I can’t say the precious seconds lost trying to get my Fuelband to tell me the time is what made me late for the meeting but it didn’t help. The question I had to ask myself, then, is what help is it giving me?
I guess when I first got the Fuelband it was interesting to see how many steps I was taking each day and how on some days I was more sedentary than I realised. That made me change how I structured my days so that I had time to walk from meeting to meeting across London. It was a good example of how the data collected (steps) was translated into information (active versus sedentary days) and then into actionable knowledge (change more sedentary days into active ones).
But now what? I want it to help me do something else. But it doesn’t. That’s pretty much all it does. I was hoping to map my activity to my weight to see how that changed over time, but Nike doesn’t offer that. I think FitBit does, but I lost my “One” a few weeks back and I have to admit that I wasn’t remotely bothered (I got it for free at TEDMED so there wasn’t even a financial loss). In truth, I also felt a little nerdy walking about with something clipped to my belt so it was sort-of a relief.
To my mind, the quantified-self movement has plateaued. I suspect enthusiasts will tell me that with new sensors we’ll be able to collect more data (see here, for example), which can equally turn into information. Fine, but the real magic is the leap from information to actionable knowledge. In my example that leap was fuelled by what I wanted to do – spend less time on my bum and more time walking. Why? Because it helps to stretch my hip flexors, which, in turn, helps to overcome my almost-absent lumbar lordosis, which, in turn, helps to open up the space around the root of my sciatic nerve, which, in turn, helps to reduce my ongoing sciatic pain. How can any sensor know all that, and hence make the leap for me?
Sensors can’t, at least not yet. If you really listen carefully for the signal in the health innovation noise you’ll hear cogent voices talking about the need for “a high-level approach for creating emergent multi-device user experience”. Great, but it still won’t convert information into actionable knowledge. To do that we need to understand what people are trying to do.
Now I have to be honest and say that I am borrowing my thinking from one of the smartest people I have ever met – Kingshuk Das. He’s now one of the Wellthcare Explorers but after we first met he said something on Twitter that it’s taken me five months to understand: ‘We need to change the focus from “health & wellness” to what folks are actually trying to do in their lives.’
What I’m trying to do is lengthen my hip flexors. The impact of achieving this is to reduce my likelihood of pain and hence, quite frankly, lengthen my days given that when pain-free I’m not as tired as I am when my pain is my constant companion. With longer, pain-free days I can “do” more.
Kingshuk mentioned “wellness” in his tweet and this week I listened in on what I can only describe as a tempestuous webinar about the over-promising, anti-scientific, and perhaps even fraudulent behaviour of the wellness industry. In it, Al Lewis and Vik Khanna continued to do what they have been doing so well to date, which is to examine the evidence underpinning wellness programmes and point at the inconsistencies between the data and the marketing claims.
They made their usual convincing case but my more fundamental problem with “wellness” is that it’s defined by what health providers think we should be doing. I can’t think of anything less motivating than being told what to do, especially when what I want to do is not being considered. I’m sure that when I asked why I want to spend less time on my bum you thought of the cardiovascular benefits of being more active but I couldn’t give two hoots about that in comparison to reducing my sciatic pain.
Therein lies the unspoken tension that inhibits imagination in health and health care. It’s not what you think I should want that matters, it’s what I want that matters. Wellness and health care are what I increasingly see as “supply-side thinking”. Health care, as the all seeing and all knowing Big Brother, is telling us what we should want – and we have to trust it because we don’t know any better. We probably don’t, but you, health care, can’t make me want what you want me to want.
In my ongoing quest to carve open new thinking in health and health care, I call this the “wantified self”. It’s only, as Kingshuk said five months ago, by knowing what people want can we really figure out what health-related services to offer them – in other words, “demand-side thinking”.
Interestingly, my physiotherapist doesn’t buy my flexor-lordosis-sciatic theory. She thinks I have a “chemical neuritis” post-surgery. I don’t really know what that is, but the treatment seems to be the same – to work on my hip flexors. I’m “adhering” to my treatment because it’s aligned with how I justify my “want”, a happy coincidence rather than a validation of the role of health care in my life.
At the end of the first debate between the Wellthcare Explorers they asked: “How do the things that people care about relate to health?” For me, this is about understanding “demand”. How is it that we have a US$7tr global industry that has no mechanism to truly understand demand? It’s time to ease off on the quantifying and think more about wantifying.
This post was first published on MedCrunch and is part of an ongoing series.