Tag Archives: Fitbit

Me and My Apple Watch

IMG_5239

 

So as you know from my earlier posts, I have used and blogged on FitBit, Garmin, Moov, Basis Watch (2nd post on Basis Watch), Google Glass and apps like BodBot as well as posted on issues with wearable trackers in general.  At the recent HiMSS conference I was given an Apple Watch for participating in a 20 minute meeting with a vendor.  Great gift by the way.  Anyhow, I have now worn this watch daily for about two months and have come to a few early conclusions.  So here we go:

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Fitness Trackers, Not so Accurate After All

As employers continue to push  employee health improvement or Wellness programs, they are looking at gathering more “validated” results instead of relying on the always questionable self reported data.  In particular the tracking of physical activity is one that has gotten much attention and companies now hand out Fitbits, Garmin devices, Jawbones and even Apple watches to track people’s walking and running. These are often tied to incentives for participation and many are associated with premium reductions.

The question is, just how accurate are these things and might there be some negative legal liability associated with their use?  I can tell you from having used a few including Fitbits, Garmin, and Basis as well as some GPS trackers, there are clearly issues, which I’ve highlighted in other posts. For instance, one can often get more steps for driving on a bumpy road, brushing one’s teeth, drying off after a shower and a myriad of other ways.  On the flip side, some devices worked while I was operating a power mower and others did not count any steps at all.

Now an article comes out that places even further doubt regarding the use of some of these devices.  You can read it here:

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The New Moov Fitness Tracker: Major Issues Make it Less than Useful

Update to Original Post (4/3/16)

Moov reached out to me via twitter after apparently reading the post and asked me to contact customer service saying they wanted to fix the issues I had experienced and wrote about below.  They offered me a free replacement band. I thanked them for their efforts and will let you know if there is anything different with the buckle or the bands ability to hold the tracker. I have not used the device in ages and gave one to my son who runs and rides a bike so I have 2 left.

 

Moov Box

I saw an article announcing the new Moov fitness device with a special rate on pre-orders so I decided that it looked really cool and would solve some of the workout issues I face. As you may recall I have used Fitbit’s, Garmin, Google Glass and a number of apps.  My exercise routine includes both aerobic activities like running and elliptical, all counted by the steps on most devices but I also like to use the rowing machine and have used Bodbot for my stretching and weight training.  None of these activities are effectively counted by a step tracker like a Garmin or Fitbit.

The Moov includes two straps, one for your wrist and one for your ankle, one Moov device and an app on your phone. The app is easy to install and you link the device by pressing on it, a short light indicates its available to pair and you pair it for each activity you want to do on the app. Pairing was easy although I often had to press the device multiple times to get it into pairing mode as indicated by the flashing light.

The app comes with a number of exercise routines that cover walking, running, swimming, boxing and an under 10 minute workout.  These were easy to select and set up. During the workouts the app provides you with feedback on pace and impact.

Issue #1, Ordering

I easily ordered one unit within days of the announcement and began waiting for the delivery announcement. As the date approached, I saw that they had a special offer if I ordered a second at the discounted price, they’d add it to my first order and I’d keep my place in the pre-order line.  I went ahead and ordered the second and notified them via email to put the two orders together.  Well they weren’t capable of that, they emailed back that I needed to place a new order for two of them and they would cancel the other orders and place the new order for two in my previous place in line. So I ordered two and sent them yet again another email to cancel the other orders.  In the end for some strange reason, they only cancelled one of my orders so I ended up receiving two red ones as my first order and a few days later one blue one, paying for all three.

Issue #2 The Strap

Lets face it the strap is a pain to put on. There are a lot of complaints about this online.

Moov strap pulled over itself

Moov strap pulled over itself

Moov strap connected correctly

Moov strap connected correctly

 

Its hard to snap the little piece into place

It’s difficult to get it tight without having something like the top of a table hold it in place while you try to get it to the right tightness (in fact I tried wrapping it back over itself, to get some leverage with the strap for a while, just to make it tight).

 

 

Moov Strap with Clip

Moov Strap with Clip

The first time I pulled the longer strap out of the box the clip that is used for the strap fell off (I was unaware until I got to the gym and went to switch the Moov to the longer strap to run with it and realized it was gone. So I emailed them immediately and asked how I could get additional clips for the strap, its now been over a week and I have not received any response. The little clip can get caught when putting one end of the strap through the other and pulled off so watch for this. I then found the clip right where I had pulled the strap out of the box.

 

 

My Moov is gone

My Moov is gone

And perhaps the BIGGEST ISSUE the little Moov device can fall out of the strap if you are doing things.  On the second day I was pulling some backpacking equipment out of the closet and about 20 minutes later noticed that while I had the strap on, there was no Moov in it.  I proceeded to look throughout the house and then remembered that I had some difficulty pulling something out of the closet.  Sure enough I found it in there on the bottom.  Apparently the strap can get caught, spin around and stretch enough for the device to fall out.    NOT JUST ONCE So this morning I awoke and my strap was in fact empty again, the device was not in my bed or bedroom.  The only thing I can think of is that last night as I was taking luggage out of a car, the strap got caught on something, pulled, stretched and the device fell out! Maybe I’ll find it in the back of the car.

Issue #3 The Workouts

I have used a few of the workouts including the Walk to sweat, Run my own way and Get toned in under 10 minutes. There are others including Push to the limit, Improve my pace and distance,  Ride outdoors, Record and analyze a swim and Have fun burning calories.  Given the issues above I probably won’t be using it much anymore but anyway:

  • It doesn’t Count Steps.  WHAT???? It only activates above a certain level which is a fairly high walking or activity pace.  While it will show your activity level throughout the day, only activity that reaches a certain threshold counts and steps aren’t counted at all. While they can think this is cool because they want you to get above a certain activity level to improve your health, not counting steps is a major issue and just plain dumb. So I wear two devices to see steps as well.
  • The feedback you get from the device while working out is neat and giving you pace and impact while walking or running is well done and useful. In fact that is what I have been looking for, a device that goes beyond a tracker to provide useful information and motivation; but the messages regarding posture etc can be repetitive.  During the Run my own way training I found the feedback regarding my pace spaced too far apart, during the Walk to sweat it was about right, but it lowers the music volume too much when providing feedback and then increases the music back to the previous level.
  • The Get toned in under 10 minutes workout had difficulty tracking my squats so I ended up doing maybe 5-7 extra each set trying to get the 10 counted in the time allotted.  I ended up one short when I reviewed the activity.
  • If you are working out on a treadmill it counts distance via GPS so you have to manually enter your distance upon completion.  A few times somehow I clicked through the manual entry step and ended up with little to no distance and there was no way I could find to correct this after the fact.
  • It did nothing with my rowing and really can’t count weightlifting or those types of activities.
  • Apparently they admit it doesn’t work on a elliptical, so I decided not to test it.

Overall its really just a cool toy.  It’s too easy to lose if worn all the time, is a pain to put it on, doesn’t count steps, so I wear two devices, doesn’t track other activities that I do on a frequent basis like treadmill, rowing and weights (well the others don’t either but that was what I believed Moov would do), doesn’t count some of its own activities well like those in the Get toned in under 10 minutes workout and the response from their customer service is poor to non-existent.

Unless they make some major changes to the strap, device, customer service and overall usefulness of this tracker, and if I can find the device, this one’s headed to limited use and the two others may get donated to charity, I just can’t give them to people I know as gifts.

 

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My Garmin Vivofit – the Good, the Bad and Lessons from a Challenge

As I’ve written about before (here , here, here, here and here)   I’ve used a number of tracking devices and apps including the Fitbit flex, Basis watch, Google Glass and the Actiped.  I lost my Fitbit when backpacking, apparently my trekking pole caught it and it fell off.  Although I looked for it, I was unable to find it, even though I knew where it fell off. Lesson one, if you do outdoor activities like I do, get one that is bright-colored so you can find it, this one was black.  Apparently I didn’t learn, keep reading…

At the Lake Nona Impact Forum February 2015, Garmin graciously had a step challenge and was giving away free Vivofits as part of it, I thought that was a great idea and got one. The challenge would be a month-long and everyone who wanted to enter was required to register with the online group.  I did and decided I would try to win this one.  More on that later as this was one lesson in how not to have a step challenge and a few other issues with Garmin.

Anyhow I found that the good points for the Vivofit were its battery, its supposed to last for a year, well longer than the few days of the Fitbitflex. That I liked.  I also liked the clasp which I thought was better than the Fitbit Flex, which has a propensity to fall off.  BUT….. this morning when mowing the lawn I caught the Vivofit on a tree branch and noticed a few mowing rows later that it was gone.  After finishing the lawn it took me about 10 minutes to find it. Fortunately it had not been run over but was sitting in a cleared area.  Lesson one, get one that is bright-colored so you can find it! This one was grey, oops guess I didn’t learn from my Fitbit.

Issues with the Vivofit

  1. It’s not very accurate. I counted off steps and the Vivofit was always lower, except,
  2. It reacts to shaking, using a fork (someone at dinner with me noticed it was counting my fork movement), it counts shaving, washing your hair, drying off with a towel, bumps in the road. The point is you can really cheat with this thing if you wanted, so I took it off when doing these types of activities.
  3. It does not count steps when mowing the lawn with a power mower. The only way to count steps is to remove your hand from the lawnmower and be sure to swing your arm as you walk. The Fitbit Flex was much better, even counting steps when using a big DR 13 horsepower mower working the Florida Trail.
  4. You can’t read it in the dark.
  5. It does fall off.

Anyhow, let’s get back to the challenge. I decided that it would take 20,000 steps per day to win, so I altered my work out and went completely aerobic, walking, running and elliptical which by the way caused me to gain weight.  I put myself easily into first place by doing two sessions a day and oftentimes lunch and cruised along. With a week to go I was still in first, but did not realize that one person registered but was not sharing their steps. Turns out at the end they somehow caught me.  Even though by my calculations they would have had to do about 6 days of 40,000 steps each (the last report was with about a week to go and the second place person, who was reporting their steps, was about 100,000 behind me).

Not reporting your data is like playing a basketball game and not knowing how many points the other team has.  Do you go to a four corners office and stall because you are in the lead or crank up the scoring in an effort to catch up?  As an organization, never allow someone to do this, I did write to Garmin and provide them with my thoughts.  But imagine the thinking of the other employees (teammates supposedly) who have to work with the guy or gal who did this and wins in the end by in effect manipulating the game? That’s sure to be an interesting work environment. So when running a challenge like this be sure all participants fairly and consistently report their activity throughout the challenge.  It sure taught me something about this unknown person.

So I finished second and won something.  The reason I say something is that Garmin informed me that my prize was backordered and should be shipped in a few weeks.  They got my address and told me they would send it once it came.  Almost six months later it’s still not here. I’m sure whoever ran the challenge long ago forgot about it.  I could write to them, but it’s not worth the hassle as I’m moving on from the Garmin Vivofit and pre-ordered a Moov.

So far the Fitbit’s the best for tracking except for falling off, but we’ll see what the Moov has to offer when it arrives in a few months.

As far as Apps, I still use Bodbot, and really like it.

 

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PopHealth Week Month End Wrap-up: Healthways, Fitbit, Oschner, Aledade & Anthem

by Fred Goldstein, Gregg Masters and Douglas Goldstein

Listen to the episode here:

 

In our second month end ‘news/e/um‘ style PopHealth Week Review this Wednesday June 24 at 9 AM PT/12 PM ET we’ll feature hot topics in the news. Our regular panel of Fred Goldstein @fsgoldstein, Gregg Masters @2healthguru and Doug Goldstein @efuturist will identify newsworthy stories and offer commentary along the way. The initial slate of stories in the news includes:

  • Healthways revised guidance
  • Fitbit’s IPO and Garmin’s lawsuit
  • Ochsner Health System
    • What they are getting, news about Apple Watch – Chronic Care Management
    • News B4 the Release – what they are working on the “New Mission Control”
  • The physician led ACO management company Aledade’s VC raise
  • Insights from the Personalized Medicine Coalition Study
  • Anthem’s sparring bids for CIGNA (and Aetna’s pursuit of Humana) Could the ‘Big Five’ be reduced to the ‘Big Three’?

Here’s some background:

Healthways: A Perenial Disappointment?

 

This company just reported revised downward guidance and their stock was hammered.  Last month, on May 18th their longtime CEO Ben Leedle stepped down and last year a group of dissident sharedholders filed to take over the Board, though they ultimately came to an agreement with a few of them joining the Healthways Board.  As one of the largest population health companies, with unique programs like Silver Sneakers, the Gallup-Healthways Well-Being Index, and relationships with Blue Zones and Dean Ornish, how can they miss?  Well the irreverent 3 have some thoughts you don’t want to miss this.

We’re sourcing our discussion from recent news: ‘Healthways Revises Financial Guidance for 2015‘ and Healthways (HWAY) Stock Sinks on Lower Full Year Revenue Guidance

Fitbit: The Wallstreet Darling of the Wearables Industry?

Fitbit went public, Woohoo! Lets take a walk as we discuss: 

  • the opportunities for wearables
  • Fitbit’s first day pop (can you say JUMP) you know, we can get them to exercise, but hey its only the first month, is it sustainable?; and
  • the recently announced Garmin lawsuit (what? So they hired employees from a competitor….. but maybe… they took more than their minds with them)

The company narrative is here, and recent discussions found via CNBC ‘Fitbit soars 20% on second trading day

The good here, and some questions, here and here. And then there’s the ‘always-in America’ litigation angle via ‘Fitbit Sued by Jawbone for ‘Plundering’ Employees, Secrets‘ with all the gory details of the complaint here.

Ochsner Health System: The New Normal?

Doug Goldstein recently visited Ochsner Health and has some interesting insights to bring us. Perhaps more interesting is this announcement:

 

Ochsner Health System First in Nation to Manage Chronic Disease with AppleWatch

We all know how much buzz the product (better yet, platform) has produced in the digital health and exploding apps market, we’ll lean into the real world implications for its deployment to population health via Ochsner’s first mover vision inside their EHR.

Select Highlights:

…it’s not about the wearable – it’s about the “new mission control” being built into the EPIC workflow that will change how doctors support patients in life, fitness, health and healthcare.’ Douglas Goldstein

Aledade: The Physician Led ACO Management Company “ACOcor” Revisited?

Aledade just completed a $30 million series B raise, see; ‘Bethesda health tech company raises $30 million‘. What implications if any can we draw from this continuing investor confidence in the approach and ‘secret sauce’ enabling the transformation of the U.S. healthcare ecosystem from volume to value? What does this say about the ACO market writ larger and the continued embedding of the ACA’s moving parts as the new normal for American healthcare? For discussion of this milestone event, see: Leading the Transformation: Aledade’s Growth authored by Aledade CEO Farzad Mostahari, MD.

Themes: ACOs continue their market penetration, and the need for physician led ACOs can only be expected to continue to grow as well. Someone need fill that void. Aledade intends to be a front runner.

ACA repeal types are increasingly irrelevant and the King V Burwell trial decision –  which could hit this week – is likely to only affirm the continued availability of Federal subsidies language issues notwithstanding.

Physician led ACOs are another shot at the bow of traditional hospital system led innovations including any ACOs the sponsor.

Personalized Medicine Coalition Study 

Most of us have heard about the 17 year time-line for innovation to transfer from ‘bench to bedside’ into mainstream medicine. Clearly in days past, we could tolerate such a delayed ‘on-ramp’. Yet in the Internet age, with M0ore’s Law and the explosion medical information and informatics, plus opportunities for crowd sourcing and the connected global village are within the means of anyone carrying a smartphone, laptop of PC, such a delay is unacceptable.

Yet, there’s more in the way of innovation uptake. A recent study by the Precision Medicine Coalition outlines some of these concerns, particularly as it relates to ‘alternate payment models’ (APMs):

‘..as APMs continue to develop and these, and other alternate models are proposed, it will be important to consider what effect changing incentives and payment systems will have on the decision by interested stakeholders to invest in personalized medicine. The Report concludes that “if new incentives begin to hamper access to personalized medicines in a meaningful way, the ability to invest in research and development of highly personalized therapies and diagnostics will likely shift to align with the inflexible payment systems.”

“Understanding the dynamics and challenges facing the industry as payors move toward APMs is the first step to ensuring that these therapies can continue to be developed and made available to patients. This Report is an important first step to raising the awareness of these issues as payment models continue to evolve.’

Practical Impact or ‘Reading the Tea Leaves’

As the challenge of integrating the promise of precision medicine (utility of biomarkers and better understanding of disease pathology and associated risk management opportunities) informing and guiding to day to day lifestyle (including health) choices, another potential uptake inhibitor are the hoops payors or risk bearing organizations may require before deeming the application of such technology to better patient outcomes. So in a way, it’s not just about tech innovation adding value to medicine and healthcare, but also the bureaucracies we create to protect the public while stimulating innovation.

PM remains an on the come potential to current medical practice. The theory is compelling, but the 17 year bench to bedside standard is not likely to step aside any time soon. Perhaps incentives [and compelling outcomes studies] can accelerate an otherwise glacial pace of [tech transfer] adoption.

Anthem’s Determined Dance to Acquire CIGNA

Are we revisiting the Big 6, then Big 4, and ultimately fill in the ____ of the too big to fail accounting firms [RIP Arthur Anderson’ but now squarely laid at the feet of America’s Health Insurance Industry market leaders….

This is a story on a number of levels! See: Anthem continues $47B Cigna takeover battle and Anthem offers $47 billion to buy Cigna.

Themes: Is health plan consolidation the antidote to counter the recent and persistent wave of hospital, health system and medical group mergers? One CEO’s post merger standing in way of merger. Will investors stand by and watch a premium bid sit idle?

Bottomline? Might market consolidation for price leverage (and oh yeah, scale and operating efficiencies) enable the construction of a virtual single payor (or Ellwood vision of “SuperMeds”) via acquisitions or arrangements? Is this scale required by ACA as some opine? Or just more opportunity to generate fees and exit packages for senior executives? When has scale reduced costs?

So pull up a chair, get out on a walk, put on your headset, and tune in to PopHealth Week!

 

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