Are you still wearing your wearable? We must confess that, by and large, we aren’t. This, despite the fact that between the two of us, we own countless such devices. Each was bought with the best of intentions: Walk more, run more, sit up straighter, quit slouching, eat less, lose weight. You know the list, right? You might even have one yourself.

Don’t get us wrong. We love digital health and we love our gadgets. It’s just that lately, we’ve found ourselves wanting something that is even more mindless. Something that we can put on once (or once a month) and be done with it. Simply stated, we are ready for the migration from external wearables to something easier – say, embeddables? Or even implantables?

Believe it or not, our wish isn’t as far off as it sounds. Read on for our rundown of what’s in the pipeline and, in some cases, already here.

 

Embeddables

The embeddable trend is already well underway with examples of devices disrupting sports, infant monitors, and medical diagnostics. Sensoria, for instance, has developed a “smart sock” which purportedly has a more accurate step count, measures heart rate, and analyzes running gait, giving feedback to the runner on how to improve their foot strike and stride length.

implantables-new-wearables
Alisa Niksch, MD, Director, Pediatric Electrophysiologist, Tufts Medical Center

MC10, partnering with Reebok, has created Checklight, a multiple sensor skullcap that athletes can wear under their helmet to capture head impact data. At CES earlier this year, Intel showed off a baby “onesie” embedded with sensors that can transmit, via a tiny PC, a baby’s vitals (temperature, heart rate, and breathing) to his parents.

Moving beyond fitness and wellness, we are also seeing diagnostics, such as Cyrcadia Health’s (previously known as First Warning Systems) breast cancer screening bra embedded with a network of thermal sensors that detect abnormal circadian heat patterns in tissue, specific to tumor.

When it comes to designing embeddables, we think it is important that flexible electronics are placed into stuff we would use anyway – shirts, shoes, belts, hats, underclothing. We are also fans of temporary tattoos like the beautiful ones soon to be released by MC10.

We want embedded garments that can be washed, folded, and stuffed into a suitcase without fear of damaging the sensors. And, we want garments that are stylish and fun. (We have already suggested that Cyrcadia add a bit of lace to that breast cancer screening bra.)

We believe it is inevitable that sensors will continue to be embedded in items that people wear and/or use every day, limited only by the affordability and practicality of the product.

 

Implantables

When we move to implantables, some people get hung up on what they say is an “ick factor”. They don’t want anyone putting anything in their bodies – unless it is absolutely necessary (e.g., a pacemaker or a defibrillator). There is a difference, they say, between a device that saves lives immediately as opposed to fitness/wellness devices that may contribute to longer lives, but albeit on a much more prolonged timeline.

MC10 temporary tattoo with embedded sensors
MC10 temporary tattoo with embedded sensors

Indeed, implantable cardiac devices have paved the way for implementation of adjunct diagnostics for heart failure. Lead data are collected for measures of heart rate variability and derivatives of right ventricular pressure. Thoracic impedance (e.g. Optivol Fluid Status Monitoring System, Medtronic, Inc.) and minute ventilation have also been able to be incorporated into pacemakers to predict (to varying degrees of success) heart failure decompensation.

The potential for expansion of implantables outside of this narrow scope of devices is just beginning to be demonstrated. We have already been inspired by US servicemen experiencing better prosthetic limb function through use of the implantable myoelectric sensor (IMES) system, a true breakthrough for a heartbreaking medical need. Another interesting implantable is the recently announced remote-controlled contraceptive microchip that will be implanted under the skin. It releases birth control hormones into the blood, like taking the pill or using a drug-eluting IUD. But unlike those methods, this one can be turned on and off by the user and, it is said, can be used for up to 16 years.

Implantables are under investigation for other clinical challenges such as diabetes control, Parkinson’s Disease symptom assessment, and elevations in intracranial pressure after traumatic brain injury. DARPA is even getting into the game, recently receiving $78.9 million to develop a micro implant for neuromodulation.

Realistically, implantables will likely be restricted initially to new integrated functionality of already existing technology, such as implantable cardiac devices, insulin pumps, coronary stents, or even artificial eye lenses.

Most consumers of health monitors for fitness goals, who are right now in younger age groups, may not reasonably opt for an implantable device. However, for wearables and their relatives, embeddables and implantables, to be worthwhile investments for the consumer in the future, they will need to be unavoidably or indispensably worn.

Right now, wristbands have been the tracking mode of choice because they are placed on an easily accessible part of the body, and they are gender neutral. Yet the problem with these lies with their lack of versatility from day-to-day and the fact that you have to actively remember to keep them charged and then place them on your wrist.

There is no doubt that, to date, the revenue from wearable devices has been astronomical, and that there will continue to be fans of this form factor. But we believe that, increasingly, people are going to want to quantify themselves with devices that are always on and always there. We would love to hear what you think.


First posted on The Doctor Blog on 9/3/2014.

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