Old School Song by John Fogerty, Creedence Clearwater Revival: Put me in coach, I’m ready to play…
New School Response by Warriors Coach Steve Kerr: Well, you’re biometric readings tell me you need a rest….
So if you’re me, and lots of other people I know, this is the best time of the year – a virtual harmonic convergence of orgiastic sports joy. I can watch back-to-back baseball and basketball and, since I live in the San Francisco Bay Area, I get to root for some pretty great home teams: Go Giants! Go Warriors! If you need me, just look for the remote control as it is glued to my hand as I switch between games.
Yeah, yeah, I know. By sitting on the couch for a 3-hour baseball game and a 2-hour basketball game my wearable devices are only hitting 10,000 if they are measuring calories. But there are also those entirely countable steps to and from the refrigerator, so back off.
The whole wearable devices thing is a hot topic when it comes to professional sports. The weekend warrior uses his or her FitBit or whatever wrist-borne item to show up their friends, impress their family members, and make themselves more neurotic, professional athletes have gone all-in on the wearables concept. For the capital “W” Warriors and other pro sports teams, big data is big money. (Oh no! I have used the dreaded “big data” term; according to my own official policy, that means I have to drink).
But now back to SportsCenter…check out THIS STORY about how Golden State Warriors head coach Steve Kerr took a bunch of heat from fans when he decided to rest players due to the story being told by their wearables. It presents an interesting paradox. On the one hand, by using data instead of intuition, Kerr believes he can tell when his players need time off due to higher risk of injury, a story told by the Catapult devices they utilize to monitor the teams in practice. On the other hand, fans give him a hard time for taking out the superstars that the fans pay handsomely to see. If you are a Warriors fan, you know it costs about a few Tesla payments to see a game. If you show up and the Splash Brothers are sitting, not splashing, you are going to be seriously disappointed. It’s like going to a Bruce Springsteen concert and finding out the Boss needs a rest and you will be rocking to his understudy, the vice president, instead. Not so much.
The whole concept of using wearables in pro sports is fraught with controversy for many reasons. On the one hand, some of the players aren’t excited about it, fearing that it will cause them to be judged by “objective” measures that aren’t correlated with the reality of their actual awesomeness. This is entirely possible. Sometimes the data tells you what you need to know and sometimes the data aren’t placed in enough context to tell you anything meaningful. I think back to a story told to me by Dr. Brennan Spiegel, which he relays in my and David Shaywitz’ Tech Tonics podcast, about how lack of context told doctors that a patient had stopped moving (based on FitBit readouts) and thus they should be alarmed. Truth was, the patient had stopped moving because she finally felt healthy enough to sit still and write for long periods of time (she was an author). So there.
Players and their unions worry about whether players could get smashed in the face by wearable devices (see article on Cleveland Cavaliers player Matthew Dellavedova getting his wearable-wearing wrist slapped over playing with his Whoop on). They are also worried about how data may be used against players in contract negotiations. And of course, there is the ever-present refrain of WHO OWNS THE DATA? Imagine the leverage that those with the data have when deciding who to sign and who to cut. But on the other hand, imagine the leverage that the players have when their data shows they are better than their conventionally-viewed waistline (Babe Ruth, Prince Fielder) or height (Steph Curry, my hero Spud Webb) might suggest.
It is all so familiar of a discussion, as I sit here eating a salad (really!) while watching the Giants play the (boo!) Dodgers (don’t worry, there is beer in the fridge so I haven’t gone all kale on you). The all-too-familiar questions about data ownership, context, predictive value of the data, and data context dominate the discussion about wearables in pro sports just as they do and should in healthcare. And even home-town hero Steph Curry has weighed in:
“I just get a little worried about information overload at certain points,” Curry said. “It’s kind of the same thing with advanced stats and the cameras in the ceiling and all that stuff. There’s some benefit to it, I guess, from my standpoint. But I haven’t figured out what readouts I really need to pay attention to vs. other ones. It’s kind of an ongoing development…It’s helpful as long as that doesn’t trump my own perception,” Curry said. “Let’s just say it rolls over into affecting games and coaches changing rotations, that’s where you might lose some players. You’re playing five or 10 less minutes less than you think you should because the readout says you’re overloaded?”
Does that sound familiar? If you replaced “Curry” with “physician” you might recognize the concern about years of training and judgment being over-ridden by data in the interests of the patient’s best outcome. You will also hear the concern about there being so much data and so little clarity of how to find the signal in the noise. But in the end, I’m guessing the data junkies will win in both fields. Because in medicine we know that misdiagnosis is rampant and active compliance with best practices of medicine is pretty weak. Should doctors be replaced by algorithms? Hell, no. Should they be improved by them? Well. yes.
Everybody likes the idea of sensors in sports when it prevents against something like a concussive head injury, which everyone has become laser-focused on trying to minimize. But lots of people hate the idea when it comes to preventing more “routine” (aka orthopedic) injuries or, even worse, helping decide what player should play and what player should come out. This is Money Ball taken to the extreme. Statistics augmenting or replacing the judgment not just of the scouts, but the trainers and the coaches. Before we know it we will have robots for General Managers and Roombas running the bases.
Just this month Major League Baseball (MLB) approved the use of two kinds of wearables during games, which is a major change of pro sports policy and a contrast to the NBA’s position on this topic. The two devices allowed by the MLB are the Motus Baseball Sleeve, which measures stress on elbows, and the Zephyr Bioharness, which tracks heart and breathing rates. The decision to do this was so controversial that it hasn’t even been officially announced and the article I saw about it said that the sources spoke on condition of anonymity, as if this were the Panama Papers. Interestingly, the data gathered during the game will not be allowed for use until AFTER the game, but I’m guessing that we are now on the slippery slope of the pitchers’ mound to real-time data tracking and actionable response during games in the near future. At least the decision came with a proactive plan to ensure the player has some control over who gets to see the data, which is more than most people can say in the healthcare world.
One thing I find very interesting about the high tech, high cost pro sports version of wearables, like the Whoop, is that the focus is on prescriptive analytics, not just data. In other words, the readings trigger recommendations for what the players should do about the trends they are experiencing. This is so much more advanced than what most of the consumer wearables are doing now, which is raining data down on people with little on the “so what?” front. Perhaps this is because the minute you start making health recommendations from data for health purposes, you have to make friends with the FDA. I think most wearables companies have to get comfortable with that particular F-word if they want to prosper in the long term. Note these statistics about how NCAA players have prospered from the combination of sensors and personal recommendations that come with the Whoop devices:
“But where Whoop sets itself apart is that it is geared to change behavior, not just inform. The device delivers actionable and behavioral recommendations tailored to the user, depending on the information it receives. From September 2015 to January 2016, Whoop tracked the user behavior of 119 athletes among eight NCAA Division I teams — including those in basketball, tennis, swimming, and track and field. What did they find? Within that sample, the average time dedicated to sleep per night increased by 42 minutes across the four months. And the group’s “sleep hygiene” improved as well; according to the study, athletes reduced their late-night caffeine consumption by 86 percent, reduced their alcohol consumption by 79 percent and reduced the use of screened devices in bed by 20 percent. Resting heart rate and heart rate variability, key biomarkers of stress, improved as well.”
Whoop doesn’t have to play with the FDA because they are in the realm of sports performance, not health, but it seems to me a fine line. Nearly every quote from every trainer and coach in these sports wearables articles talks about keeping players healthy so they can play, so I’m guessing these are some blurred lines, as Robin Thicke might say.
In any event, one thing pro sports teams owners are good at (and also players’ agents) is making stadium-loads of money. And why shouldn’t this business use data to optimize its product selection and customer experience just like retail consumer businesses do? Yes, their products are human, or nearly so in the case of a few, prone to domestic violence, who should be removed from the game if you ask me. Oh, and DeMarcus Cousins. But it’s still a business and the essence of business improvement is data analytics. The better the athletes, the better the results, the happier and spendier the fans, the richer the owners. If wearables and biometric monitoring are essential parts of that equation, it seems quite reasonable to me that such tools be utilized.
But on the other hand, data privacy should also be maintained. Teams may decide to sign or bench or cut athletes based on their personal data, but it would be really questionable to report the substance of those decisions publicly. If this were healthcare, that would be a HIPAA violation and it’s probably only fair to extend those consumer protections (or something similar), imperfect as they may be, to the pro sports teams.
Couch potato update: Giants have been the Dodgers 9-6 (yay!). Now watching the Warriors play the Spurs in the GAME OF THE CENTURY, as it’s been billed by many. I can’t help but notice that Steph and Klay are missing more 3-point shots than usual. I wonder what their sleep and skin conductivity readings look like right now?