App a Day Keeps the Doctor Away

Exhaustion from the current healthcare system and increased interest in longevity has prompted people to take more interest in their personal health in recent years. The inaccessibility and complicated nature of healthcare is no mystery to people. Good health is the basis of practically anything we do in our day-to-day life, but the barrier of entry to understand our own health is tremendous due to the sensitive nature of health-related decision-making.

In a previous post, I discussed the value of people taking charge of their own individual wellbeing, simply because an annual visit to the doctor shouldn’t be the extent of people’s awareness of their own health! Technology is going to be a huge bridge to individuals taking charge. Tracker apps, wearables, health social networks have all become more prevalent in the last couple of years.

For the purpose of this post, I refer to consumer health tech as only some categories of what it is generally considered (also check out this a16z report): focusing on categories like wearables, biometric monitoring, wellness/health management apps, and slightly on specialized health. Thus, this discussion would disclude topics like insurance, patient portals, payments, etc because I want to focus my analysis on how individuals can directly use technology to be better informed about health.

Through my analysis of the current consumer health tech space, I looked at the functions and offerings of 50+ companies and classified them into the following categories:

Throughout this post, I will discuss my main takeaways from studying the current offerings of consumer health technology. First, we will look into some of the core functions of health tech. Then, we will dive into the importance of holistic health and whether current health tech enables individuals to achieve good holistic analysis. Finally, we will discuss the importance of context and interoperability amongst the health stack in relationship to holistic health.

Observations from Analyzing the Consumer Health Tech Landscape

Similar core functions

At the core of many of these health tech apps and products, they all served a couple of similar functions:

  • Tracking: How many meditation practices did you do? How many calories did you eat?

  • Data-based insights: Very general insights, comparing your data to a population average perhaps

  • Access to some community or social network: Mostly a side/extra function which often leads to small spread out networks on all of your different apps

  • Education: Articles, videos, podcasts which I feel like I don’t even notice anymore because there are too many on every app I use

Sneak peek into the consumer health tech stack database

Within each category, like in women’s health for example, the differences lie mainly in the UI/UX. Underlying algorithms and the research behind them are definitely different, but there doesn’t seem to be a huge gap in the data that’s getting factored in. For example, Flo and Clue both account for previous menstrual cycles, mood, pain symptoms, etc.

Clue on the left and Flo on the right

From the user’s perspective, it seems that they get comfortable using whichever app they began on, rather than having strong opinions on which one is better. It may be too difficult to migrate data once they get started, or their friend circle may be using one app over another leading to their influenced preferences.

Similarly, Whoop, Oura, and Apple Health have pretty similar functions at the core - all enable continuous data tracking, recovery insights, recommendations, and more, but they all have pretty different experiences, use different algorithms, and may emphasize some metrics over others.

The UI/UXs are a very important part of being a successful consumer health tech app. If the goal is to get people to incorporate health tech like these in their everyday life, it has to be as seamless and intuitive as possible, especially due to the perceived difficulty people already have regarding health/medical education.

Holistic Health

Being a “sleep & recovery” product doesn’t mean an app is focused strictly on just sleep data. Out of the categories which I mentioned above, you can expect any health app/tracker to touch on at least a couple of different areas. It makes sense for topics like mental health to be interwoven into women’s health, nutrition, or even physical activity.

People creating these apps know that the customer will get the best results for one category if they also factor in other topics - otherwise, it’s a partial take on the person’s health. Health is holistic, and people often forget that when it comes to taking action to achieve better health. You can’t expect amazing workout results with poor nutrition, or a less painful menstrual cycle with terrible sleep.

However, I believe that even though current consumer health tech does a good job recognizing that most of these aspects of health go hand in hand (thus the overlap in most apps), there is far more progress to be made to actually enable people to make more comprehensive and actually personalized health decisions.

Context

Analysis on holistic health can be better achieved by gaining more context on the individual. Similar to how knowing the entire story behind something can allow us to reach more valid conclusions and opinions, gaining the entire story behind our health can enable more accurate and detailed insights and recommendations to better practices.

For example, a wearable like Whoop can recommend I reach “13 strain” based on my performance the last couple months, but it doesn’t factor in that I’m recovering from jet lag or I’ve had a stressful week because of the start of a new job or a move to a new city. Basically, factoring in context could significantly change what recommendations look like based on just past data (a successful example of context being factored in is menstrual data factored in on Whoop).

Currently, the value of these data-based insights are plateauing because these insights aren’t too personalized. The recommendations from devices or apps are pretty limited once you make a couple of significant changes in your lifestyle (helps you stay consistent, but there are better ways to achieve that without paying so much). For example, a trend I noticed with some Whoop or Oura users is that people use the wearable for a year or two, and then realize they don’t have much value to gain anymore. As a Whoop user myself, I understand the reasoning: after six months of using it, I learnt a lot about my healthy and harmful habits. If I was able to give Whoop more context on how and why I feel a certain way or tell it about my commitments at work that won’t let me sleep at the time it recommends, I could get more specific solutions that work around my context in addition to physiological data.

Bills Ugh GIF - Bills Ugh GIFs

Speed running work when my Whoop tells me I need to sleep rn to get 85% sleep even though I have 3 hrs of work left.

I wanted to highlight a type of mental health tech app that I looked into: AI journaling. The main goal of this is to use AI to discuss your emotions, thoughts, and to visualize your state of mind. This is a solid execution of gaining context.

However, I believe that the insights from AI journaling are limited unless they’re paired with other data like my physiological responses during a meeting or my performance at the gym. A flipped example of the context issue is demonstrated with wearables like Whoop or Oura. They do a great job of recording physiological patterns, but don’t quite reach the optimal execution on gaining and factoring in context on the person (although Whoop has a good start through their journal feature, paired with the AI coach). Imagine the rich insights from AI journaling overlaid on Whoop’s physiological data.

Interoperability

More interoperability amongst health tech is crucial to unlock the next level of insights. Apple Health is a good example of a central hub where people can connect and feed their health data from other apps whether that’s sleep trackers, workout apps, and more. Strava enables integrations with wearables, getting data like heart rate or strain from Apple Watch or Whoop. A more surprising instance of data sharing was Oura’s partnerships with various women’s health apps like Natural Cycles and Glow. However, these are instances of just one or two categories of holistic health being combined.

It’d be interesting to see what user experience could create the most seamless integration into people’s daily lives. Do people prefer a singular hub where they log all of their data? Would they prefer it to be separated and feed into one app? I’m curious how social networks could be better leveraged if there aren’t seven different profiles you have to handle for each app. The preferences on all of these small things could be so varied for different people, so finding balance between giving flexibility but not being overwhelming will be a crucial problem to solve for.

In my current setup, I use Whoop as a central hub and apps like Flo (women’s health), The Art of Living (mental health), Strong (workout tracker), and Strava (run tracker) to feed data (of these, only Strava directly connects with Whoop). However, right now, I have to look at insights from each and weave together predictions on my own, “my pace for a three-mile run was probably low because I didn’t sleep or eat well since I am still jet lagged from traveling last week.” Imagine if your health stack could give you future predictions and explain to you root causes of health outcomes, as personalized and detailed as that - that would definitely be a level up from the claims of “personalization” right now.

Future direction for consumer health tech

Reaching such a predictive level of health tech is going to be a big achievement for the industry as it will enable lay people to make decisions for their health in real time, as seamlessly as possible. AI/ML is going to be a crucial part of this journey as more sophisticated pattern recognition, predictive modeling, and personalization is going to be necessary to achieve the desired outcomes.

The case for crypto

I feel like the AI use case in consumer health tech development is obvious, but a more unexpected (and probably difficult) implementation is going to be that of crypto and decentralization to build out the consumer health tech. As mentioned before, interoperability can change the game for consumer health tech, and current infrastructure makes this a big challenge. Yes, apps enable integrations, but it’s not the most intuitive feature and is definitely not prioritized.

Imagine the development of apps or protocols which enable you to customize your stack of health tech products and have your different apps overlap and work together to give you the best results. Right now on consumer crypto apps, I can mint (collect onchain) things on different platforms and websites, and find it all in my crypto wallet. I desire that kind of experience with my health activity. To achieve the same results for my health stack right now, I have to go to app settings and approve forty different permissions for each, if they offer it in the first place. Being able to start a run on one, journal in another, and log calories in a third - knowing all of that data will follow me so I can plug it into some other app to give me insights, or post about it on the “fitness” part of my social profile.

NFTs that I minted in four different places online, all found in one wallet.

I don’t want to go into the data ownership part too much because I know there are a ton of implications there, but I want to focus on the concept of just having more authority over your actions across the health stack (like collectors/minters are experiencing onchain now!).

Health onchain could be a crazy opportunity and even potentially open up other use cases like a token economy which enables you to participate in research studies. Current app integrations are powerful, but health onchain, combined with AI, could eventually take health personalization to a whole another level.

Looking forward

Data, privacy, and regulation are all factors which companies should continue to account for. However, I think there could be a significant shift in the development of health technologies, enabling faster timelines and more focus on the consumer. Use cases for crypto and AI are revolutionizing other sectors like consumer/creator economy, finance, and more. It’s only a matter of time till we figure out how to optimally tap into the power of these technologies to build out consumer health tech tools.

I believe that more focus on consumer health technologies will change the game for so many stakeholders involved - patients, health professionals, technologists, public health experts, and so many more. Shifted focus to consumers is necessary as people aim to take more control over their health and lifestyle.

The next couple of years of growth in this space is going to be crucial, and hopefully we will start to see a shift towards a more health educated and conscious population.

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Thank you to Alexa Murray, Ben Ersing, and Sophia Rubino for their feedback on this piece!

DM me on Twitter FC if you want to see the full map I made. I wrote this article to synthesize my knowledge and personal health experiences with the use cases and technological capabilities of crypto & AI. If you have challenging or supporting perspectives, please feel free to share :)

Some questions I still have:

  • To an AI/ML person: Is it possible to get much better insights from “layered” data from these many different apps? How may models start “hallucinating” with an overload of too many different types of data sets?

  • To a health expert: To what extent does “science support” making conclusions that connect many different aspects of health? Like I can make an assumption that my work stress and increased running activity led to a change in sleep quality, but are these kinds of statements a “jump” to make?

  • To a developer: How does difficulty compare building app integrations (like those that health apps use right now) versus building some protocol and creating different health apps on top?

  • To a health consumer: What gets you motivated to use health technology? If you don’t, why?

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