Inevitably, those responsible for elderly or infirm relatives outside the home must live with a degree of uncertainty, not always confident about how and when they need to intervene. Now Care|Mind, a new smartphone app that allows its users to remotely track the vitals of their loved ones, promises to allay such worries. To begin, however, we'll have to start equipping them with Fitbits.
Developed by a company called Reassure Analytics, Care|Mind draws its data from Fitbit trackers, turning the fitness devives into de facto medical monitoring systems. It takes advantage of Fitbit’s ability to share information with paired devices over Bluetooth connections to transmit activity levels, sleep patterns, and even (with the right device) heart-rate patterns. In theory, the app can convey this information in something like real time, allowing it to send out alerts during some health crises and provide other notifications. This last capability may make it an ideal fit for cardiac patients, but the developers hope it will be adopted in elderly care more generally, especially by those with aging parents, grandparents, and other relatives who live alone.
As Hanson Chang, CEO of Reassure Analytics, pointed out to me, digital health technologies have traditionally been “geared toward a younger population.” The so-called “quantified-self” movement is easy to mock, largely because it’s not always clear what we’re actually learning when we use our smartphones to monitor calorie intake or our watches to record heart rates. Moreover, it’s a surprisingly slippery slope from tracking our footsteps to measuring the emotional lives of our pets. Though Care|Mind treads into similar, if less ridiculous, terrain, it targets those who might benefit more directly from acquiring and sharing information about their well-being.
There’s some evidence that this data exchange could make a difference. An increasingly large body of research has begun to investigate whether medical wearables can be used to treat conditions such as osteoporosis that tend to affect elderly populations. One recently published study connected Fitbit use by postmenopausal women to increased physical activity. Lisa Cadmus-Bertram, one of the authors of that study, told me by email that she believes fitness trackers can be “useful tools to work towards behavior change, particularly when combined with additional support.” And in a roundup of research into Fitbit efficacy last year, Mikel Delgado noted that the devices appear to be most helpful when users actively and consistently engage with the data they’re generating. Some research still suggests that Fitbits may not provide enough information to truly transform behaviors, but it’s still possible that Care|Mind will contribute to positive changes by involving others in the monitoring process.
Because it wanted to target the elderly, Reassure Analytics aimed to keep its product as simple as possible. Hanson told me that his company settled on Fitbit in part because of its large share of the wearables market and in part because it was a relatively simple device. By contrast, the Apple Watch and the Microsoft Band offered too many features, potentially obscuring the practical app’s functionality. In its simplicity, the Fitbit is relatively unobtrusive, making it easier to convince the less tech-savvy to incorporate it into their lives. Further, the devices can go days on a single charge, meaning it doesn’t place new burdens on its wearer. (That being said, constant Bluetooth connectivity can rapidly drain a phone’s battery, which may be an issue for some users.)
Inevitably, certain elements of Care|Mind are bound to raise concerns, most obviously around issues of privacy and security. When I brought this up, Chang explained that privacy consciousness is fundamental to the app itself. “We set up the workflow so that it requires authorization from every person who’s being monitored,” he told me. It likewise insists that the monitored give permission to anyone surveilling them. Other problems may remain, not least of all because research indicates that fitness wearables are highly vulnerable to hacking, as Lily Hay Newman reported in Slate last year.
For some, the emotional effects of the Care|Mind approach may be more troubling still. When you come to think of yourself in terms of the data you generate, falling short of your targets can be a source of frustration or shame. Constantly sharing that information with others can therefore be difficult, since it sometimes leaves you projecting an undesirable image of yourself to the world.
Aware of these issues too, Chang suggests that Reassure Analytics has tried to address them through the app’s design. In addition to the alerts it provides for crises, abnormalities, and the like, Care|Mind can notify its users when those they’re monitoring hit their targets, encouraging them to reach out or send a note of congratulation. Chang claims that the app has improved his relationship with his grandmother, who’s been using it during its trial phase. He told me that it’s inspired them to talk more often, allowing him to learn things about her and her life—not just about her health—that he’d never known or thought to ask before.
In the longer term, apps like Care|Mind may help transform various arenas of medical care. Connected to a constant glucose monitor, for example, they could allow diabetics to share blood sugar information with their endocrinologists, making it easier to develop more flexible treatment plans. While the quantified self can get a little silly, it’s possible that Reassure Analytics’ emerging model could offer something else: Call it the quantified other.