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Illustration by Trevor Alixopulos

"I did my research and liked
the fact that it tracked so many different things," she says. "I entered my weight and goal. Set my number of steps per day, calorie intake, etc. After the first week, I was pretty impressed with the overall scheme of things. Entering each glass of water, every bite, every morsel and every aerobics class and then reviewing it weekly to see your progress—and believe me—I was making progress."

In general, the companies that make these devices are in a very early stage of development, so their sights aren't set so far ahead, says Julien Blin, organizer of a recent Wearable Health and Fitness conference held at the Plug And Play Tech Center, a startup incubator in Sunnyvale.

"Most of the wearable technology is about fitness, and they are mostly trackers of footfalls and heart rhythms," Blin says. "When people talk about being worried about where the data is going, or how it is being used, they are mostly talking about whether it is being sold to advertisers."

That's a viable concern, since many makers of fitness trackers try to increase market share by getting users to socialize their achievements—which is why you may see Facebook and Twitter posts from friends telling you how far and how fast they ran this morning. In effect, such posts are an advertisement for these companies.

For some of these startups, the decision to avoid the medical market is deliberate. There is a clear line between simple sports monitoring devices and those that require FDA approval, and some makers just don't want to cross that line.

Still, other device makers are strategically targeting the health care market.

For example, the CarePredict Tempo is a "smart watch" that monitors a senior's vital signs and sends an alert to a caretaker or relative if a "disruption" occurs. Caretakers are usually provided by home care companies contracting through insurance carriers, and many of them will see this device as both an efficiency improvement and a way to cut the cost of on-site care.

Similar medically oriented devices are already made by GERO Corporation, Sense.ly. Sensoplex, RxMatch and InfoMeters, among others.

"That's the likely direction of things, but it's not even just wearables," Scoble says. "It's your pill bottle telling you that you haven't had your pill or your refrigerator door telling your health care specialist that you didn't open it this morning."

Pill bottles and refrigerator doors typically fall within a tech area now known as the "Internet of Things," but they could easily communicate with wearable devices, computers and ultimately health care providers through low-energy Bluetooth technology.

Some smart watches now offer limited health-monitoring capabilities. The Samsung Gear Fit's amenities include a Fitness Manager that monitors heart rate and makes suggestions to improve the wearer's next workout. The new Apple Watch, due to be released next year, can track fitness info such as daily steps taken and heart rate.

But further possibilities exist within a new addition to Apple's latest iOS: Health, an app that complies data from health and fitness apps, like heart rate and calories burned, as well as offers a place to store emergency info. HealthKit is the accompanying new developers' tool that enables such info to be shared between apps. According to the Wall Street Journal, as part of this venture, Apple has partnered with Epic, a medical records provider, to supply data to HealthKit, but little is known yet about the arrangement.

Also on the medical records front, developer drchrono is currently taking sign ups for Beta testers for its Google Glass medical records application—not for patient use, but for doctors'. The app allows doctors to consult patients' info more quickly and without having to break eye contact when they're in conversation with a patient.

"We're a new wearable 2.0 technology platform," says Igor Mikhnenko, co-founder and CMO of Moscow-based Gero Lab during his investor pitch at the Wearables conference. "Our mission is non-invasive diagnosis of chronic diseases in early stages." The company bases its product on groundbreaking research of the Human Locomotome Project, which uses everyday activity trackers such as FitBit to measure motor activity signatures, stress and behavioral changes and identify triggers that may indicate metabolic, psychiatric and neurological conditions.

Using this research and data from individual wearsable devices, Gero can identify subtle, unconscious adjustments brought on by chronic conditions. The company claims 60-85 percent accuracy identifying conditions such as Parkinson's Disease, obesity, depression, migraines, anxiety and sleep disorders, osteoarthritis and Type II diabetes.

"Today most Bluetooth devices don't talk to each other, but our Bluetooth hub serves as the hardware platform to communicate with all these devices in a 'connected home' environment," says Nahid Alam, CEO of Lithouse, which markets to wearable device makers.

For start-ups in these areas, the health care market tie-in provides potential investors with an attractive business model, especially since studies show sports wearables are often returned or left unused after a month or so—a phenomenon recently tagged as "wearables abandonment".

"Will I retire Flex when I get there?" Lori G says of reaching her weight loss goal. "Not a chance." She says she previously used an app to track her walking and found it wasn't as accurate as her Flex just at counting steps and accounting for pauses. She has currently met about two-thirds of her weight-loss goal.

Health care wearables could be prescribed to patients, making their use a medical necessity—translating into a captive market for which a premium can be charged.

Faced with this dynamic and with increasing competition in the field, some sports wearables makers are feeling the pressure to engage the medical market sooner rather than later.

"The opportunity in the U.S. alone is about $2 billion," says a representative of SmartMonitor, a company that makes "SmartWatch," essentially a bracelet that can detect epilepsy attacks, sleep disorders or even Alzheimer's emergencies and alert families and caregivers.

The health care industry is, in turn, embracing wearable technology.

For many health care companies, the new wearable tech represents a huge leap forward. A bracelet that could alert an emergency room or senior care nurse that a patient is showing signs of a stroke, could be a lifesaver at a fraction of the cost of current technologies.

Consumer health care organizations are also weighing in.

"We are definitely seeing a lot of movement in this space, and we are very interested in technologies that are driving to improved health outcomes for patients by enabling and empowering them to better track and monitor their health at home, as well as improving engagement between patients and their health care providers to manage health conditions," says Carisa Hodges-Kaplitz, senior manager of publishing and digital innovation for the American Heart Association's Patient and Healthcare Innovations Team.

"Our organization does much in the way of scientific research and engaging in programs that leverage these emerging technologies, to learn what can drive to positive health impact. For example, leveraging Heart360—a cardiovascular wellness tool at Heart360.org—to help improve blood pressure control. We are also collaborating with the University of California in San Francisco on a long-term heart health study which leverages connected health devices in new ways to conduct research," she adds, citing Health-eHeartStudy.org as the home site for this effort.

Though it's tempting to suggest that the health benefits and lower cost of wearable devices could translate to reduced medical bills for users, in reality the relationship is not that clear or direct.

On the one hand, wearable devices could soon be used to identify otherwise unseen problems, representing a leap forward in not just patient monitoring, but also diagnostics and treatment. And, if wearable devices encourage their owners to exercise, then their health is improving anyway.

After acquiring her fitness tracker, Lori G. says, "I challenged myself to walk a little further, pay more attention to what I was putting inside my body. Before you know it, my Flex and I were the best of friends."

However, this same information can be shared with, and used by, insurance companies to reclassify subscribers into different categories based on their reported condition and probable outcomes. This could potentially increase the overall cost of health care to the individual long before symptoms appear.

That scenario is still a long way off, and it is not well sorted out, Scoble says.

"It's true that wearable devices are changing how we are taking care of own health, but giving information over to insurance companies is another ball of wax," he says. "Otherwise why not just give it to my athletic brother and let them think they are getting data from me?"

"People are going to be pretty resistant to insurance companies getting that stuff, unless there is a discount involved, but even then others will just go, 'Hell no,'" says Scoble.

Still, he acknowledges, the insurance company interest is inevitable.

"They're already putting black boxes in cars to see how you drive, so I imagine they will want to do it for health, too," he said.

The Affordable Care Act may actually protect some users of these devices. Previously, if an insurance company had been able to get early diagnostic information from a wearable device, they could have denied health coverage altogether on the grounds of a pre-existing condition. Obamacare takes the pre-existing condition clause away from insurers, while still allowing them to shift users into a different coverage category based on health status.

Left out of the equation so far is the protection of health care information. As devices become smarter and better at diagnostics, the information they upload and share becomes increasingly sensitive. Yet at the same time, it is being shared to the cloud. Does it stay with a doctor or insurance provider, or does it travel elsewhere?

Currently, most companies with plans to take the data to the cloud say that they are only interested in big data analysis—that is, creating data sets about huge numbers of anonymized users. But others are already using individualized data in new and seemingly useful ways. such as Chronos, which collects information from your smartphone and wearable devices to monitor everyday eating, sleeping, driving and other habits to create a pool of information that is ultimately designed to help you improve your daily routine.

And we're just scratching the surface of this technology. After all, industry giants like Apple, Samsung, Google and others are only now beginning to show their capabilities.

However, it may turn out that none of these devices is particularly successful.

"Actually, it's the simple ones that are the most useful," says Sharon Barclay, principal of Blue Trumpet Group and an avid triathlete. "Devices that try to do it all, never do anything right. It's like buying an SUV sports car. It will be a pretty lame sports car, and a mediocre SUV, with lots of compromises.

"Right now my favorite device is my running watch," Barclay says. "Garmin Forerunner 10. About $120 with a built-in GPS. I can see how fast I run, how far, elevation, weather, and even if I make a stop at a traffic light. I upload when I get back and it shows me all the details of my run. It's very good at making me feel guilty about slacking off."

That may be the best health information of all.


Digital Dog

The Bow-Lingual, introduced 12 years ago by Japanese company Takara, purported to offer dog-to-human translation, analyzing barks transmitted wirelessly from a microphone on the dog's collar to a receiver that categorized them into different emotions. A Meow-Lingual soon followed.

Even if the resulting translations had proven totally comprehensible, basic pet emotions don't seem all that impenetrable—more food and more attention appear to be universal motives. But the current spate of pet wearables popping up focus not on Rover or Fluffy's feelings, but on quantifiable data—mostly in the realm of health. Among the many:

FitBark, much like the human device its name suggests, tracks a dog's physical activity and rest, allows a user to set fitness goals and syncs up to a phone app. The health data it gathers can be shared with a veterinarian. To ensure that neither owner nor pet laze around on the couch, FitBark can receive data from some human fitness trackers.

A device worn as a collar and synced to an app, Voyce monitors vitals, such as a canine's heart and respiratory rates, sleep and calories burned. This wearable also offers users the ability to share info on social media (mostly photos—no one probably wants to know Rover's heart rate) or with a veterinarian.

Tagg, which attaches to a pet's collar, offers health monitoring in addition to its primary function as a locator. The device (also synced to a phone—there's a theme here), sends notifications if a pet has gone beyond pre-set boundaries, and if that's the case, provides a map of the pet's current location.—Heather Zimmerman

Fit for (Certain) Bits

A new fitness tracker in the works focuses on one specific way to get your heart rate up. Bondara, a British company specializing in sex gadgets and lingerie, will soon start testing the SexFit, a fitness tracker worn on the penis during sex. Many wearables are modeled on watches—this device is modeled on a different sort of accessory.

"We expected the device to be well received, our knowledge of the industry told us that sex-focused wearables is a very fertile ground for development and we're excited to be leading the charge in this area," says Chris Simms, founder and CEO of Bondara. He notes that the company has been inundated with requests to pre-register for purchasing the wearable—and volunteering to Beta test the device. Simms says the SexFit will hit the British market in the spring, but there are also plans to bring the device to the U.S. market.

The SexFit, equipped with an accelerometer and Bluetooth capabilities, is not the passive sort of fitness tracker that merely reports stats after physical activity. The device takes a more active role—not only constricting as more traditional rings of its type do, but also in the ability to vibrate and give a lift to its wearer during the "workout."

SexFit can vibrate in a number of pre-set rhythms to help set the pace and also displays flashing lights that offer feedback—too many lights indicate the wearer should slow down, for instance. Simms demurred on whether those flashing lights might cause a distraction. But if they ever did, it seems likely the SexFit would also log that interruption.

After a session, users can review stats such as timing and pace using the accompanying app, called the SexFit Personal Trainer. The thrust of the data collected by this device focuses on performance—including the potentially deflating notion of assigning a grade to said performance. But it's all meant to be positive feedback.

"The personal trainer will provide you with new targets to achieve and tips to build up your abilities in some the areas of the bedroom that require most development," Simms says.

Existing pretty much in the opposite universe from the worry that insurance companies will get their grubby hands on this data, the SexFit's accompanying app not only rates its wearer's performance but—assuming that bedroom jocks will want to brag about their scores—allows users to share their results on social media.

"A user can choose to auto-share stats from an entire session or an individual milestone. We appreciate that the majority of users will use the app for personal feedback however, I'd challenge you to find someone who would say they wouldn't check out their friend's performance if it was posted," Simms says.

And that said, a user's ability to hack results is thus far unknown.—Heather Zimmerman