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Mobile and Wearables for Health, Wellness and Optimal Living Manifesto Draft V1.2

Lee S Dryburgh
Email @leedryburgh LinkedIn

The first draft manifesto has been marginally updated (please see the original for an introductory cover letter). All changes herein were made to improve the readability of the text. No technical changes were made.

Already in the pipeline is another version with technical changes 1) clarifying how insurance incentivizes are often not aligned with the long-term health of the individual 2) clarification that Hyper Wellbeing is not in opposition to healthcare but is in fact a compliment – it simply stretches the doctor-patient relation across a wider span of time (it gets people communicating with their doctors sooner and more closely) 3) clarification that Hyper Wellbeing does not conflict with the overall scope of the way medicine is practiced – it’s simply incomplete and can get involved in people’s lives earlier and it can aim for a heightened state of wellness – this is going to happen and is happening whether healthcare likes it or not.

“I believe Lee’s Hyper Wellbeing vision is as profound and prophetic as, say, those offered in the 1960s with the rise of cyberspace and hypertext.” — Martin Geddes

Technology

  1. Technology innovation the past two decades has had negligible impact on wellbeing.
  2. Computing in the form of mobile, wearables and sensors is integrating with the human being. It is becoming an extension of our physicality ushering in the “third computing revolution”.
  3. Machine intelligence will rise rapidly over the coming decade and will fundamentally alter how we relate to each other and our socio-cultural environment in ways we cannot predict today.

Global Health

  1. Diseases resulting from lifestyle choices are now the leading global cause of death, a position formerly held by bacterial and viral infections. Non-communicable diseases, the four main types being cardiovascular diseases, cancers, diabetes and chronic lung diseases, accounted for 68% of global deaths in 2012. This was up from 63% in 2008 and 60% in 2000.
  2. In California 55% of adults have prediabetes or diabetes. Diabetes has almost quadrupled since 1980 affecting 8.5% of adults worldwide. Yet “diabetes is the kind of disease you can see coming from miles away”.
  3. Only 2.7 % of the U.S. adult population has a basic healthy lifestyle, which includes exercising regularly, eating a balanced diet, avoiding smoking, and maintaining a normal body fat percentage.

Healthcare Industry

  1. Traditional healthcare oscillates between being reactive and passive in that it waits for us to get sick first before intervening. Thus it more properly dubbed “sick care”.
  2. The interests of its stakeholders, which includes patients, providers and payers, are misaligned. For example, payers, the insurer or employer, have little interest in a lifetime (or even three or four years’) preventative focus as benefits would likely accrue to a competitor.
  3. There are many structural incentives that are not aligned with the long-term health of individuals. For example, while the provider is often  motivated to do as much work as possible and subsequently bill the insurer as  high as possible, the insurer is incentivized to pay more claims.
  4. The U.S. healthcare industry costs 18% of GDP ($2.9 trillion in 2015) with 88% of it being spent on preventable diseases. These costs are predicted to rise to 21% of GDP by 2021.
  5. Public health won major achievements, such as immunizations, antibiotics and vaccines, during the 20th century. Today, however, our most pressing health issues are caused by the lifelong, daily dynamic interplay among our genetics, environment, and lifestyle choices.

Mobile & Wearable Computing Industry

  1. Mobile in its current format is a mature industry. The “minutes, messages and megabytes” is no longer sufficiently valuable to be a core driver of future industry growth.
  2. The future of mobile and wearables is inseparable; they share a joint destiny.
  3. The number of peripherals and wearables that can use the smartphone as a central connectivity and processing hub will  continue to increase. The majority of these peripherals and wearable devices will be for the purposes of health and wellness.
  4. The “third generation” telephone (~ Android/iOS) relegated telephony and text messaging to the position of just being “apps” on a “pocket computer”. It also made mobile multi-sensor rather than just single sensor, e.g., in addition to the microphone, iPhone added a gyroscope, an accelerometer etc.  More and more built-in health sensors will be added in the future.  The “fourth generation” will consist of a “telephone” as hub with wearables and sensors distributed across the body. Calls and messaging will be “hardware-agnostic”, allowing them to move onto wearables without the need for a smartphone.
  5. We are being ever more “intimately known” as computing in the form of mobile and wearables moves closer to our bodies and into our lives giving meteoric rise to “intimate data”. Examples of “intimate data” include our physical and even sexual activities, motion and gestures, sleep and reproductive cycles, stress and energy levels, nutritional intake, and ever increasing physiological measurements. More recently intimate data has begun to record our emotions and the meaning of our conversations.
  6. The intimate data derived from the unfolding third computing revolution (see “Technology”) will be strongly complemented by a sharp increase in intimate data from private laboratory testing, which will chiefly include our genetic and microbiome sequences.

New Health, Wellness & Optimal Living Economy

  1. Over the coming decade, intimate data (see “Mobile & Wearable Computing Industry”) coupled with developments in data science and machine intelligence is likely to have a larger impact on health than any new drug, device or procedure. Of the devices that do have an impact, it is likely to be the smartphone.
  2. A new Hyper Wellbeing industry ecosystem based upon intimate data is starting to emerge. It is complementary to the healthcare industry.
  3. Hyper Wellbeing represents computer and data science moving towards health. This is the converse of the existing trend of healthcare moving towards digitization (~ digital health).
  4. Instead of being based upon episodic physiological data, a mere snapshot taken by a healthcare provider when you are sick, it will be based upon a more continuous flow of physiological data taken automatically by your devices when you are not sick.
  5. Moreover, instead of being solely based upon physiological data, Hyper Wellbeing will extend the biomedical model towards a holistic biopsychosocial model, thereby capturing multipoint data– namely, it will add psychological data pertaining to our emotions and stress levels as well as lifestyle data about how we actually live our lives such as nutrition, sun exposure, physical activities, environment, sleep, relationships and various fluctuating biorhythms.
  6. Hyper Wellbeing will aim to prevent us from getting sick over the course of a lifetime.
  7. Instead of seeing health as binary (sick or not sick) it views health as an extensible spectrum and seeks to propel not sick people towards psychological flourishing, peak health and, in the longerterm, optimal living.
  8. Analogous to the emergence of the “digital economy” in the mid-1990s this new health, wellness & optimal living economy is the new battleground unfolding. Companies are set to jockey for their position in the emerging value chain. Everyone from connected sports apparel to mobile companies are set to battle and/or form partnerships around sensing, capturing, deriving and trading intimate data, and/or leveraging it in order to be your health/wellness/life coach/app/system, for example.

Consideration of Other Events

  1. Now that wearables are no longer niche it seems relatively arbitrary to keep grouping events under the generic heading “wearables”. Rather, they are better grouped by distinct subcategories related to purpose (intended outcome), e.g., health and wellness.
  2. It now seems unreasonable to have “mobile health only” events as that precludes wearables. Wearables stand to have a large impact upon health, and their future is inseparable from mobile. Furthermore, these events blindly commingle the healthcare model (“sick care”), e.g., chronic disease management apps, with emerging wellness and optimal living apps.
  3. Digital Health refers to healthcare (sick care) moving towards digitisation – remote patient monitoring, electronic medical records, telemedicine etc., whereas Hyper Wellbeing represents a new, converse trend which is computer and data science moving towards health. Furthermore, Hyper Wellbeing does not cover sick care and instead covers a) preventing people from getting sick over the course of a lifetime and b) propelling non-sick people towards psychological flourishing, peak health and, in the longer term, optimal living.
  4. Mobile events exclude wearables. But the much bigger issue is that they view communications as the core product offering and driver of industry value. However, going forward such value is now incremental at best. Value is shifting instead towards health, wellness & optimal living. Far from incremental, the value of Hyper Wellbeing will have exponential growth.

“Our generation has an opportunity, in our lifetime, to put a massive dent in human suffering and make trillions of dollars in return.” — Dustin Moskovitz

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