Another spring, another bout of allergies for John de Souza's 8-year-old son. Too little medication, and he couldn't sleep soundly through the night; too much, and his usual chipper personality was lost to sedation that had yet to wear off the next morning.
De Souza, a San Francisco-based CEO of an online health community called MedHelp, turned to cutting-edge technology for help. He found it in the Jawbone UP, a wristband and app that lets users track their sleep cycles, food, mood, exercise and more. In four days, the de Souzas determined the precise dose of medicine needed for their son to get plenty of deep sleep and wake up rested.
Tracking health is nothing new. "That's why there's been a business in bathroom scales for a long time," says John Wilbanks, senior fellow at the Ewing Marion Kauffman Foundation, a Kansas City, Mo-based group focused on education and entrepreneurship.
[See Don't Stress About the Scale.]
New technology, however, has made the means and the data more sophisticated. The rise of apps and sensors that can track anything from pain, to diet, to the progress of personal goals has led to a movement known as Quantified Self. (Harvard Medical School called the concept "connected health" when in 1995 it founded a center to study advanced technology for health care.)
Quantified Self was coined by two journalists at Wired, Kevin Kelly and Gary Wolf, who created a website six years ago to follow the array of emerging tracking systems. "Numbers are making their way into the smallest crevices of our lives," Wolf wrote in a 2009 issue of Wired. "We have pedometers in the soles of our shoes and phones that can post our location as we move around town. We can tweet what we eat into a database and subscribe to web services that track our finances. There are sites and programs for monitoring mood, pain, blood sugar, blood pressure, heart rate, cognitive alacrity, menstruation and prayers. Even sleep – a challenge to self-track, obviously, since you're unconscious – is yielding to the skill of the widget maker."
These gadgets promise not only better health care, but a kind of self-mastery and goal fulfillment. "If you don't measure it, you can't change it," says Tony Stubblebine, CEO of Lift, an app and social media platform that lets users track and share goals and habits.
Much of the activity stems from San Francisco, where experimentation with high-tech health data has been well under way. "People were tracking every little detail of their lives [like] what was their mood after eating a tangerine," Stubblebine says. What starts in Silicon Valley evolves to meet the needs of the rest of the country, he says, suggesting that the value of the movement for mainstream America is the power to measure health across any number of variables. In the case of Lift, he translates that metric in mundane terms: "Are you on the path to a habit or not?"
According to a study released this year by the Pew Research Center's Internet & American Life Project, seven in 10 American adults track some measure of health for themselves or a loved one. Almost half of the so-called "trackers" keep tabs on these matters "in their heads." Another 34 percent do so via pen and paper, and 21 percent use technology. Those who tracked their health more formally – whether on paper, spreadsheet or mobile device – reported greater success managing their care than those who relied on memory, according to Susannah Fox, associate director of digital strategy for the Pew program and co-author of the study. Pew also found that people with chronic conditions are more likely to track their health and cites Mayo Clinic research showing that people better manage high blood pressure and diabetes if they track their health data.
Of course, some conditions lend themselves more easily to monitoring than others. Diabetics, for example, have long employed blood glucose monitors to periodically check blood sugar. On the other hand, doctors overseeing people with asthma have relied on limited, unscientific data – patients' own recall and reporting of inhaler usage, says David Van Sickle, an asthma epidemiologist in Madison, Wisc. His company, Asthmapolis, aims to change that through sensors that attach to inhalers and record the time and place of usage. The data get recorded in an app and transmitted to the user along with customized feedback that can be shared with a physician.
The reward for such tracking means managing a condition that, uncontrolled, spirals quickly into an onslaught of symptoms and $3,000 to $4,000 a year in doctor visits or trips to the emergency room, Van Sickle says. "The goal should be for us to develop products and services that make it easier for people to accomplish what I think of as the work of illness," he says, referring to the opportunities presented by new technologies.
Managing illness is one such opportunity. But that's just the start of what's possible.
With Lift, for example, Stubblebine says that usage follows Maslow's "hierarchy of needs" theory, in which people address their basic needs, like health, before moving to more enlightened ones, like happiness. Stubblebine used the application initially to revive his exercise routine, and having done that, he's on to more refined priorities. "I just started tracking random acts of kindness," he says. Couched as a community for self-improvement – investors include motivational gurus Tony Robbins and Tim Ferriss, author of "The 4-Hour Workweek" – Lift lets users share their experiences around common objectives like meditation or one called "tell my wife I love her."
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But collecting personal data doesn't always make life easier. Wilbanks of the Kauffman Foundation gave up on his activity tracker, which he kept leaving in his jeans, where it went through the wash. There's also the matter of what to do with all that data. "I don't know what to do with a giant file of my steps," he says.
Beyond the level of the individual, and even health care more generally, the Quantified Self movement carries political overtones, Wilbanks says, explaining that people are trying to gain control over valuable personal information. He points to Facebook, cell phone companies and any other provider in which "you sign a contract, click OK without reading it, that says we own all the data that comes off of your sensor."
It's why you receive random text messages or see an ad for something you just looked up on your iPhone. "The sensors are going to get cheaper, smaller and more ubiquitous, and the ability of the researchers to figure out how to infer health from those sensors is going to continue to explode," Wilbanks says. "Everyone's going to be getting quantified a lot faster than they realize, and it really comes back to who is in charge."