Beyond the quirky gadget lies a much larger project: changing healthcare – for better or for worse
Hyperkinetic as he is, Hosain Rahman, the Jawbone founder, must be saturating his Jawbone UP wristband with data. The rubberised band, nicely designed by Yves Behar, is filled with miniaturised electronics: accelerometers and sensors monitor your activity through out the day, recording every motion in your life, from walking in the street to the micro-movements of your hand in a paradoxical sleep phase.
For the fitness fanatic, the UP is a great stimulus to sweat even more; for the rest of us, it’s more like an activity and sleep monitoring device. (For a complete product review, see this article from Engadget, and also watch Hosain Rahman’s interview by Kevin Rose, it’s well worth your time.)
Last week in Paris, after my meeting with Hosain, I headed straight to the nearest Apple Store to pick-up my UP – for €129 (£109) – with the goal of exploring my sleeping habits in greater depth.
After using the device for a couple of days, the app that comes with it tells me I’m stuck in a regime of five to six hours of bad sleep – including less than three hours of slow-wave sleep commonly known as deep sleep. Interesting: Two years ago, I spent 36 hours covered with electrodes and sensors in a hospital specialising in studying and (sometimes) treating insomnia — after six months on a waiting list to get the test. At one point, to monitor my sleep at home, doctors lent me a cumbersome wristband, the size of a matchbox. The conclusion was unsurprising: I was suffering from severe insomnia, and there was very little they could do about it.
The whole sleep exploration process must have cost €3,000 to the French public healthcare system, 20 times more than the Jawbone gadget (or the ones that do a similar job).
I’m not contending that medical monitoring performed by professionals can be matched by a wristband loaded with sensors purchased in an electronics store. But, aside from the cost, there is another key difference: the corpus of medical observations is based on classic clinical tests of a small number of patients. On the other hand, Jawbone thinks of the UP wristband – to be worn 24/7 by millions of people – in a Big Data frame of mind. Hosain Rahman is or will soon be right when he says his UP endeavouaaar contributes to the largest sleep study ever done.
Then it gets interesting. As fun as they can be, existing wearable monitoring devices are in the stone age compared to what they will become in three to five years. When I offered Hosain a list of features that could be embedded in future versions of the UP wristband – such as a GPS module (for precise location, including altitude), heartbeat, blood pressure, skin temperature and acidity sensors, bluetooth transmitter – he simply smiled and conceded that my suggestions were not completely off-track. (Before going that far, Jawbone must solve the battery-life issue and most likely design its own, dedicated super-low consumption processor.) But Hosain also acknowledges his company is fueled by a much larger ambition than simply building a cool piece of hardware aimed at fitness enthusiasts or hypochondriacs.
His goal is changing the healthcare system.
The venture capital firms backing Jawbone are on the same page. The funding calendar compiled by Crunchbase speaks for itself: out of the stunning $202m raised since 2007, most of it ($169m), has been raised since 2011, the year of the first iteration of the UP wristband (it was a failure due to major design flaws). All the big houses are on board: Khosla Ventures, Sequoia, Andreessen-Horowitz, Kleiner Perkins, Deutsche Telekom … They all came with an identical scheme in mind: a massive deployment of the monitoring wristband, a series of deals with the biggest healthcare companies in America to subsidise the device. All this could result in the largest health-related dataset ever built.
The next logical step would be the development of large statistical models based on customers’ recorded data. As far as privacy is concerned, no surprise: Jawbone is pretty straightforward and transparent: see their disclosure here. It collects everything: name, gender, size and weight, location (thanks to the IP address) and, of course, all the information gathered by the device, or entered by the user, such as the eating habits. A trove of information.
Big Data businesses focusing on health issues drool over what can be done with such a detailed dataset coming from, potentially, millions of people. Scores of predictive morbidity models can be built, from the most mundane – back pain correlated to sleep deprivation – to the most critical involving heart conditions linked to various lifestyle factors. When asked about privacy issues, Hosain Rahman insists on highlighting Jawbone’s obsessive protection of his customers, but he also acknowledges his company can build detailed population profiles and characterise various risk factors with substantially greater granularity.
This means serious business for the healthcare and insurance sectors – and equally serious concerns for citizens. Imagine, just for a minute, the impact of such data on the pricing structure of your beloved insurance company? What about your credit rating if you fall into a category at risk? Or simply your ability to get a job? Of course, the advent of predictive health models potentially benefits everyone. But, at this time, we don’t know if and how the benefits will outweigh the risks.