Earlier this semester I had been interested by the mobile frontier of Quantified Self and I had read Brian Leavitt’s post questioning if Apple had taken quantified self to an overwhelming limit by including EKG and noise detection technology in the Series 6 watches. He asked if having access to this data will actually have a net benefit– meaning will it help those who actually need it or will it just cause harm and worry for those who don’t need it but are afraid of not having it– and at what point are we tracking too much?
I have a Series 6 Apple Watch. I also happen to have asthma and a variety of food intolerances, that I am still struggling to get to the bottom of. So, for me, the point at which tracking becomes “too much” may be vastly different than it is for someone else. As someone with asthma, this past year has been frightening and exhausting, but my wearable tech has actually made this whole experience better. Why? Utilizing the quantified self capabilities of the Apple Watch and other apps I could actually monitor the impact of my asthma and food intolerances. For example, I could utilize my Apple Watch to determine and track my blood oxygen levels, resting and active heart rates, and my VO2 max when running or biking. On days when my readings seemed lower than usual I compare with historical data and use apps like the Weather Channel app to track air quality and pollen count levels which can influence asthma. Plus, as Mel explained, Apple now utilized contact tracing technologies to notify you if you had come into close contact with someone who tested positive for COVID-19. I remained mostly unworried about if my difficulty breathing on any random day was due to COVID-19 or not because I had so much personal quantified data from which I could make that determination myself.
Similarly, as anyone with unidentified food intolerance likely understands, the process of eliminating and reintroducing foods to determine which one is a trigger food is extremely frustrating. One app was recommended to me by my health provider called the Monash University FODMAP app. The FODMAP diet is frequently recommended to people with a variety of gastrointestinal issues to determine if food is a primary trigger for symptoms. For more information about FODMAPs and the FODMAP diet visit Monash University’s website.
When it comes to health it can be very difficult to find reliable and consistent information about how to treat and manage something as widespread as gastrointestinal issues like irritable bowel disease (IBD), irritable bowel syndrome (IBS), Crohn’s disease, and ulcerative colitis. Mobile technology and apps like this can make this process easier by providing evidence-based processes to support people in their elimination and reintroduction diet phases, and in educating them about FODMAPs–fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are short chain carbohydrates that are poorly absorbed in the small intestine and are prone to absorb water and ferment in the colon. In doing so it allows individuals who otherwise wouldn’t be able to access or contact a nutritionist or dietician to still conduct the FODMAP diet and better determine their food triggers, if any. The app provides introductory lessons, step-by-step guides, a symptom tracker and diary, shopping guides for certified low FODMAP foods, and traffic light system for identifying foods with FODMAPs. Of equal importance, in being a mobile app, the immediate and portable affordances of this technology mean users don’t have to struggle to memorize each and every food they can and can’t have and can keep track of their food data, GI symptoms, and notes all in one place.
Again, for the average person this level of tracking and self quantification may seem overboard and unnecessary, but for those who can benefit from it without feeling overwhelmed it is of great help.
Are there other health tracking apps or quantified self technologies you have found helpful throughout life or specifically during COVID?
In my opinion, health trackers apps are a good example of a learning path. They provide a lot of information, but you focus only on the aspects that interest you to accomplish your goals. This information helps you become aware of the gaps you have to fill or reflect on the changes you have to make. It is at the same time an essay/error practice until you get to know better the responses of your body to those changes or the habits you have. Then, you start to understand the process, and you become more autonomous and more unconscious of your actions. During this process, you can share information with your closest ones or maybe participate in a community to support your objectives, keep on track and learn from others’ experiences. The experience evolves, but you will finally notice that no solution fits all. Everyone has to live their own process. Health trackers are definitely useful in real life. However, I think the weaknesses of those trackers are that people do not fully understand the value of the information, or they are not able to target the critical data for changes. It would be nice that those apps were more popular among health professionals and schools to help users better understand the data they provide and how those data correspond to individual needs. Thinking of educational environments, teachers need to understand data and how to use it before providing support to learners.
Hi Deisy,
I concur with this; understanding the data was certainly my biggest obstacle when using health tracker apps. Even though I certainly do not believe that we all should be data scientists, but I honestly think that everyone should get educated to some extent on what data is and how to work with data. For instance, for the longest time, I would get data downloads on macro and micronutrients, but could not understand what they corresponded to, and what they correlated with. It took me months before I understood how my health is connected to this data and my ultimate goal.
Thank you Deisy, good post; got me thinking.
Saeid
Hi Dana,
I enjoyed reading this post; thank you for this.
As someone who has lost well over 90 pounds after getting to know the concept of Quantified Self, I can totally relate to this post. As I mentioned in one of my earlier posts; self-tracking using mobile devices and technologies functioned as a mirror for me. QS helped me monitor, measure, and self-reflect on how my body and brain functioned while tracking all the micro/macro data. Having said this, I agree with your observation; I did not necessary enjoy/needed seeing all the details in this mirror (sometimes was overwhelming), but they were merely a reflection of my own condition and were required for understanding the bigger picture.
In other words, the datafication/quantification could appear to be overwhelming at first. However, if we don’t lose sight of our vision (of why we started), it can actually be quite beneficial. Philip has a good point, greater self-control was certainly visible in my journey using smartwatches, and I felt like personal analytics facilitated my understanding of what human-computer interaction really meant.
Brian Leavitt certainly has some good points in his post, however I think the two (2) important elements of digital alerts are 1) the constant monitoring abilities 2) the increased engagement with health care system as a preventative measure. In 2019, a large-scale study (419,297 participants over 8 months) examined the smartwatch ability to identify Atrial Fibrillation and the results showed that “that 76% of notified participants [over 318,000 people] who returned a survey contacted either the telemedicine provider” or “actively sought medical attention” as a result of such close/detailed monitoring (Perez et al., 2019, para 31).
References:
Perez, M. V., Mahaffey, K. W., Hedlin, H., Rumsfeld, J. S., Garcia, A., Ferris, T., . . . Turakhia, M. P. (2019). Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation. New England Journal of Medicine, 381(20), 1909-1917. doi:10.1056/nejmoa1901183
Hi Dana,
this was a very interesting post. wearable and non-invasive tech that can monitor and improve your health can be very impowering. I also found what your reference to Brian Leavitt’s post questioning if having access to this data will actually have a net benefit. So I did a quick search and turned up the following paper which addresses issues that parallel what you and Brain mention.
Baker (2020) discusses the ironies of the quantified self. After all with automation there is an expectation of set and forget. However, like any technology or tool there is a certain amount of “learning” that must take place for the user and the device, these are the growing pains of technology. Perhaps as time goes by, wearable technology will become more intuitive and the process of “getting to know you” will happen more readily through less labored feedback loops
Baker refers to Bainbridge’s “Ironies of Automation” which was written about 30 years ago.
Baker’ paper covers the four ironies with respect to sensor driven self-quantification (wearables for example):
(1) know more, know better versus no more, no better
(2) greater self-control versus greater social control
(3) well-being versus never being well enough
(4) more choice versus erosion of choice
Needless to say, it is a very interesting area of research although originally germane to health professional. We are seeing health care become a more independent and self centered enterprise.
What are some examples of how the Apple watch, fitbit or other wearables have demonstrated one or more of these ironies?
Bainbridge, L. (1983). Ironies of automation. Automatica (Oxford), 19(6), 775-779. https://doi.org/10.1016/0005-1098(83)90046-8
Baker, D. A. (2020). Four ironies of self-quantification: Wearable technologies and the quantified self. Science and Engineering Ethics, 26(3), 1477-1498.
Phillip,
What a great and insightful response! Baker certainly sums up many of the things I have personally observed about self-quantification, but put it in better terms than I could have. I especially found the irony of greater self-control versus greater social control quite interesting. I know with my Apple Watch I can track Move (active calories), Exercise (in minutes), and Stand (if I stood for at least 1 minute per hour). While these rings were motivating to some degree when it was only me viewing them, the ability to share my activity information (which I started doing last month) has led me to have the longest streak of perfect activity that I have ever had since getting the watch 3 years ago. I would say in large part it is because it struck a nerve of not wanting to be outcompeted by my friends who also shared their information with me, and also not wanting to be shamed for being “imperfect”. A dual edged sword indeed…
Thanks again for sharing!
Wearable tech and health tracking is an area with so much exciting potential. One branch where there is developing technology is with Diabetes and insulin pumps and blood sugar tracking. Insulin pumps and wearable monitors were lifechanging for many people with Type 1 Diabetes; the next phase in this will be the development and improvement of wireless mobile tracking and adjusting. Studies have shown potential improved blood sugar control (https://www.reuters.com/article/us-health-diabetes-apps-idUSKCN1PN32D) with this type of technology, although it is not widely available in approved versions. There appears to be a movement towards DIY (“do it your self artificial pancreas” https://link.springer.com/article/10.1007/s13300-020-00823-z) and hopefully there will be sophisticated approved (AI) versions that become available in the near future. This could be another huge step towards improved quality of life for people requiring insulin for blood sugar control.
References:
Carroll, L. (2019.) Experimental phone app works with insulin pumps to control diabetes. Retrieved from https://www.reuters.com/article/us-health-diabetes-apps-idUSKCN1PN32D
Kesavadev, J., Srinivasan, S., Saboo, B. et al. The do-it-yourself artificial pancreas: A comprehensive review. Diabetes Ther 11, 1217–1235 (2020). https://doi.org/10.1007/s13300-020-00823-z
Janice,
Woah! How funny that you mention that- I actually just saw an advertisement last night for one of those wearable monitors. Thanks for linking the articles! I am glad to know that the population that can benefit from wearable tech and quantified self capabiliites is expanding.
Thanks Dana! Will try it out!
I agree with you that Apps that help provide reminders of keeping a healthy lifestyle is very helpful.
Thank you for the info Dana. The fact that mobile technology such as this is available to us on our mobile devices can help increase access of information and streamline the process of identifying food triggers. My healthcare provided recommended a similar app to this one called “Fast FODMAP Lookup & Learn” which may not have as many features but it is free to download.
Erin,
Ooh, thank you for the recommendation. I will be sure to check that out!
Hi Dana, thanks for sharing this. I think any app that helps to remind us of our state of health is a good step towards leading a healthy life. I personally don’t use any health tracking apps, but my WeChat tracks how many steps I walk everyday, and at the end of the day it sends me a number at the end of the day. You can even see how many steps you took in comparison with your friends, to motivate you to do more. Even though it doesn’t give you a very accurate track (if you don’t bring your phone with you when walking then nothing gets tracked), I still think it’s a good reminder at the end of the day to make me rethink about my choices of the day.
Emily,
The social side of these health trackers is a whole other topic, and a very interesting one! With Apple Watches you can share your activity information with friends, have competitions between friends to see who can rack up the most points, etc… My friends and I have started doing that to add more external motivation to our workouts. Accuracy, of course, with any kind of tracker is always of concern, but that is also why I think it it important to take everything with a grain of salt. Even if my Apple Watch is inaccurate, as long as it is consistently inaccurate it still helps me gauge my asthma, activity levels, etc. You might like a mobile game called Walkr, which is a mobile game my group and I discussed in our A2 last week. It lets you track steps and distance as you walk while also virtually explore galaxies and travel the universe with friends!