Health tech is coming for your bladder

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My first health tech device was the original Fitbit. The tiny Zip could be clipped to your waistband or slipped in a pocket and tracked steps. That’s all I wanted – a nudge to get me to that coveted number. I had it for years.

And then, eventually, I got a fancier Fitbit, a watch that tracked my steps as well as my sleep, which was great because at the time I was having trouble sleeping. Every morning, the first thing I would do was sync my watch to the app on my phone to see how many hours of light, deep and REM sleep I managed. I got a smart scale that delivered a spectrum of data from my body mass index to my metabolic age. I don’t actually know the definition of “metabolic age,” but I do know that I don’t like when it’s higher than my actual age.

Now I have an Apple Watch. It tracks, among other things, steps, exercise and sleep. It tracks my temperature, which syncs with its menstrual-cycle tracking capabilities. I can use it to remind me to take medication, or run an impromptu electrocardiogram to check my heart’s rhythm, and to check blood oxygen levels.

Tech creep, gadget creep, data creep, all of the above? Whatever you want to call it, there are more opportunities coming to use technology to track our health, and ostensibly improve it. Will any of it actually help us is another question entirely.

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GO GO GADGETS

At the 2023 Consumer Electronics Show, a number of personal health-related devices were unveiled. Personal health technology is no longer limited to a wrist watch or smart scale – it’s making its way into every part of our homes and monitoring other parts of our bodies.

Japanese company Yukai Engineering launched Fufuly, a “breathing cushion” which vibrates at a frequency that, when cradled or hugged, will cue the user’s breathing to sync with it and calm it down. LG launched its MoodUP fridge, which has illuminated doors that change colour. Users can select from among 22 shades, depending on how they’re feeling: “Using the tones and hues of nature, ‘Season’ represents different times of year, while ‘Mood’ elicits a feeling of well-being through the use of soft, soothing colours,” the company states in a press release. Users can opt for a cool blue for winter, warm peach for summer, or bold red and purple when they’re feeling happy or energetic.

And French company Withings launched U-Scan, a device that sits in a toilet bowl and analyses the user’s urine, sending that data to an app on their phone. Among other things, it delivers information about hydration, hormone and pH levels. “Easy as one, two, pee,” they say in a media release. U-Scan was not the only urine-tracking tech unveiled at the show.

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Consumer appetite for wellness-related products, tech included, is booming, according to a 2022 report of the American market from research consultancy McKinsey. People are looking for better overall health, fitness, nutrition, sleep, mindfulness and appearance, and they’re looking for products and services that can tackle multiple issues at once – such as the Apple watch.

Anna Pione is a partner at McKinsey and one of the authors of that report. “A trend we’ve seen in our research is an increasing desire for personalization,” she says. “I think the smartwatches and smart wearables really are at the forefront of that in terms of what they’re able to offer.” And she points to at-home diagnostics as an emerging category that delivers that personalization. “It’s not just urine analysis; there is microbiome analysis, different types of blood analysis or saliva analysis,” Pione says, pointing out that, for Americans, this is one way they can cut down on health care costs.

Withings, which makes smart watches, scales, sleep monitors, blood pressure monitors and thermometers, has been developing U-Scan for four years, and will be bringing it to market, in Europe first, later this year. The device looks like something that would be at home in an Apple store, a sleek white oval gadget that hangs in a toilet bowl.

The company started looking into this tech after they received a request from a customer, says Julius Dewavrin, U-Scan’s product manager. “Urine is an amazing and wealthy source of health information about what you eat, but also your metabolism,” he says. “It’s also a rich source of information to detect and monitor chronic disease.”

The device holds a cartridge that will monitor nutrition markers and hormonal fluctuations related to menstrual cycles, targeted at women, or hydration and nutrition markers, meant for everyone. The data, delivered to the user via an app, includes vitamin C levels, ketones (related to metabolism), pH levels and hydration. Dewavrin says a “key block of the product development” was providing education in the app so that users could read and understand the data being provided. It’s easy to understand movement minutes, ketone levels not so much. And more than 100 data points are analyzed by the device.

But if medical professionals aren’t asking us to track our data, how useful this tech is ultimately relies on individuals knowing how to interpret what they’re tracking and setting boundaries so they don’t become addicted to it.

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DROWNING IN DATA?

Acclaimed business consultant Peter Drucker, whose theories on management are the foundation for how today’s corporations operate, is known for saying, “What gets measured get managed,” but his complete statement turns the meaning of that phrase on its head: “What gets measured gets managed – even when it’s pointless to measure and manage it, and even if it harms the purpose of the organization to do so.”

Swap person for organization, and this is one of the red flags Tim Caulfield raises about this increasingly personal health tech. “It seems intuitively appealing that more data about yourself will equal better health, and the reality is that’s not always true,” says the law and health policy professor at the University of Alberta. “Almost all of these devices have at their core that somehow having that data is going to help in your health decisions, when there’s very little evidence to support that conclusion.”

Whether these devices work or not really depends on the user’s understanding of the information given to them and their dedication to using them. “You’re going to get this information, and you’re going to change your behaviour. But unless that happens, the device isn’t working, right?” Caulfield says.

Another concern is that these devices can make activities less enjoyable because they’re being quantified. Medical researchers at Rush University and Northwestern University coined the term orthosomnia to describe people who have an unhealthy obsession with getting the “perfect sleep” owing to data tracking (a.k.a. data-driven insomnia).

Being saturated with data can lead to overtreatment or diagnostic cascade, Caulfield explains. “All of a sudden you’re worried about something that isn’t likely to have a health outcome, but you start investigating it and it becomes anxiety provoking.” An unfortunate side effect of this, he adds, is that this may cause patients to request their doctor run unnecessary tests, putting strain on the health care system.

And in some instances, using this tech on an exploratory basis is inhibiting those who rely on it for serious health issues. McKinsey’s Pione identifies continuous glucose monitors as a segment of the health tech industry that could see a lot of growth in the near future. “Especially when you go beyond the ones that were designed for Type 2 diabetics. Now you’re seeing ones on the market that are much more around helping athletes or consumers optimize their own performance,” she says.

Caroline Lock, a social worker and therapist in Toronto, was diagnosed with Type 1 diabetes in November, 2021. Since then, she has been wearing a glucose monitor, something she gets from a pharmacy. For someone with diabetes, “it’s a requirement for life,” she says.

“It’s become a trendy thing for influencers to wear one and report on the ways that different foods affect their blood sugar, but they have no understanding of it,” Lock says. “There are places in which people can’t get these devices, which are life saving, because Joe TikTok wants to show everybody that oatmeal raises your blood sugar and bacon and eggs don’t and so bacon and eggs are a healthier breakfast than oatmeal.”

Thanks to the monitor, Lock says she’s “intimately familiar” with what various foods to do her insulin levels. “So I’m watching this person totally misunderstand the results. He’s also forgetting that he has a functioning pancreas. This is for people who don’t have a functioning pancreas and so they’re manually giving themselves insulin. He doesn’t realize his body’s doing work for him,” she says.

For the average user, none of this technology is essential to what’s needed to live a healthy life: not smoking, drinking in moderation, eating a balanced diet rich in fruit, vegetable and whole grains, daily movement, being part of a community.

Caulfield himself used to be an avid user of tech devices to track fitness. “I used to be that person that monitors everything. On my bike I had everything – my cadence, my speed, my power. I kept little diaries of my activity. I don’t do any of that any more,” he says. “Now I just try to enjoy the pleasure of exercising.” Though he understands that everyone is different and some users will find value in the motivation these tools provide.

“Less data. More living,” Caulfield wrote to me in an e-mail when we were arranging a time to talk. I hear what he’s saying, I do. But I still want to get my steps in, and make sure I’m sleeping okay, and watch my heart beat on occasion …

And I won’t get stressed out about it. Probably.