Welcome to the post-COVID wearables world

This week, Amazon launched a new wearable device and service, while Fitbit tweaked its product offering to include the Sense, a device designed to offer health monitoring as opposed to simple activity tracking. The launch of both devices has me wondering whether this is an inflection point for wearables, one that will allow them to become the first and most personal link in our health care delivery system. Conversely, I’m wondering if they will fail to make the leap and instead remain a fad for those focused on their health and wellness.

In short, will COVID-19 do for our health interactions what Amazon’s Alexa did for our control of connected smart home products? In five years, are we going to look back at the delivery of health care and see that it started with an earbud, a smartwatch, or a wrist strap? This is the future that Amazon and Fitbit are betting on with their new products, and the future that Apple, Samsung, and others are hoping to make real.

There are three trends here, and only one of them has to do with the pandemic. The first is a new focus on wellness and preventative health. The second is a focus on personalization that’s rooted in individual health data and decisions. And the third is a change in the delivery of health care that has been a long time in the making, but thanks to COVID-19 is rapidly occurring.

The focus on wellness has been happening for a long time. As far back 2014, I was wearing activity trackers and even a device that tracked my respiration to determine whether or not I was stressed. Companies at that time were also building sensors to track sleep quality that fit under mattresses or could be placed next to a bed. The hope was that technology and data could help all of us lead healthier lives.

As time passed, the sensors multiplied, the algorithms got better, and the regulatory bodies got involved. Now the medical research community is starting to come around to the potential benefits of using these devices, and is testing them for accuracy and clinical relevance. Such testing will determine whether a consumer wearable device becomes a gateway to our personalized health care or just another faddish gadget.

Most of these devices aren’t formally validated today, and the studies that show some of them can predict COVID a day or two ahead of symptoms onset, while good PR, aren’t medically useful yet. To get to that point, we need to create a bridge between these devices and actual health care.

I’ve covered companies that are trying to create that bridge, such as Elektra Labs and Glooko. Big-name consumer companies such as Apple, Samsung, and even Fitbit are also working toward it with FDA-approved products. Apple’s HealthKit, a framework for taking in device data and storing medical records, is one such effort. But these firms have to get doctors on board.

We also see companies building products designed to send data to health care providers, effectively acting as proxies for in-clinic visits. Bodyport, which is building a scale that tracks heart health, is one. NuvoAir, which is building a connected spirometer to send lung health data for COPD patients to doctors, is another. When building these products, the target audience is comprised of medical professionals who want devices that send clinically validated data and offer a product that a doctor can prescribe to a user. Which means developers are building both for doctors and consumers. This is tough.

And despite the hype, none of the big tech brands are really there yet. I can’t get a COVID-19 test in my home state based solely on data from my Fitbit; I need to have recognizable symptoms. There’s also a legitimate question about privacy related to these devices. Andy Coravos, the co-founder and CEO of Elektra Labs, once told me that personalized medicine is just a fancy name for constant surveillance. She’s right.

These devices will know so much about us that the thought of them in the hands of a consumer tech company that isn’t really subject to laws that protect our privacy is chilling. Mark Rolston, the founder, and chief creative officer at Argodesign, says the issue around privacy is that the better these devices become, the less you want to use them because they become frighteningly knowledgeable about you on a personal level.

With the Halo, Amazon is really pushing user trust to the limit. The device, which costs $99.99 and also requires a subscription fee of $3.99 a month for the advanced features, tracks heart rate, steps, and body composition. But it also tracks your emotions based on your tone of voice. To be clear, users have to opt into the feature, and it isn’t always listening. Instead, it is an intermittent check on the wearer’s emotional state that gets reported back to the user. Basically, it has the potential to become a giant pool of training data so Amazon’s Alexa can gain some emotional intelligence. This may seem far-fetched, but there are plenty of research studies showing that computers can use voice to detect diseases and even mental health.

Fitbit’s device doesn’t introduce an entirely new data point, instead relying on upgraded sensors to offer more accurate and clinically validated insights about heart health, recovery, and more. A cynic might look at these options, plus other options such as the Whoop band — which is an activity and recovery tracker that also requires a subscription — as ways to create a recurring revenue model. Because to get the best insights you have to pay a monthly fee.

But I think the long game is to deliver enough data to a digital assistant so it can become the starting point for health care delivery. In other words, letting the wearer know when to make a doctor’s appointment or providing a historical picture of their health at annual physicals — even during emergency events or illness.

COVID-19 and a desire to avoid in-person health care will accelerate demand for this data. But in order to ensure these devices and their algorithms aren’t just digital snake oil, we’ll need to validate them, get regulators and doctors on board, and convince consumers that the data produced by these devices will be governed by strict privacy laws. Otherwise, it’s just a device and one that many will be able to do without.

Updated: This story was updated on August 31 to correct how Amazon handles Halo’s emotion-detection. Amazon will not have access to the voice recordings. They will be deleted from the band once the band syncs with the phone, and the recordings are not sent to the cloud.