Back in 1990’s, Hilary Clinton was often in the news (filed under “ridicule”) for her hair accessory of choice, a headband. More often associated with Scooby Doo’s Daphne or Bjorn Borg or even Madonna in her Desperately Seeking Susan phase, the headband has long been considered a somewhat gauche style choice. Until recently, that is. Lupita Nyong’o, star of 12 Years A Slave, wore a diamond-encrusted headband on stage at the Oscars, perhaps ushering in a new era of headband hipness.
And not a moment too soon, as we are also beginning to see headbands emerge on the wearables scene for both fitness and medical applications. And thank goodness for that, as people are at perilous risk of running out of wrists for all the watch form factors that are the current wearables rage.
The new headband that most recently caught my eye (in a good way, not a fashion faux pas way) was the Cefaly, which just got FDA approval for the prevention of migraine headaches. This headband is worn once a day for 20 minutes and, according to its label, is intended to help the wearer experience significantly fewer migraines per month than they typically endure. For those who experience regular migraines, this could be a really big deal and a welcome alternative to pharmaceutical interventions that can have negative or at least sleep-inducing side-effects.
But the Cefaly also stood out to me for two additional reasons: 1) it is therapeutic, not just diagnostic; and 2) it is for a serious medical condition, not a fitness-related one.
I think the appearance of these two characteristics, even more than the resurgence of the headband as chic, is a pretty interesting data point in the evolution of the digital health marketplace, and particularly the wearables subset of it. For the most part the products that have come to market have been intended for monitoring and measuring to diagnose or screen or track. I have seen few examples of digital health products meant to treat or cure. The one exception has been in the mental health and counseling segment of the marketplace, where there are several algorithm-based therapies being tested with some success; but these are generally ways of creating asynchronous interaction with a counselor rather than a standalone treatment experience. The Cefaly, in contrast, is an actual treatment in and of itself and an interesting application of technology to treat disease in a new way.
As for the second point—the “serious medical condition” one, I think this is really essential to the long term success of the digital health marketplace—and especially the part of it that isn’t old school healthcare information technology (HIT) masquerading under the moniker of digital health in order to look more au currant. There has been an explosion of wearables and carryables and stuff-in-ones-purse-ables that are focused on telling you what might be wrong (heart rate up, sleep pattern sucks, glucose too high, and the ever-popular, baby’s diaper is wet) but not helping you do anything about it per se. (Free business advice: invent a digital device that automatically changes wet baby diapers and you will never have to work again).
Back to my “headbands are the new black” theme, for instance, I recently saw a device called Spree, which is a headband designed to track body temperature, heart rate, distance/speed, and calories burned. The Spree is intended and marketed as a fitness device and, thankfully, isn’t trying to pretend it is for some higher purpose, as some of the wearables pretend to do. But once again, despite its potential contribution to sartorial splendor, these headbands, Spree included, don’t improve your health; they just give you data to help you decide whether you should do something about it or return to your box of doughnuts.
There are other digital health-oriented headbands, such as the Interaxon product called Muse, or the Emotiv product, both of which I have written about before. These products have potential to use brain-sensing technology to move things with your mind. While not a “cure” or “treatment” per se, the technology is purported to be able to harness the electrical signals of the brain to allow you to move a wheelchair, for instance, if you do not have use of your limbs for that purpose. But for now the big application on the Interaxon website is remotely pouring yourself a beer from a powered tap. This might be therapeutic, but not in the FDA sense of the word.
As digital health wearables and other-ables become true methods of treating disease and helping manage chronic conditions in more active ways, we can legitimately begin to talk about this sector as one focused on digital healthcare, not just digital healthiness. And given the way the traditional medical device industry has faltered, falling prey to its too-frequent inability or unwillingness to demonstrate both efficacy and cost-effectiveness in the past, this may be the way back to health for that industry as well.
Digital health technologies offer the potential of more cost-effective interventions (in some cases of course, not all) and the added bonus of ongoing data tracking about device performance. That latter feature is a big one, as it affords medical device manufacturers a way to have a long-term relationship with the patient and, potentially, a recurring revenue model that is quite different from just replacing a stent every couple of years when the original product doesn’t create a lasting result.
I sincerely doubt we are going to see digital health products mitigate the need for joint replacements, for instance—it’s hard to imagine installing an iPhone in the hip socket, although it would make it harder to drop on the floor. I can, however, readily imagine that implantable hips and knees would now incorporate sensors to help place the devices more accurately and monitor their wear over time to aid in improved healing and healthier patterns of use (e.g., gait correction). I can also imagine much less costly capital equipment investments for products, both therapeutic and diagnostic, when a phone-like or even smaller form factor will do. We have already seen an iPhone-based ultrasound device, as one example; why not a miniaturized defibrillator on a phone instead of that big thing on the wall? There is also work going on out there to replace mammograms with sensor-laden bras, thus removing the high capital cost of imaging and potentially adding a little decolletage to the phenomenally unsexy mammogram experience.
The emergence of inexpensive technologies—mobile, sensors, etc—makes for some great medical device promise. And, as it turns out, it may also make us look even more fashionable than Hilary circa 1992, just so long as they don’t bring back that leg warmer look (peripheral nerve stimulation wearables?).