Benefits Column with Wearables

Tech giant Apple's long-anticipated introduction of its smartwatch threw wearable technology into the headlines again. But while there's no denying the value of these devices in capturing meaningful healthcare data, some serious questions surrounding their true effectiveness remain.

Monday, September 22, 2014
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Apple's recent announcement of the long-awaited Apple Watch (previously called the iWatch by many anticipating the launch) underwhelmed healthcare sector experts. The Cupertino, Calif.-based company's version 1.0 health variables will measure elements such as the wearer's heart rate, step count and body position -- little more than most fitness trackers.

This announcement, coupled with Fast Company magazine's notation in its October 2014 issue that its 2012 "Innovation by Design Award" winner -- the FuelBand -- was abandoned by Nike in April 2014, drove me to write this long-planned column.

In 2012, I became an early adopter of Nike's foray into the wearable-device space when I received the FuelBand as a birthday gift. I made a decision to not only faithfully wear the fitness tracker 24/7, but to do this for at least a year. I wanted to test the hardiness of this new band, especially given my disappointing experience with the Jawbone UP in 2011.

My one-year commitment turned into two-and-a-half years and included the simultaneous wearing of as many as three devices at one time (the FuelBand, the next generation UP and the Misfit Shine -- which I supported through an Indiegogo campaign).

In the aftermath of this wearable journey, I now find myself device-free and much happier. (Despite Socrates' advice, it seems I prefer living an unexamined fitness life.) But the good part of the last 30 months was the wide variety of discussions I had -- both public and private -- with colleagues on how my experiences compared with theirs. So I've enlisted one of those friends, my CoHealth Checkup colleague, Fran Melmed, to weigh in on wearable devices and share her experience. Below are excerpts from our conversation.

CH:       You're about to moderate a panel at the Benefits Forum & Expo on activity-tracking devices. What is your top question for the panelists?

FM:      Ah, Carol. Making me pick one? Unfair.

According to the market research firm, Canalys, we expect 17 million wrist-worn activity trackers to ship in 2014. The Apple Watch, as well as an infusion of fashion detail (through partnerships like Fitbit's with designer Tory Burch), give these trackers broader appeal.

Still, the drop-off rate is fairly high. Endeavour Partners cited independent research in its white paper series, Inside Wearables. It found a third of U.S. consumers who own a device stopped using it within six months.

So my top question for my panelists will be about effectiveness. These devices cost quite a bit; the Apple Watch starts at $349, not counting the required iPhone to go with it. Are they a worthwhile investment in employee health if workers are going to stick them in a drawer in six months or less?

CH:       Great level-setting information, Fran. There are so many ways I can answer a question about the effectiveness of wearable devices and, in turn, how human resource executives should consider the inclusion of these products in their employee health initiatives.

My largest frustration with tracking devices was the breakdown rate. Over 30 months, I had to replace my Nike FuelBand and Jawbone UP four times each. (The Misfit Shine, however, is still going strong.) I'm not certain how many employees would make the time to work with the vendors to replace the bands.

A second distracting element was the measurement inaccuracies. I twice wore at least two of the devices during the same marathon in back-to-back years. None of the trackers came close to correctly recording 26.2 miles as my covered mileage. Each device was consistently inaccurate.

If HR leaders want to include wearable devices as part of their health-and-wellness strategies -- and especially if they allow employees to bring their own devices to work -- the programs must be careful to not compare employees using one tracker with co-workers using a different device.

I know you've done your own experimentation with a multitude of devices. Do you see a place for wearables in an employer's health-and-productivity approach?

FM: A client-issued, non-fancy pedometer was my first experience tracking with a device. I used it as part of a 12-week social-wellness challenge. The dang thing fell off my waistband and into the toilet twice. I'm not alone in experiencing this sort of breakdown.

Despite this experience, I see a place for wearables as part of a corporate wellness program. Employees use activity trackers and are -- at least, initially -- excited by them. They look at their numbers, talk about the devices with friends, compete against others and become momentarily motivated.

Most wellness vendors are ensuring their platforms integrate with the devices and health apps employees use. They're also making these devices more attractive to employers through partnerships and giveaways, and by making their own competing devices, too.

There's a lure for employers to pull this user-driven energy and user-generated data into their wellness programs. It's understandable. I would caution, however, that HR leaders should be deliberate in how the devices are introduced into the workplace.

If the budget is limited, I'd recommend using activity trackers as a contest prize because of their cachet. I would also advise that employers consider working with their health partners to see how the vendors could support their introduction. And I'd be very clear about how an employer is going to use the data and inform employees of that plan.

The Robert Wood Johnson Foundation researched people's interest in sharing data tracked by these devices. RWJF found participants were open -- under certain conditions -- to sharing their data, but they generally wanted to own it and share it with friends, or for the public good.

Carol, I'm curious. I also tested a number of activity trackers. The non-fancy pedometer I mentioned, plus a Philips DirectLife, a Fitbit Zip and Fitbit One, the Jawbone Up, the Nike Fuelband and the Misfit Shine. Before I reveal my hand, which did you like best, and why?

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CH: I, too, started with pedometers. In fact, my last employer branded one and gave them out as gifts when I presented at conferences. And, yes, there are at least a dozen of them sprinkled across the United States when the pedometer fell off my waistband.

I wanted to love the Jawbone UP because I'm a fan of the designer, Yves Behar. I was taken with his presentation at my first TED conference in 2008 on how to design objects that tell stories, and was personally appreciative of the headset he created for Jawbone. It was the first one that delivered to me what it promised. I thought if anyone could craft a wearable device that worked, it would be Behar. But after testing three generations of UP bands, I gave up when the fourth one simply stopped working.

I stuck with the Nike FuelBand throughout the entire 30 months -- despite the need to replace it four times -- for one simple reason: It had a purpose other than tracking my activity. The FuelBand clearly and accurately displayed the time. I was also determined to break the code behind the algorithm, which calculated NikeFuel. After a few months, I figured it out. And while the FuelBand tracked a limited number of variables, its simplicity was part of its allure for me.

The Misfit Shine was a pleasant surprise. It never broke down, was waterproof and the company delivered the best customer service of any, by far. About half a dozen of my friends bought the Shine on my recommendation and all had the same experience. Since I was an Indiegogo investor, I owned the first-generation Shine. I suggested to Misfit that the display was too hard to see outdoors. The next run of Shines boasted a much brighter set of lights. I stopped using the Shine for two reasons: I was tired of tracking every moment of my life, and I gave it to a friend who was intrigued with it.

So we're running out of column space, Fran. Why don't you tell me what your favorite tracker is and also your best piece of advice for human resource executives who are going to include these devices in their workplaces?

FM: I appreciated Philips DirectLife's requirement that you establish a natural baseline reading and then use this information to set a personalized activity goal. It gave users a realistic stretch goal, which is very different than saying: "Here, take this tracker and now go walk 10,000 steps."  For some, that goal is too hard to reach, and it's demotivating.

But my favorite tracker remains the Fitbit Zip. I have no desire to wear a device on my wrist or as a necklace. The Zip is small, so I can tuck it away, yet it has a clip so I'm not at a loss if I don't have pockets. It also gives me a lot of data at a tap: steps, time, miles and more.

As a communications professional, I judge these devices by their communications. In my opinion, the Nike FuelBand fell down here. I felt I had to fight through Nike's online store to get information. Fitbit does an excellent job of presenting data on your dashboard, online and with its app. It makes good use of "push" communications to stay in touch with me, motivates me by showing me my weekly standing on my leaderboard, and markets its goods.

What I think we're pointing out in this column is there's no single activity tracker that suits everyone -- or every company for that matter. And that's what employers should keep in mind. Be device-agnostic, be targeted about your investment, and be sure to get the data and use it with discretion and integrity.

Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.


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