March 01, 2015

Road Warrior: Health and the Road Warrior

Jeffrey Allen

I think this issue represents a good time to take a look at some of the health-oriented mobile technology out and coming out, including some of the wearable technology that can help you keep track of health issues on the road and at home. In keeping with the new trend to make up words with stray letters in front of them to refer to a new evolution in technology, the mobile health technology industry now has its own term: mHealth (the “m” stands for “mobile”).

mHealth Devices and Apps

The evolution of mHealth has attached itself to our telephones and tablets in the form of a plethora of apps that work to track your activities or sometimes simply accept and record information and transfer it to a storage facility in the cloud. Our computers have programs to accomplish the same thing. In addition, we have a number of relatively compact measuring devices that sync with Bluetooth, near field communication (NFC), WiFi, or sometimes a wired connection to computers, tablets, or smartphones and consolidate information in the cloud. We also have a whole wing of wearable technology that will record information about the state of our health, the amount of our activity, the intensity of our activity, and how long and how soundly we slept. Some of the devices and software simply link to storage to save information for our personal use. Some will facilitate your doctor’s use of this information by actually linking directly to your doctor’s computer or to a cloud storage database that your doctor can access.

When I went to the Consumer Electronics Show this year, the wearable mHealth tech devices on display represented a large piece of the show, much more than in times gone by, evidencing the continuing and rapid growth of this segment of the market. There is even a rumor that the soon-to-be-released Apple Watch will have the ability to measure and track blood sugar using a new testing technology that will surely win the hearts of diabetics and pre-diabetics as it supposedly will use an incredibly small device to take a very small blood sample for measurement.

You can even get small, very portable, battery-powered transcutaneous electrical nerve stimulation (TENS) units to provide muscle massage to help relax you, relieve nerve-based pain, and treat sore muscles while you travel on planes, trains, and automobiles or rest in your hotel room (or elsewhere). Speaking of planes, trains, and, particularly, automobiles, you can also get very small (pocket-sized) breathalyzers to tell you, as you leave the dinner or party, whether you should call a cab and pick up your car in the morning. Although not directly a health product, if it helps keep you out of a car wreck, it might save you a lot of pain and suffering. Even if you do not consider yourself a heavy drinker, having one of these in your car (or your pocket) when you go out makes a lot of sense and might save you a lot of dollars by helping you avoid a DUI prosecution.

Some of these devices travel in stealth mode under your clothing; others you wear more visibly, sometimes even as jewelry. As with everything tech, companies have jumped on the bandwagon, and many more will likely jump on before it reaches top speed. In truth some of them have released products that should probably not have come out yet (or ever), but many of the products work well and provide a useful and helpful (to say nothing of healthful) functionality.

A variety of testing devices has come onto the market designed to link portable devices to measuring devices to databases online or on the device. This structure, while perhaps appearing superficially cumbersome, actually works fairly well. It requires you to pair the measuring device to your mobile device and sometimes requires you to set up an account online to access the stored information (sometimes it resides on your device). Once you have it set up, all you need to do is perform the measurement, and the software and hardware do the rest. Examples of the types of measurements available include, inter alia, blood glucose, blood pressure, weight, pulse rate, and oxygen levels. You can get connected to record all this information and more. Note that in many cases you can avoid buying the vendor’s hardware and manually record the information, but you can get hardware that will automatically transmit the data from the device to your mobile unit, which is much more convenient than doing it manually.

Fitness and Weight Control

Each of us has different health needs and concerns, but we can group ourselves into rough classifications that may help us focus on the mHealth tech we will most likely find useful.

The largest group of users will likely consist of those who want to focus on tracking their activities and calories to assist them in weight control and/or fitness training. Whether you want to lose weight, gain weight, or maintain your current weight, monitoring and tracking the quantity of calories consumed as well as the efforts expended and the calories burned during the day can help you succeed. The three best-known vendors of devices to do this recently became two as the folks at Jawbone (maker of the Up devices) bought the BodyMedia company and appear to be engaged in the process of phasing out all the BodyMedia units. I used a BodyMedia unit for several years and will be sorry to see it go as I think that the BodyMedia devices and software made a very useful package.

The two surviving companies vying for king of the hill, Jawbone (jawbone.com) and Fitbit (fitbit.com), are in the process of upgrading their hardware. Fitbit has already brought out some new devices (such as the Charge) and anticipates releasing the Surge (expected in April). Jawbone has not released any new models recently but has announced the impending release of the Up3 (also expected in April).

Jawbone’s Up3 will cost $179.99 and will come in black or silver. The Up3 charges through a USB connection and holds about a seven-day charge. It tracks activities, calories burned, steps/distance traveled, sleep, and your heart rate, and the accompanying app will help you keep track of your calorie consumption. While the Up3 has no display and does not tell time, you can use it to set alarms that vibrate when the alarm time arrives. You can sync it to most computers, tablets, and smartphones.

The Up3 will supersede the Up24 ($129.99) as the top of the Jawbone line when it ships. The Up24 provides most of the features of the Up3, but Jawbone describes the Up3 as water resistant to ten meters and the Up24 as merely “splash proof.” Other differences: You need to spring for the Up3 to get the advanced sleep mode and heart-rate monitoring.

Fitbit’s Charge ($129.95) does pretty much the same thing as the Up3 but also has a display and provides the time for you. In addition to steps taken, it also keeps track of how many stairs you climb in any given day. The Surge ($249.95) provides all the features of the Charge but with a larger display that contains more information, plus continuous heart-rate monitoring, caller ID, music control, and GPS tracking. You can pre-order the Surge now, with expected delivery around April.

For the record, while I do not consider any of these devices completely accurate, I do consider them useful. My distrust of their accuracy comes from the fact that I have worn two or three of them at one time and received (sometimes significantly) different information from them. One might say I walked 4,500 steps and another gives me 5,000 or 6,000 steps. One might say I slept for 6 hours while another says only 4.5. Simply put, I view them as giving me some useful feedback that I accept as guidance as to how I am doing. The devices do tend to be internally consistent, so if one says I walked 4,500 steps and then the next day I walk the same distance again while wearing it, it will come up with about 4,500 steps again. On the flip side of the coin, I find that the process of keeping track of what I eat helps keep me from overeating. Again, most of the time you need to look at the calories assigned to food by the accompanying software as estimates only because the recipe or serving size may not match exactly (your normal serving may be my large serving). But it still helps to keep track of how you are doing. Oh, and don’t fudge in what you record; you are only tricking yourself. If you eat two ounces of chocolate and record only one, your records will show a lower amount of calories than if you report two. Your body, however, responds to what you actually put into it, not what you write down, so you will still have to deal with the consequences of that second helping you ignored.

There are many other devices available that can track your activities and monitor your body (heart rate, pulse, etc.) during a workout to give you some information about your status and the effectiveness of your workout.

Apple Watch Rumors

It remains to be seen what the Apple Watch will offer and whether it fits in the mHealth category or not. As usual, rumors abound, but that seems to be how Apple likes to see things go. There are rumors that the Apple Watch will come with several built-in health apps and the ability to measure such things as distance moved, workout intensity, heart rate, and blood glucose level, to list those that I have heard most about. You can find descriptions of all but one of these functions (blood-glucose monitoring) on the Apple website (apple.com), so you can consider them pretty reliable prognostications. I don’t like writing about technology that has not yet been released, particularly Apple products as Apple tends to remain secretive and let the rumor mills churn up public interest and discussion. Accordingly, I won’t say anything more about the Apple Watch here. I will write more about it after I have one in my hot little hands (or around my wrist).

Sleep Aid and Monitoring

If you suffer from sleep apnea, you can get apps that will give you some feedback about how long you slept, how deeply you slept, and how often you woke up during the night.

If you have issues falling asleep, you can get any number of apps designed to help you fall asleep at home or on the road. Some of them simply provide “white” noise to blank out other and more offensive sounds. Others provide tones designed to lull your brain into various states of relaxation. These apps travel on a two-way street, however, and you can also get apps that generate music, sounds, and tones intended to help you wake up or energize you or focus your powers of concentration. You have the choice of playing these apps using headphones, an external speaker, or the speakers built into your device. I strongly prefer (and recommend) using headphones, especially wireless headphones, for this purpose. The quality of the sound of a good set of wireless headphones promotes the effectiveness of the sounds generated by the app and also helps insulate you from external noises and distractions. The absence of wires makes the device much easier and more comfortable to wear as you relax and fall asleep because you do not get tangled up in the wires if you move. A good set of lightweight headphones travels nicely and is less likely to prove bothersome as you try to sleep. I have found that they do not create problems for me.

A relatively new evolution in the app world respecting these sounds is the binaural sound–generating app. If you go to the iTunes App Store (apple.com) or the Android Play Store (play.google.com) and search for “binaural,” you will find a great many binaural apps, some of which are available free and others that cost varying amounts of money. Get some and try them out with a good set of headphones. You may find the results refreshing.

Mental Fitness

While we are on the subject of your brain, I do want to make sure you know about the Fit Brains products, a series of apps from Rosetta Stone (the language-training people) for use on various portable devices. You can get them from the iTunes App Store or Android Play Store (search for “fit brains,” or go to fitbrains.com to get more information). You will need to set up a free account to use the apps. To get the full benefit from the apps, you will need to buy a subscription, which will keep track of how well you do in the various games and exercises. You can access the programs from any Internet-connected computer or from a tablet or smartphone with one or more of the Fit Brains apps. Even if you only use the free account, it is a good way to help keep your mind sharp at any age.

Hearing Aids

One other thing that I will mention is that, in the last few years, hearing aid manufacturers have started to release models of their products that tie to mobile phones, using them as control devices to set or modify programs. The most frequent pairings I have seen are via iPhone apps, but several companies have also released Android apps. I have located such apps for models in the Starkey (starkey.com), Seimans (usa.siemens.com), and Resound (gnresound.com) product lines. Depending on the manufacturer and the model, some of these apps allow you to use hearing aids to answer and make calls on your connected smartphone.

While this column does not cover the waterfront, it should whet your appetite and give you a basic idea of the scope of health-related tech available to those interested in using it.

Jeffrey Allen

Jeffrey Allen (jallenlawtekblog.com) is the principal in the law firm of Graves & Allen in Oakland, California, Editor-in-Chief of GPSolo magazine and GPSolo eReport, and a member of the Board of Editors of Experience magazine.