Posted on June 4, 2015 at 4:04 AM
by Craig Klugman, Ph.D.
How much did you sleep last night? How many calories did you burn? How many steps did you walk? What was your average resting heart rate? How many calories did you consume? What was your blood oxygen level? If you were a part of the “Quantified Self” movement, then you would have all of these numbers logged on your wearable, your mobile, your phone, your tablet, and your laptop.
The Quantified Self movement is an attempt to use technology to keep track of all physiological aspects of a person’s life. The goal is to quantify yourself by taking biometric measurements so that you can track your health. Similar to a company trying to improve its performance, you can use your metrics to try to improve your numbers, which are used as a stand in for your health and fitness.
The term comes from 2007 when two Wired editors, Kevin Kelly and Gary Wolf, were thinking about what it meant that there were new devices that allowed a person to track their lives. Each person becomes an experiment seeing how habits, actions, activities, and health choices affect the numbers. There are now QS conference, meet up groups, blogs, articles, devices, and programs.
But that’s not all, more than just trying to improve your numbers, you can share your data through websites that can help you keep track of those numbers, share them with your doctor, or even make them available for researchers. You can track your life and contribute to improving other people’s health at the same time.
The notion of keeping track of every aspect of your body and life, of turning into a number that can be tracked with the goal of improving your numbers, is not completely new. Competitive athletes have done this for a long time to fine tune their training to give them the perfect competitive advantage. The difference is that these tools are now available to everyone.
My concern is that we are reducing human experience and human lives to a set of recordable datapoints. We are more than the sum of our numbers though. Having strong numbers does not mean you are healthy just as having bad numbers does not necessarily mean you are unhealthy. They are substitute indicators for health.
At the end of May, the cartoon Pickles even got into this discussion. The May 26 comic shows an older female character complained that her Fitbit only shows 6,000 steps. After announcing that she tries to get 10,000 steps a day, she asks her grandson to take the device and run around the yard. The May 27 comic shows the grandson handing the device to his grandmother who finds it now reads over 12,000 steps. Her response is that she feels tired and should go for a rest. She feels tired because a device told her that she exerted herself when in fact, she did not. We begin to believe a machine more than our own bodies.
Many people who use these devices are either ones who like to track data, are early adopters, or people who need motivation—after all, tracking calories has been an effective weight loss tool for a long time. How far, though, is too far? At this point, you can even track your sexual activity including calories expended, performance, and pace.
What if your employer made a wearable health tracker available to you and gave you a discount on your insurance premium for doing so? The Fitbit company itself has a division dedicated to being part of corporate wellness—the latest health craze where employers hire companies to create programs to improve their worker’s health. However, reports indicate that these programs do not improve health or save money. Besides, do we really want our employers to be keeping tabs on our fitness and eating habits? Come in to work one day and the boss might say “Saw you had a few extra cookies last night. Better do some extra laps today!”
To make matters even more surreal, as of April, John Hancock insurance gives a 15% discount on your life insurance if you use a wearable device and share that data with the company.
It’s very easy for a discount to turn into a penalty. What if your employer later charged you a penalty for not using such a device? Remember that non-smokers used to get insurance discounts and now they get an insurance penalty. You might be a health marathon runner but unless you wear the device, you would be viewed as unhealthy.
Of course, there is also the issue of privacy—these numbers really are private health information. When you share them on a website, an app, with friends, you are sharing your PHI. And since the information is on a computer, it can be hacked.
As it turns out, the devices are not necessarily accurate compared to external, calibrated measures. The device might be consistent within itself, but different devices will record different numbers.
When I tried to look up articles that were critical of these devices, what I found were that they may not be necessary—because your cell phone can keep track of all these numbers without a second device. Where are the voices speaking out against digitizing our lives? There is no critical commentary against turning our behaviors and activities into a dataset, just discussion on the best way to make that happen. Even a blog on “the pros and cons of fitness trackers” listed as the only con that they are not accurate. The conclusion: They are helpful and just be aware that they are only based on averages created by an algorithm, not on your unique self. The article is mainly pro and not any real con.
Sadly, I think this is a case where we have the technology, so we will be increasingly encouraged/required to use it. The point then becomes to limit these devices’ obtrusiveness into our lives. First, we need to ask our legislators to pass laws making it illegal for insurance companies to use this data for setting rates, giving discounts, or assessing penalties. Second, data from these devices should be clearly stated by the appropriate agencies as private health information, thus ensuring a higher level of security. Third, just say no: Don’t use a device, don’t sign up for a program that gives you a benefit for using the device. If we refuse to play, then eventually these devices and the companies that stand to profit from them will have to leave the playground. And third is that we should separate insurance from employment, separate caring about our health from our place of work. This would eliminate things like workplace wellness and selling these devices through employers as a “benefit.”
What the Quantified Self movement gets wrong is that life isn’t only about the quantity, the quality matters as well.