来自苹果、亚马逊和谷歌等公司的健身追踪器正在发生重大转变，从计算步数的低技术设备到现在成为个人健康的时尚。
跟踪健身和锻炼数据以供个人使用或与朋友分享可能有用且有趣。但是，人们越来越有兴趣将更广泛的医疗数据整合到数字健康生态系统中——借助 Covid-19 大流行期间所需的远程远程医疗服务的急剧增加——使医生和医院可以访问个人信息作为电子医疗的一部分健康记录。
十多年前，可穿戴设备市场随着基本的健身、锻炼和运动活动跟踪设备而发展。现在，近 30% 的美国人现在使用可穿戴医疗保健设备，其中许多设备现在能够跟踪、监测和传输有关心率和节律、血压、体温、血糖水平、睡眠质量甚至Covid-19 感染的早期预警信号。
Fitbit 于 2009 年推出了一种夹式小发明，可记录佩戴者的运动、睡眠和卡路里，从而推动了这一趋势。该模型演变成腕带，多年来增加了更多的生物传感器和蓝牙连接，用于将数据下载到智能手机。谷歌母公司 Alphabet 在 1 月份以 21 亿美元收购了 Fitbit。
Apple 于 2015 年首次推出 Watch 进入该领域，因为它添加了一系列与健康相关的功能和应用程序，并为第三方开发人员创建了一个平台，以创建不仅供消费者使用的工具，还供医疗保健组织和研究人员使用以访问并分析在他们的智能手表上捕获的数据。它还与耐克、Strava 和阿迪达斯等健身公司合作，允许他们将他们的活动应用程序同步到手表。研究公司 Strategy Analytics 估计，2020 年，Apple Watch 的销售额接近 130 亿美元，按收入计占全球智能手表市场的 65%。
这个蓬勃发展的市场吸引了其他大型科技公司，包括 Halo 智能手环制造商亚马逊和今年推出 Watch 3 的华为。还有来自消费电子领域的各种其他智能手表进入者，其中包括三星、Garmin 和 Withings。
在纯游戏类别中，芬兰初创公司 Oura 设计了一个嵌入生物传感器的戒指，用于监测睡眠、心率和体温。 5 月，该公司宣布了 1 亿美元的 C 轮投资，使其总资金超过 1.48 亿美元。据报道，Peloton 正在计划一个数字心率臂章。
根据财富商业洞察，全球可穿戴健康和健身设备市场——包括带传感器的手表、腕带、戒指、皮肤贴片、眼镜和服装——在 2020 年将达到 360 亿美元以上，预计到 2020 年将达到 1140 亿美元。 2028 年的复合年增长率为 15.4%。德勤全球预测，2022 年仅智能手表和智能贴片细分市场的全球出货量将达到 3.2 亿台，到 2024 年这一数字可能会达到 4.4 亿台。
德勤副主席兼美国科技行业负责人保罗·西尔弗格拉特 (Paul Silverglate) 表示：“这方面的资金来自风险投资和私人投资来源。”
几家医疗技术公司已经推出了智能贴片，即粘附在皮肤上的便士大小的条带，并使用充当生物传感器和输送药物的微型针头。 BioIntelliSense 总部位于加利福尼亚州雷德伍德市，创建了 BioSticker，佩戴在左上胸，用于持续监测和捕获呼吸频率、休息时心率和皮肤温度的数据。位于马萨诸塞州阿克顿的公有 Insulet 开发了 OmniPod，一种用作胰岛素泵的贴片。
感应式服装也出现了。总部位于蒙特利尔的 Hexoskin 开发了一系列智能衬衫，可以收集心脏、呼吸和活动数据，并将其传输到 iOS 或 Android 兼容设备。该公司与加拿大航天局合作开发了外星版本 Astroskin，以跟踪宇航员在飞离这个世界时的生命体征。
提供准确的数据和信息
除了技术能力之外，现在还有一个关键的功效问题——设备、链接到它们的应用程序以及生成的 PB 级数据——这导致可穿戴设备制造商与独立研究人员协调，看看它们是否如宣传的那样交付。
Joshua Hagen 是俄亥俄州立大学集成系统工程系的研究副教授，十多年前，“在可穿戴设备真正出现在现场之前”，他就在空军研究实验室研究生物传感器，他说。哈根随后开始在精英运动员身上测试设备，监测他们的表现数据。 “那里有大量的设备，但我们首先必须信任来自它们的数据，”他说。
哈根发现佩戴设备的身体部位很重要。例如，自 1980 年代初以来，Polar 心脏监测器胸带“已经通过上千种不同方式得到验证。”手腕适合测量静息心率。 “但手指是一个非常有趣的地方，”他说，指的是他对大浦戒指的研究。其中之一，它在设备中的准确度第二高，胸带排名第一。
在 Covid 袭击后启动的另一项研究发现，通过将算法应用于 Oura 用户数据，Hagen 的团队可以在冠状病毒感染前三天识别早期预警信号。一项单独的概念验证研究检查了各种可穿戴设备的功效，结果表明它们可以检测发烧、Covid 和其他感染的普遍症状。
2019 年 11 月，Apple 与研究小组合作，使用 Apple Watch 启动了三项健康研究。与哈佛公共卫生学院和美国国立卫生研究院合作的妇女健康项目旨在促进对月经周期及其与各种健康状况（包括不孕症、骨质疏松症和更年期过渡）之间关系的理解。 Apple 与布莱根妇女医院和美国心脏协会合作开展的心脏和运动研究正在探索某些运动信号以及有关心率和节律的细节如何作为房颤或心房颤动、心脏病或运动能力下降的潜在预警信号。
医生如何使用这些数据
健康可穿戴设备的最终场景是让普通大众佩戴经证明有效的智能设备，将重要数据持续下载到实时跟踪患者、监控其整体健康状况并应对任何紧急情况的初级保健提供者。然而，要实现这一飞跃，医生必须确信这些设备是有效的，患者正确使用它们并且数据是可靠的。
为实现这一目标，美国医学会 (AMA) 对医生进行了一项调查，以评估他们对包括可穿戴设备在内的各种数字健康工具的看法。超过 87% 的受访者认为他们的整体使用至少有一些优势，尤其是可穿戴设备和远程医疗设备。然而，医生们也表示，数字工具需要具备“必备条件”才能将他们的热情转化为采用，包括提高效率和加强对患者数据隐私和安全的保护。 “医生对技术的热情与解决方案帮助他们更好地照顾患者的能力直接相关，” AMA 数字健康战略副总裁 Meg Barron 说。
对于营销人员来说，最关键的因素将是人们是否真正购买和使用可穿戴设备。 Needham & Company 的高级互联网和媒体分析师 Lauren Martin 表示：“健康是消费者的杀手级应用程序类别，”尤其是随着物联网的出现。她说，如果用户外出时可以受到监控，然后将他们的数据上传到他们的电子病历中，这将越来越有用。
虽然现在选择赢家和输家还为时过早，但马丁说，“苹果有自己的机会，因为他们通过实体店拥有了这个强大的分销网络。因此，当您走进商店购买 iPhone 时，他们可以推动手表。亚马逊可以将他们的健康设备与 Alexa [智能扬声器] 联系起来。”
不过，马丁并没有算上独立玩家，他很想看看 1 月份在拉斯维加斯举行的消费电子展上会出现什么（Covid 变体允许）。 “与市场上已有的公司相比，弄清楚新公司在做什么会很有趣，”她说。
确实，“你穿的是谁？”可能成为下一个应用于医疗保健的时尚公理。
What devices like Apple, Google smartwatches are beginning to display about our health
Fitness trackers from companies like Apple, Amazon, and Google are making a significant shift from being low-tech devices that counted steps to now becoming what's fashionable in personal health.
Tracking fitness and workout data for personal use or sharing with friends can be useful and fun. But there's an increasing interest in incorporating a wider range of medical data into the digital health ecosystem — piggybacking on the dramatic rise in remote telehealth services necessitated during the Covid-19 pandemic — making individuals' information accessible to physicians and hospitals as part of electronic medical health records.
The wearables market got moving more than a decade ago with basic fitness, workout, and sports-activity tracking devices. Now, nearly 30% of Americans now use a wearable health care device, many of which now have the capabilities to track, monitor and transmit data on heart rate and rhythm, blood pressure, body temperature, blood sugar levels, quality of sleep and even early warning signs of Covid-19 infection.
Fitbit helped launch the trend in 2009 with a clip-on gizmo that recorded the wearer's movements, sleep and calories. That model morphed into a wrist band, which over the years added more biosensors and Bluetooth connectivity for downloading data to smartphones. Google parent Alphabet acquired Fitbit for $2.1 billion in January.
Apple entered the space in 2015 with the debut of its Watch, since adding a bevy of health-related functions and apps and spawning a platform for third-party developers to create tools utilized not only by consumers but also health care organizations and researchers for accessing and analyzing data captured on their smartwatches. It has also aligned with fitness companies like Nike, Strava and Adidas to allow them to synchronize their activity apps to the watch. In 2020, the Apple Watch generated nearly $13 billion in sales, capturing 65% of the global smartwatch market by revenue, research firm Strategy Analytics estimates.
This burgeoning market has attracted other Big Tech players, including Amazon, maker of the Halo smart band, and Huawei, which unveiled its Watch 3 this year. There also are a variety of other smartwatch entrants from the consumer electronics realm, among them Samsung, Garmin and Withings.
In the pure-play category, Finnish startup Oura designed a ring embedded with biosensors for monitoring sleep, heart rate and body temperature. In May, the company announced a $100 million Series C investment round, bringing its total funding to more than $148 million. And Peloton is reportedly planning a digital heart rate armband.
The global market for wearable health and fitness devices — including sensor-laden watches, wrist bands, rings, skin patches, eyeglasses and clothing — reached more than $36 billion in 2020, according to Fortune Business Insights, and is projected to top $114 billion by 2028 at a CAGR of 15.4%. Deloitte Global predicts that the market segment just for smartwatches and smart patches will ship 320 million units worldwide in 2022, a figure likely to reach 440 million by 2024.
“There is significant money in this area from venture capital and private investment sources,” said Deloitte's Paul Silverglate, vice chair and U.S. technology sector leader.
Several medtech companies have introduced smart patches, penny-sized swaths that adhere to the skin and use microscopic needles that act as biosensors and deliver medications. BioIntelliSense, based in Redwood City, Calif., created the BioSticker, worn on the upper left chest for continuous monitoring and data capture of respiratory rate, heart rate at rest and skin temperature. Publicly owned Insulet, based in Acton, Massachusetts, has developed OmniPod, a patch that serves as an insulin pump.
Sensorized clothing has emerged, too. Montreal-based Hexoskin developed a line of smart shirts that collect cardiac, respiratory and activity data, and transmits it to an iOS or Android compatible device. The company partnered with the Canadian Space Agency on an extraterrestrial version, Astroskin, to track astronauts' vitals while rocketing out of this world.
Providing accurate data and information
Beyond the technological capabilities, there is now the critical issue of efficacy — of the devices, the apps that link to them and the petabytes of data generated — which is leading wearables makers to coordinate with independent researchers to see if they deliver as advertised.
Joshua Hagen, a research associate professor at The Ohio State University's Department of Integrated Systems Engineering, was studying biosensors more than a decade ago at the Air Force Research Labs “before wearables really exploded on the scene,” he said. Hagen then started testing devices on elite athletes, monitoring their performance data. “There's a ton of devices out there, but we have to first and foremost trust the data that's coming off of them,” he said.
Hagen has discovered that the part of the body where a device is worn matters. The Polar heart monitor chest strap, for instance, around since the early 1980s, “has been validated a thousand different ways.” And the wrist is good for measuring resting heart rate. “But fingers are a very interesting place,” he said, referring to his studies on the Oura ring. In one, it had the second-highest accuracy among the devices, with chest straps ranking first.
Another study, launched after Covid hit, found that by applying an algorithm to Oura user data, Hagen's team could identify early warning signs three days in advance of coronavirus infection. A separate proof-of-concept study, examining the efficacy of various wearables, showed they could detect the onset of fever, a pervasive symptom of Covid and other infections.
In November 2019, Apple partnered with research groups to launch three health studies using the Apple Watch. A women's health project, in conjunction with the Harvard School of Public Health and the National Institutes of Health, aims to advance the understanding of menstrual cycles and their relationship to various health conditions, including infertility, osteoporosis and menopausal transition. Apple's heart and movement study, with Brigham and Women's Hospital and the American Heart Association, is exploring how certain mobility signals and details about heart rate and rhythm could serve as potential early warning signs of atrial fibrillation, or Afib, heart disease or declining mobility.
How physicians might use the data
The ultimate scenario for health wearables envisions the general public donning smart devices, proven to be efficacious, that continuously download vital data to primary care providers who track patients in real-time, monitor their overall health and respond to any emergencies. To make that leap, however, physicians must be convinced that the devices work, patients use them properly and the data is reliable.
Toward that goal, the American Medical Association (AMA) conducted a survey of physicians to gauge their opinions on a variety of digital health tools, including wearables. More than 87% of respondents see at least some advantage in their usage overall, especially wearables and telehealth devices. Yet physicians also said there are “must-haves” that digital tools need in order to turn their enthusiasm into adoption, including improved efficiency and increased protection of patients' data privacy and security. “Physician enthusiasm for technology is directly tied to a solution's ability to help them take better care of patients,” said Meg Barron, AMA digital health strategy vice president.
For marketers, the most critical factor will be whether people actually buy and use wearables. “Health is a killer app category for consumers,” especially as the internet of things emerges, said Lauren Martin, senior internet and media analyst at Needham & Company. It will be increasingly helpful if users can be monitored when they're out of the house, she said, and then have their data uploaded to their electronic medical record.
And while it remains too early to pick winners and losers, Martin said, “Apple has a play because they've got this great distribution network through its physical stores. So they can push the Watch when you walk into the store to buy an iPhone. Amazon can tie their health devices into Alexa [smart speakers].”
Martin is not counting out standalone players, though, and is anxious to see what emerges at January's Consumer Electronics Show in Las Vegas (Covid variants permitting). “It will be interesting to figure out what new companies are doing, compared to what's already in the marketplace,” she said.
Indeed, “Who are you wearing?” may become the next fashion axiom applied to health care.
