10 most active subsectors include big data/analytics, navigating the care system, practice management, sensors/diagnostics and patient engagement.” We don’t touch the first three of these areas here and focus on consumer electronic monitoring. Also we touch only lightly on the tremendous area of associated software apps and online services. Perhaps in a subsequent blog entry we will try to make sense of the some 100,000  health and fitness apps currently available on iOS and Android.

ACTIVITY TRACKERS

A few years back, a first generation of personal health and fitness wearables appeared, like the first and movement-tracking devices.  They provided crude but effective constant real-time measurements of number of steps taken, intensity of exercise, flights of stairs climbed, calories burned, and different stages of sleep. They communicate by bluetooth with computers and smart phones and it is possible to see how these indicators change throughout the day and night, compare them from day-to-day, and even share them with other people in a personal network.  I have been using a FitBit One for about a year now and have found it quite useful for telling me at the end of the day whether I have had sufficient exercise, and, when I wake in the morning a rough indicator of how well I have slept.

From : “The term “activity trackers” now primarily refers to wearable devices that monitor and record a person’s fitness activity. The concept grew out of written logs that led to spreadsheet-style computer logs in which entries were made manually, such as that provided in the us by the  as part of . improvements in technology in the late 20th and early 21st century have made it possible to automate the monitoring and recording of fitness activities and to integrate them into more easily worn equipment. Early examples of this technology include wristwatch-sized bicycle computers that monitored speed, duration, distance, etc., available at least by the early 1990s. Wearable heart rate monitors for athletes were available in 1981. wearable fitness tracking devices, including wireless heart rate monitoring that integrated with commercial-grade fitness equipment found in gyms, were available in consumer-grade electronics by at least the early 2000s. Wearable fitness tracking computers withtightly integrated fitness training and planning software were available as consumer products by at least 2006.?\ — Electronic activity trackers are fundamentally upgraded versions of ; in addition to counting steps, they use  and  to calculate mileage, graph overall physical activity, calculate calorie expenditure, and in some cases also monitor and graph heart rate and quality of sleep. some also include a silent alarm. some newer models approach the us definition of a , and some manufacturers hope to eventually make them capable of alerting to a medical problem, although  approval would be required. early versions such as the original  (2009), were worn clipped to the waist; formats have since diversified to include wristbands, armbands, and smaller devices that can be clipped wherever preferred.  and  together developed the , a sensor-equipped shoe that worked with an . In addition, logging apps exist for smartphones and facebook; the nike+ system now works without the shoe sensor,through the  unit in the phone. The forthcoming  and some other  offer activity tracker functions.in the us,  has developed a disposable activity tracker to be worn for a week, which is aimed at medical and insurance providers and employers seeking to measure employees’ fitness. other activity trackers are intended to monitor vital signs in the elderly, epileptics, and people with sleep disorders and alert a caregiver to a problem. –

 and  are a better location for measuring some data, including core body temperature;  has developed sensor technology for new activity trackers that take their readings at the ear rather than the wrist, arm, or waist. — There are collar-mounted activity trackers for dogs. — Much of the appeal of activity trackers that makes them effective tools in increasing personal fitness comes from their making it into a game, and from the social dimension of sharing via  and resulting rivalry. the device can serve as a means of identification with a community, which extends to broader participation.”

The December 2015 issue of PC magazine report  provides a lot of comparative data on some current trackers.  This is what they look like.  As you can see, the most popular ones are worn on the wrist

DEVICES FOR THE HIGH-END SPORTS AND FITNESS MARKET

Smartphone sensors

Many smartphones have built-in sensors that allow them to function as first-generation trackers.  Such as:

– accelerometer pedometer-type motion sensors which allow them to monitor movement and even sleep – if you are willing to sleep with your cell phones

– cameras which can double as optical heart rate monitors.  They can also serve as bar code scanners for screening packaged foods at supermarkets or some restaurant menus that print barcodes.  Software apps can then give you nutritional values and calorie counts.

HIGHER-END CONSUMER FITNESS TRACKERS AND SMART WATCHES

The higher-end devices are embodying the functionality of the first generation, in some cases doing a better job at that, plus additional functionality due to the incorporation of additional sensors.  They are evolving from being basically movement trackers to more general health biotracking devices.  Again, the first generation was based on pedometer/accelerometer and altitude sensors. The higher- end second-generation trackers variously embody additional other sensors such as for heart rate measurement, skin temperature, 02, skin galvanic resistance, and GPS capability. Some of these are sold in the form of wrist straps, and some in a new generation of smart watches,   In general, these devices offer a higher level of integration with smart phones, and come with broader and more comprehensive but still proprietary health and wellness apps. Estimates of levels of exercise and associates stress can be based on combinations of the sensor outputs.  The following as representative of thehigher-end second generation trackers/smartwatches with heart rate measurement capabilities:

• $150 or the $250
• The (annouced but possibly not available until Spring 2015) Very exciting for Apple and iOS followers, with many health and wellness and advanced features.  Probably starting at $350)  See .

How can one make sense of this avalanche of offerings?  I don’t know. My personal choice a few weeks ago was based on my health/longevity biomarker primary focus of interest – rather than a strongest interest in  fitness/exercise, elegance, or general smartwatch capability.  After limited research I ordered a .  That and my trusty old are the only devices I am personally familiar with and will discuss here in any detail.

THE BASIS PEAK

The Basis Peak arrived at my doorstep about three weeks ago, so I can tell you what motivated me to buy it but am not yet quite ready to report on my experience with it.  The package claims “The ultimate fitness and sleep tracker.” Based on its published specifications and positive reviews, it indeed may be that right at the moment. However, there is no guarantee on how long it will remain that way.  A November 2014 review in PC world  reports: “this is a second generation device, an improvement in multiple dimensions over the first generation device which appeared about a year ago. Among the sensors it encompasses are a FitBit-type accelerometer, an optical sensor that measures heart rate through the skin 24-7, a galvanic skin resistance sensor and a skin temperature sensor. Basis was recently acquired by Intel and has a history of earlier devices basically marketed to the fitness community.  As I write this, smart watches with heart rate measurement capabilities are announced andwill be available in the coming months from Apple,  FitBit, and Jawbone among others, but these will be first generation devices which will no-doubt need improvement.  Now being an Intel company, I expect a continuing process of improvement in the Basis products.”

So far, I am very happy with the choice.  Here is the Peak’s record of my sleep for a typical night..

I do not know how the Peak can distinguish REM sleep from light sleep and cannot vouch for the accuracy of its findings. The FitBit was on my wrist next to the Peak.  It is interesting that the estimates of both devices for any period of sleeping are off by only a few minutes, although the details of the sleep is reported differently.  The FitBit does not try to distinguish among depth or type of sleep.  Here is A FitBit sleep record for me for a week:

Here is a day’s(24 hours) activity record from the Peak:

I have been logging these Basis Peak patterns every day on a spreadsheet since the watch arrived and studying them to see what their implications might be for my health.  After just 24 days of doing this I can say the results so far are quite exciting.  I am coming to believe these activity indicators can be combined with the sleep indicators to produce interesting new constitutional stress-state measures,  I expect to report on my observations after a full month of data gathering and analysis in the Part 2 Blog Entry for the wearables topic.

A preliminary observation relating to the device is that the existing software could be more comprehensive in providing consumer advice,   Also, I strongly suspect that the sensor data might be combined in different ways to provide measures of other physical conditions such as hydration and heat exhaustion stress.  My sense is that the Basis Peak is probably a superior hardware platform but that its software and user-friendliness integration might be significantly enhanced.  My hope is that the Basis company will move in this direction.  Earlier, the company promised an API for Peak outputs that would allow new customized forms of use data analysis.  And the company promised a software upgrade for December 2014 that would include smartwatch notifications on the Peak.  But so far these have not been forthcoming.

A more basic downside of the Basis Peak or any other single smart wearable available today is that its measurements are limited by the sensors it contains.   Ideally, my smartwatch would provide good measurements of heart rate variability, breathing regularity, blood pressure, body posture, glucose levels, blood oxygen, ECM, and embody a GPS capability.  At present the Basis Peak does not measure any of these although other new-generation consumer wearables do. (None measures all or even most of these).  Further, it is doubtful that third-party applications from either iOS or Android will be able to compute adequate heart rate variability (HRV) measurements from the physical sensor inputs the Peak watch provides.

NO SINGLE SMARTWATCHCAN PROVIDE THE BIOSENSING WE WILL WANT

So, some of the devices are becoming more bossy and nanny-like.  Some may end of virtually screaming at you if you start doing something healthwise foolish.  For now, they’re mostly simply flashing reminders on your cell phone or smartwatch screens or giving you a gentle buzz.  The , a wrist wearable, is more aggressive and gives you electrical shocks.

“2. Sweat sensor strips”

“Want even more insight into what’s going on in your body? You’ll soon be able to track your internal biochemistry with a simple biosensor strip.   is developing a printed, flexible strip sensor that inserts into the back of your wearable device and measures the metabolic substances secreted in your sweat, allowing you to track your electrolyte balance, hydration level, muscle exertion and physical performance. According to electrozyme, the chemical analysis enabled by its disposable biosensors can give people actual insights into their metabolism that go way beyond steps and heart rate.”  Ok.  Another bunch of indicators.  “see also: .  “The advantage of tracking sweat using chemical sensors is that it gives insight into your body chemistry and how it is responding to your workout that is not available using traditional sensors,” says Jared Tangney, Ph.D., co-founder and COO of Electrozyme, llc. “Chemical sensors open up a whole new world of information that was previously neveravailable in wearable devices.”  “Tangney sees a range of different applications for this technology, including letting you know when it’s time to drink some water — something most of us probably need: according to some reports, up to 75% of americans may be .”

“3. Smartphone case devices”

“You’re already carrying around a smartphone with a protective case. Why shouldn’t it do double-duty as a medical device?  “We’re starting to see some initial forays into using smartphones and their cases to measure medical conditions that previously required specialized equipment,” says Joanne Rohde, CEO and founder of . “imagine an electrocardiogram anywhere — not just at your doctor’s office — or a dyi blood test to check your glucose right in your pocket. Some of these innovations are already available, but there are many more to come.”  One of the first to hit the market was the  heart monitor, an FDA-approved iPhone case that allows you to record ECGS and heart rate on the go. You can rest it on your fingers or chest to record an ECG in 30 seconds, and know right away if atrial fibrillation is detected, which could be an early indicator of stroke.”  This could be valuable because the pulse rate monitors currently being marketed fall far short of providing ECG levels ofinformation.”

” in 2015, watch for more such devices to become available as they pass through the FDA approval process. — For example, Azoi’s  is a mobile health tracking device which doubles as an iphone case and is currently in the process of getting FDA approval. It can measure vitals such as ECG, heart rate, blood oxygen saturation levels, respiration and temperature.”

“4. Prescription-only apps”

“There are already thousands of health apps you can find on Google Play or iTunes. Soon, some of these apps may require a prescription.  One early example is Welldoc’s , the first “mobile prescription therapy” for people living with type 2 diabetes. The prescription-only app allows people to input data about their glucose levels, diet, exercise, well-being and other factors, which Bluestar automatically analyzes to give the patient immediate guidance and feedback. Bluestar also analyzes the data for the patient’s physician and allows the patient to provide a detailed summary of their progress to the physician for review prior to or during office visits. — While you might not see a flood of prescription-only apps hit the app store in January — launching one requires FDA approval, clinical trials, insurance reimbursement and more — Welldoc’s co-founder and chief medical officer Dr. Suzanne Sysko Clough says we should “expect to see more mobile prescription therapies for many majorchronic diseases over the coming years.”

“5. Healthier lighting

“Finally, ever wonder why “you have trouble drifting off after staring at your iPAD in bed? The culprit may be the blue light emitted from your device — the part of the light spectrum that causes the biggest changes to your internal circadian rhythm, which can disrupt your sleep and impact your health.”

(Check out our blog entry )

“People who don’t get enough sleep have trouble being productive, controlling their emotions and coping with change. They’re also at greater risk of major health issues such as heart disease, diabetes and stroke,” says Cameron Postelwait of Sewell Development Corporation, developer of the low-blue-light  light bulb, which launched in May of this year. Postelwait believes that in 2015, we’ll see a much bigger focus on the effects that artificial light has on people’s health, as well as new product innovations to address the problem, particularly in clinical environments and hospitals.  “A patient in unstable condition requires nurse visits all through the night. Every time the nurse enters the room, he activates some kind of lighting to help him check on the patient’s condition and to give medication. This throws off the patient’s natural circadian rhythm, which not only disturbs sleep, but may also ,” explains Postelwait. “There’s a huge need for lighting that either has an absence of

Integrated data analysis platforms

With regard to the second question, we already seeing the emergence of software platforms that will receive data from multiple sources and display them integrated together. As can be expected, the main competition now seems to be between Apple and Google and their respective operating systems iOS and Android.

In the Apple world, “Apple’s new mobile operating system, iOS8,  included a new feature in the Health app that displays various bits of health data collected by various apps in one place. In the same vein, the app’s  feature lets you input various pieces of health information that could be important for emergency services workers if you are involved in an accident. This includes such things as allergies, blood type, medical conditions and emergency contacts. Importantly, this data can be accessed even if your phone is locked.()”  The appears to be the main current Apple effort. “Healthkit will allow a user to view a personalized dashboard of health and fitness metrics, which conglomerates information from a myriad of different health and wellness apps, helping them “communicate” with one another.  With this technology, it’s easy to envision hospitals, clinics, pharmacies, laboratories, and even insurers integrating bilaterally with any patient information housed on healthkit, at thediscretion of the user. ” Mayo Clinic, Cleveland Clinic, Kaiser Permanente, Stanford, UCLA, And Mount Sinai Hospital are all rumored to be working with Apple to figure out how to exchange relevant patient information to enhance the continuity of a patient’s care. In addition to these potential collaborators, electronic health record providers epic systems and allscripts are rumored to be working with Apple in some sort of partnership.3,4”  at least 56 apps to start with will connect to healthkit(). The consumer interface of healthkit, called Health is preloaded on all iphones running iOS

In the Android universe, it appears that is the main competitor to Apple’s Healthkit. “Mobile fitness apps are a dime a dozen these days, but Google is trying to add value by letting fit act as a hub for third-party apps like those from Strava, Withings and Runkeeper. Fit users can access data gathered by those apps within the Fit app, instead of having to switch between them. That functionality makes Google Fit the prime competitor to Apple’s , a software platform for iOS 8 that lets third-party apps share their data with Apple’s health app. Google Fit is available for devices running Android 4.0 (Ice Cream Sandwich) and above. Whether Google Fit catches on likely depends on the number of integrations it will support with other apps, and how well it presents the combined data. It’s unclear if other popular apps from device makers like FitBit or Jawbone will be integrated with Fit, and Google didn’t immediately comment.  In addition to it being an app, Google Fit is a . Its apps aim tolet developers access data from other sources to make their own apps more powerful. Fit, therefore, could be a win for Google by strengthening the broader ecosystem of health apps, and then weaving them into Fit.  Fit API partners include Basis, Adidas And Motorola.” (As of the writing of this blog the Basis Peak data cannot be imported into Google Fit)

Both the Healthkit and Googlef Fit apps have had their own problems.  See the October 2014 articles and .  I had no problem downloading the  Google Fit app yesterday but found it quite useless in its present state for what I wanted it to accomplish,  I wanted it  to offer me an integrated view of data from my three current health and fitness devices.  Those are my FitBit 1, my Basis Peak and my Samsung s5 smartphone which also has a pedometer and instantaneous heart rate measurement capabilities. As far as I can tell, there is no way right now to import data from the FitBit 1, or the Basis Peak into Google Fit.  Apparently, neither the FitBit nor the Basis organization have released the necessary APIs (application program interfaces).  So, a serious impediment to the emergence of software platforms that offer integrated data views from multiple devices could be the device manufacturers themselves who want to hold on to their own users via their own software.  It could be that bothHealthkit and Google Fit are actually on the right track but just not there yet.  A Google fit soliciting participation of sensor-makers lists 20  “partner” organizations including Intel, Basis and Withings. A list of apps that are presumably now compatible with Google Fit is , as of this writing 13 in number.

MEDICAL AND RESEARCHER SKEPTICISM

The health and wellness consumer movement is seen by some members of the Health Care and Medical Establishment as possibly unsanitary trespassing on their pre-owned territory.

They rightly point out that the devices mentioned here are not regulated and who knows what these gizmos really can and cannot measure.  And human behavior being as it is, information feedback may or may not be enough to influence personal health related behavior.  Already we are seeing a few warning rockets being fired.  For example, check out this research report: . “New Year’s weight loss resolutions are in full swing, but despite all the hype about the latest wearable tracking devices, there’s little evidence that this technology alone can change behavior and improve health for those that need it most, according to a new online-first viewpoint piece in JAMA. The paper, written by researchers at the Perelman School of Medicine, the Penn Medicine Center for Health Care Innovation, and the LDI Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, points out that even though several large technology companies are entering this expanding market, theremay be a disconnect between the assumed benefits and actual outcomes.”  Personally, I think this kind of engagement of serious researchers and questioning in the Wild-West health-wearables market could be a very good thing and should be welcomed.

SOME QUESTIONS AND SPECULATIONS

Will the area of consumer health wearables continue to take off as seems to be happening now or will it turn out to be a current fad as people do not find the health-measuring facilities of their smart watches to be that useful?  

I expect the wearables trend will continue to take off and become mainstream, although there are likely to be fits and starts and many products and concepts that go nowhere.  The trend will be part of and empower a broader trend of consumer health consciousness and individuals increasingly taking responsibility for their own health and longevity

Where is body sensor tracking going?  What, beyond smartwatches and straps will be the next big way of embodying consumer health- measuring sensors?

I do not see the present major trend continuing – that is integrating more and more sensors and measuring capability into a single device, be it wristband or smartwatch. Every added sensor, especially if it is constantly active in measures 24/7, takes space, has weight and consumes power. There are only so many sensor devices that can be compacted into the case of a smartwatch.  Nobody wants a 2 pound smartwatch.  That is why the different fitness band and smartwatch offerings available today are all compromises and none have all the functionality that is possible. Some leave out the altimeter, some leave out the pulse oximeter, some leave out the continuous pulse rate monitor, some cannot measure O2, etc.  I see the emergence of numerous specialized measuring devices which may be associated with different parts of the body, which are integrated together by third-party multi-sensor tracking systems.  The earbud sensors and leg motion sensors mentioned above are examples.  Others mightbe in the form of patches, pills that are swallowed, shoelaces, pieces of clothing, shoe inserts, and subcutaneous implants.

Specifically, how popular can we expect clothing that embodies biosensors to become? 

My guess is, in the longer run, very popular, along with smart shoes, hats, scarves, gloves, earrings, rings and pins. wallets, jewelry, skin patches and what-have you.

Standards will have to be developed, getting us beyond the current Wild West of proprietary software platforms associated with individual pieces of proprietary hardware and the over 100,000 health and wellness apps out there.

To what extent will there be a confluence of consumer health-and-fitness and medical sensing devices?  Will the consumer health systems connect with or become integrated with or evolve into professional ones utilized by the medical profession? Or will they continue to evolve in their own trajectories and be regarded by medical professionals as “toy” systems. How and when will mainline medical practitioners tune into and adopt their practices to what health-conscious consumers are doing? 

This is very hard to predict.  I expect the consumer and medical devices and systems to remain in separate categories for some time.  I foresee a slow and bumpy process of reconciliation of consumer-driven health initiatives and medical-establishment protocols and initiatives, one that may require 30, 50 or more years.  In the shorter term, the consumer-related technologies and personal use patterns are likely to evolve very quickly in comparison to the hardened institutionalized patterns of the medical establishment, big pharma and the FDA.  There will be controversy.  There will be continuing efforts to regulate the consumer products as medical devices, but these will be mostly resisted. If history is any predictor, I expect soon to hear solemn warnings from medical device doctors in white coats not to trust health measurements made by consumer devices.  A few forward-looking HMOs or medical insurance companies may move to accelerate a process of reconciliation, however.  It will befun to watch how this all unfolds.

ON TO PART 2

I will publish a soon related to the likely emergence of practical health stress biomarkers, based on both theory and very recent personal experience.  I acquired a Basis Peak smartwatch a little more than three weeks ago and have been building a log of daily and nightly experience with the parameters it can measure – continuous heart rate, movement, skin temperature, ambient temperature and perspiration.  Based on these measurements I have been looking for overall health measurements – basically measures of overall constitutional condition of stress.  I believe I have been successful at identifying such, but don’t want to publish my conjectures until I have at least a month of data and personal experience to report on.  I am very excited by this effort.  In addition, in a Part 3 blog entry Jim Watson will report on  what is generally  thought to be a good measure of constitutional health – HRV, Heart Rate Variability,

DISLAIMER

None of the authors has or has had a personal or commercial relationship with manufacturers or sellers of any of the devices mentioned here.   In mentioning personal choices and experience, we acknowledge that our choices were necessarily relatively uninformed, given a general lack of reliable technical and performance specifications.  More capable products might appear on the market at the same or lower price point within six months, and any existing device may be obsolete in a year.  These are characteristics of a fast-paced consumer electronics market with multiple competitors at its current stage of development – like the situation was with consumer digital cameras about seven years ago.