David Kerr: An Apple a day keeps the doctor away?

david_kerrIt might be cool, but will it make a difference to health? This is still the unanswered question after the launch of the latest must-have device from Apple, 30 years after the launch of the original Mackintosh computer in the same building in California. Due to be released next year at a starting price of $349, the Apple Watch (not iWatch) already has the tentative approval of big names in fashion and apparently is causing nervousness among high-end Swiss watch makers. The other potentially significant item previewed by Apple was the company’s plans to “do way with wallets”—it will soon be possible to pay for goods at the supermarket checkout simply by using the Apple Watch device—but only if you also own an iPhone.

At the Apple Watch launch, CEO Tim Cook made a big deal out of the potential for their new device to “motivate people to be more active and healthy,” using a heart rate monitor and accelerometer to assess fitness. The watch can also use the tracking features of a paired iPhone to add activity and workout features to be embedded within a forthcoming HealthApp/HealthKit. The watch also has the ability to send the sensation of a user’s heartbeat to friends and family! A more novel feature of the device is the Stand Ring, which records the when a user is no longer sitting around—Apple has apparently embraced the concept that “sitting is the new smoking.” Overall the aim, according to the company, is that the  “Apple Watch actually gets to know you the way a good personal trainer would … using intelligent reminders to keep you motivated and on track. It can suggest goals that are personal, realistic, and most important, achievable, which gives you a far better chance of succeeding.”

Critics have already pointed out some of the shortcomings of the new device, most notably the drain of battery life, the lack of waterproofing, as well as the small screen, which is likely to be problematic for older users. Given the recent publicity about naked pictures of celebrities and the iCloud computing system, there may be reluctance to embrace the new proposed pay-by-your-watch suggestion.

In the first instance the Apple Watch is most likely to be used by the health conscious and the worried well, rather than the parallel universe of those at risk or already living with chronic disease and those on the other side of the digital divide. In a nutshell these “wearable sensor” devices need to prove that they are capable of behaviour change—we should not just assume they are. One additional, but as yet unanswered, question is what happens to the data? This will be especially relevant as these types of devices start to collect other data—such as glucose levels, heart rhythm, and blood pressure—information that could be enormously valuable to employers, insurance companies, and the driving and vehicle licensing agencies.
However, given the failure of traditional public health policies to stem the tide of obesity and diabetes, maybe clinicians should consider assessing the potential value of devices like the Apple Watch, rather than leaving them as playthings for the trendy hipsters of Silicon Valley?


David Kerr has worn many hats, sometimes at the same time—diabetologist; editor of Diabetes Digest; researcher; and founder of VoyageMD.com, a free service for travellers with diabetes, and Excarbs.com, which focuses on exercise and insulin. He is now director of research and innovation at the William Sansum Diabetes Center in Santa Barbara, California. You can follow him on Twitter (@GoDiabetesMD) and LinkedIn.