Fashion, Fitness And Health Faced-Off At CES 2016
By Paul Teich, Principal Analyst
Health is a unique area of the Internet of Things (IoT). Health spans both industrial and consumer IoT markets, from institutional emergency care and hospitals to personal health and fitness monitoring. Companies like Under Armour, Fitbit, Huawei, Apple, Fossil and even ADT are converging on personal and home health care markets. A month ago at CES 2016, I saw quite a few health-related devices. My focus here is on wearables, health and the potentially lucrative intersection between the two.
Connected (and Fashion) Wearables
Apple’s watch is so far the only connected fashion wearable with a dedicated and well-defined audience, mostly because Apple’s brand but also because Apple has done a good job integrating their wearable user experience with their iPhone experience. Apple’s challenge is that their watch’s appeal is mostly limited to consumers who already own Apple phones or are willing to switch from Android or another phone ecosystem to buy Apple’s watch. Huawei and Samsung also offering their own Android-compatible watches, but like Fossil’s band and watches, their feature sets are dominated by smartphone notification functions and differentiated through the watch bands and face displays.
There isn’t much return on investment (ROI) for offering wearable smartphone fashion accessories for the next few years. UX design for smartphone notifications is still primitive and limited. Also, using fashion watches and accessories to track activity seems like a mismatch given the early state-of-the-art for fitness tracking today — consumers might wear an inexpensive watch through only one fashion season, but might wear an expensive watch for decades.
We believe that Apple is likely to run into a replacement cycle challenge 18–24 months after the Apple Watch launched — most of their target audience cannot afford to spend $500 or more per year on upgrading their watch, even if it is from Apple. The real opportunity for smart watches is to displace most of what a smartphone does — however, this is also a substantial challenge, because the smartphone is so good at what it does (having mostly displaced the potential tablet market, after tablets capped laptop PC growth.
Health Wearables
Most of the successful wearables are fitness trackers, and their audience in 2016 is still professional and enthusiast amateur athletes. Companies that depend on broadening the appeal of fitness based wearables, such as Fitbit and Jawbone, are having growth challenges. Many of their target customers have tried at least two products so far and have either become bored or frustrated. As a result, they have given up on fitness trackers completely or have settled into a single vendor ecosystem to track their steps and sleep. Companies that focus specifically on pro and enthusiast fitness, such as Polar and Garmin, seem to be doing better as they move their customers to more and better features.
One of the big challenges for the consumer health tracking industry is that the data gathered from their products is not calibrated to any kind of standard. Each product tracks movement differently and then labels any detected movement as “steps”, “sleep”, or other activities. Which means that even if a vendor allowed consumers to download their tracker data, consumers would not be able to directly compare data from different products and manufacturers. The first step in creating portable tracker data is to create certification metrics that define the motions required to measure steps or sleep, so that trackers can be calibrated to measure the same thing. The next step will be to then correlate the calibrated sensor patterns to basic demographic information, such as gender, age, weight, height, etc., so that common baselines for “normal” health metrics can be established across large populations of consumers.
At TI’s booth, Texas A&M’s Engineering Experiment Station (TEES) Center for Remote Health Technologies and Systems (CRHTS) demonstrated their “Automated In-Vitro Wearable Device Validation Test System”. While they need assistance naming the product, the gist of their demo is that Texas A&M is licensing a very comprehensive automated tracker test suite to wearable device manufacturers. They pump simulated blood through a simulated wrist encased in simulated skin, and simulate human cardio and other electrical signals under the skin in order to test state-of-the-art pulse and body performance sensors. Skin tone can be varied to match different ethnic groups, and different gender and health profiles can be simulated, as well.
The simulated wrist is mounted on a robotic assembly that can currently replicate a limited range of human wrist motions — it can move its simulated wrist in one position through a pattern of up-down, left-right, forward-backward motions.
There are two facets to automated health and fitness tracker testing: 1) ensure accurate measurements across devices and vendors and 2) ensure the most accurate advice possible to wearers. Not only will this kind of tool help define accurate metrics for data interchange and portability, it will enable mostly homogeneous collocated developer teams to test their products for populations they may have no direct access to — such as an Asian team developing for North American use or a 20-something year old startup team designing a product for use by elderly consumers. This kind of test rig help will help vendors design and test products that will work well for all people, across the planet.
Dedicated Sleep Tracking
The dedicated sleep tracking community also looks like they are being more scientifically rigorous about what they measure and how they measure it. While wrist-based trackers purport to measure sleep based on motion, they require that consumers wear them to bed. Often this means consumers must find other time during the day to recharge their tracker, and wearing a watch to sleep is definitely obtrusive and a change of habit for most consumers. Several companies are working on under-mattress sensors to record sleep patterns much more accurately. These in-bed sleep trackers don’t require consumers to wear wristbands, headbands or really anything else [editor: really?].
Fitness tracking and in-bed sleep tracking companies should partner together to design more accurate and complete solutions.. Consumers can recharge their tracker at night while getting higher resolution and more reliable data from wall-powered “always on” in-bed sensors. It’s a win-win situation for everyone, even before the health tracking industry delivers health tracker data portability.
My advice to the in-bed sleep tracking folks is to do your homework on potential electromagnetic (EM) emissions to satisfy rational folks looking at possible sleep interference due to EM fields, especially for European consumers.
Medical Health
The most comprehensive crossover product between consumer and medical that I saw at CES was in the Eureka Park start-up section — UnaliWear’s Kanega watch. I have talked with UnaliWear before, we are both based in Austin. CES was the first time I have seen functioning models of UnaliWear’s watch.
Kanega is essentially a “wearable On-Star for seniors” — it is a smart health monitoring watch that operates independently of any other consumer or connected health devices. Kanega does not need a smartphone at all, because it includes GPS and cellular network connectivity, as well as Wi-Fi, Bluetooth and an accelerometer. The watch body is completely sealed and waterproof, and is inductively charged through two independently replaceable rechargeable batteries. The battery compartments are the wide shields in the band on either side of the watch.
Wearers interact with the watch via voice (normal speaking and through Bluetooth accessories) and taps — the watch contains a vibration motor and speaker, as well as the watch display. Operating touch displays requires too much fine motor dexterity for many seniors, as well as people of all ages with other degenerative muscular or neurological conditions.
UnaliWear put a lot of thought into their hardware platform, but in many respects shipping their watch to beta customers marks the beginning of their service development. The service behind Kanega needs to accurately and reliably:
- Tag different kinds of motion– standing, walking, falling, sleeping, etc.
- Determine location for geofencing and emergency services
- Operate seamlessly between cellular and Wi-Fi networks
- Give wearers and caregivers timely alerts based on wearers’ preferences and actions
All of this training will occur in a server or cloud back-end. UnaliWear’s next step will be scaling their base of wearers to collect more sensor and behavioral data from more and different kinds of target wearers. That data feeds into different kinds of analytics, including deep learning, to extract the patterns and insight that will drive a service that wearers or their caregivers will pay for.
It is not just start-ups who are working in this space. ADT is now offering medical alert and remote patient monitoring services, based on both wearable and other in-home medical and communications technologies. Why is ADT interested? They are a services company, and remote health monitoring is a service, not a hardware product.
What’s Next?
CES is a consumer event, but this year we saw many business-to-business (B2B) and industrial IoT vendors demonstrating products that will be worn by consumers, but perhaps paid for by their caregivers, insurance or other medical programs.
As doctors and the medical industry, in general, shift to electronic health records (EHR), data portability and the ability to analyze EHR data across large populations will become business opportunities. Sharing EHR data across medical practices, especially small businesses, is already a challenge. There is a need for EHR data exchanges that anonymize patient data. The more data we have to analyze, the more impact EHR will have on uncovering sort-term health threats and long-term population trends. As of today, consumer grade health devices do not produce data accurate enough for medical purposes, but that may change as better testing methods are deployed and better sensors are developed.
All of this starts with wearable sensors. If consumers won’t wear the sensors, there will be no data to analyze. I don’t think our industry has figured out the right combinations of lifestyle accommodation and services yet. I do think that the new in-bed sleep tracking systems, the TEES wearable testing system and companies like UnaliWear are all moving along on the right track.
Disclosure: I do not hold an equity position in any of the companies mentioned in this article. Over the previous few years I have purchased many fitness tracking products through retail channels, including products from Fitbit, Garmin, Pivotal Living and Fossil. Serendipitously, I earned my bachelor’s degree in computer science from Texas A&M.
