Smart Shift

I’ve been under surveillance for a while now. I don’t know quite when I was sure, I’ve had a nagging suspicion for some time. But I do know it really started a month ago when I put on that so-called ‘fitness watch’. On its underside is a heart rate monitor, shining dual LEDs into my wrist and reading my pulse. Within it are a temperature gauge, GPS-based location sensor and tiny accelerometers which detect the smallest of movements. Every now and then it links to my phone to upload data; an app informs me of various aspects of my progress. “Well done,” it says, “You’ve been wearing the watch for 12 hours, three times a week! You’ve walked more than 2,000 paces a day! You’ve burnt enough calories, got enough sleep!” Before long, the emails started. “Here’s your weekly sleep summary,” they told me. It was at that point I realised that I was being monitored — first and foremost by myself. I was wandering alone in a wilderness of mirrors, each reflecting back some aspect of myself. My existence, writ large on a management console for my own perusal.

In 2015, according to¹ industry research company Parks Associates, 33% of US households with a broadband Internet connection (that’s just shy of 100 million households²) also had some kind of ‘connected fitness tracker’ — the definition included everything from treadmills with app support, to fitness watches such as Fitbit and Jawbone devices. Another research house, CCS Insight, predicted³ in 2014 that over 250 million ‘smart wearables’ would be in use globally by 2018. Perhaps even these figures underestimate the actual demand of this expanding range of gadgets, coming not only from big names such as Microsoft and Garmin, Fitbit and Jawbone but also, and far more cheaply, from the far East. As a consequence, such devices are now appearing in their thousands. It’s big business.

We can capture our every movement, whether we are awake or asleep. Thanks to apps such as Under Armour’s MyFitnessPal, we can log our meals and alcohol intake and link these daily factoids to our heart rates, body temperatures and levels of activity. And meanwhile of course, what we collect, we share. At the turn of the millennium, technology industry analyst James Governor coined the term ‘declarative living’ to describe our innate drive to tell the world what we are up to, where we are, what we eat, how fast we can run. Others refer to this as ‘oversharing’ — what works for some is an anathema to others. And as we have also seen, we do so without really thinking about what the cleverly-named service providers — Strava, MapMyFitness and the like — might do with such lovely data. Sharing might have been fine for our book choices and opinions, but even if we should be more circumspect with our vital signs, we show no sign of doing so. It is as if we have been softened up by technology to such an extent that we now see it as acceptable, without any T’s and C’s, to give away data about our core functions.

Overall our identity is becoming something which can be defined in terms of the data that surrounds it. To what end? The most immediate effect is that with which amateur athletes are all too familiar, in that we already do know more about ourselves, and our health, than we did. Our ability to measure is aiding our ability to manage — we can see the progression of a lowering heart rate or a weight loss programme, for example; and indeed, those suffering from some conditions, such as Type A Diabetes, now have far more accurate tools at their disposal for the management of their situation. In more general health and fitness, providers have made certain features into more of a game: for example, receiving points for non-drinking days, or gaining ‘prizes’ through having walked more than a thousand steps a day. Such mechanisms have themselves been awarded with a name — ‘gamification’ has become an essential element of any fitness device or mobile app.

The second benefit is that we can make better judgements, not just about ourselves but about others. If we understand how many calories are in a croissant compared to a piece of fruit bread, for example, we might be more likely to choose the latter. Tracking devices can be used to keep tabs on animals, children and indeed, ageing relatives who might have a tendency to ‘go walkabout’. Indeed, it wouldn’t be a surprise to find, in five years, that a ‘safety’ wristband becomes standard issue for the older and more doddery, to detect an unexpected fall, or even a heart attack or stroke. Indeed, the ability to monitor heart rate will likely become a default rather than an exception, not only for the older population. And hospitals are already starting to use technology for patient monitoring — with advances as they are, the main question may well become, what took them so long? Remote monitoring is helping people stay at home longer, as well as ensuring that help is at hand when they need it in cases like Emphysema which involve long periods of relative calm between high-alert needs for treatment. As Ray Kurzweil notes⁴, “Some people such as Parkinson’s patients already have computers connected into their brains that have wireless communication allowing new software to be downloaded from outside the patient.” In healthcare, this is seen as shifting the balance from doctor to patient. "It's really the democratisation of medicine," says⁵ Dr. Eric Topol, director of the Scripps Translational Science Institute.

The positive use of technology for personal safety also extends to people working in risky environments — not least of course, the military. In 2013⁶ Lieutenant Corporal Edward Maher, Lieutenant Corporal Craig Roberts and Corporal James Dunsby died as a result of ‘neglect’ on the 16-mile march during selection for the Special Air Service. The official autopsy ruled hyperthermia on what was a very hot day. While candidates were given GPS trackers, it was understood that the equipment was not ‘fit for purpose’ — in other words, the tragedy could potentially have been avoided with better monitoring devices, to work in parallel with staff supposed to be monitoring the trainees. Outside of the armed forces, devices are being tested to health-monitor drivers of trains and long-distance transport⁷, with the obvious benefit of keeping tabs on whether drivers are likely to fall asleep at the wheel. Another area is sport. In American Football for example, players have the option⁸ of wearing head sensors in case of concussion.

Yet to be seen is how such technologies will affect play on the pitch. Considering American Football again, it has long been speculated that helmets make players hit each other harder; equally, truck drivers are dubious about whether technology is being installed entirely for their benefit — if it feels like they are being spied upon, they probably are. Equally, it might it mean that we push people more to physical limits, if their vital signs are still below ‘acceptable thresholds’? In sport, we are already seeing a change in attitudes to rehabilitation from injuries, and athletes could potentially take ‘informed risks’. The broader potential for misuse is not hard to point out — for example the technology to determine whether an aged parent has had a fall could be misused in the accelerometer-based version of happy slapping⁹.

Meanwhile our brand-obsessed consumer culture could create, for our benefit, the cyber equivalent of the Jack Russell, snapping and yapping at our heels with product suggestions. Fitness information takes such possibilities to a new level — for example, could there be an additional insurance risk of having a higher than normal heart rate? We have already seen insurers penalise people who like motorbikes, whether or not they have ever ridden one. What, indeed, about pre-determination – what do our histories reveal about our future actions, particularly if based on incomplete data sets? Given the coastline paradox, the picture is impossible to complete — so will it ever be good enough? Marketers seem content that such representations are still perceived to be better than the alternative. Knowledge is power, but in reality a partial picture could prove to be worse than none at all.

And who will be picking through the information? “Where, precisely, am I going to have time to look at the ongoing health statuses of my patients,” was the gist of an interview with a US doctor in the US, shortly after Apple released its HealthKit framework (on the upside, another US doctor, Jae Won Joh, MD noted that its correct use could, “potentially solve one of the single worst problems in healthcare today: the inability to easily transfer patient records from one care location to another.”). Our hard-pressed medical services are already bowing under the weight of the so-called ‘walking well’. We are creating a potential haven for hypochondriacs, as people know more about their health and depend on the powers of Google — in which more extreme cases bubble to the top — for initial diagnosis. It’s a dilemma, undoubtedly, as we are encouraged to think more pre-emptively about our health. Simple hypochondria is one potential consequence, but there could well be more deeply felt psychological impacts. “An obsession with self‐quantification and self‐monitoring has the potential for individuals to become hypochondriacs or, more likely, hyper anxious,” write¹⁰ C. D. Combs, John A. Sokolowski and Catherine M. Banks in their book The Digital Patient. From current fears of internet addiction¹¹ we shall experience the psychological ramifications of sensory overload, even as our offspring learn to live in a world where everything is measurable. Our online personas could be the loneliest on the planet.

This will take time, however. At the moment we still only have a weak ability to analyse data at the same level that we can with our own brains. Consider something as simple as a smile: not a big, beaming smile but… let’s say, a slightly embarrassed one, like you remembered doing something you shouldn’t. Or an eyes-widening, still-can’t-quite-believe it smile, about a remembered piece of unexpected good news. Or a wistful shrug of a smile, as if you knew it was too good to be true. The human face has some forty-three muscles in the face, from which we can represent a plethora of emotions to others, and indeed to ourselves. According to a 2014 computer-based study¹² from Ohio State University however, only 20 distinct facial states exist — for example happy surprise was different to angry surprise. Which, it has to be said, will come as no surprise to any human being. A kind of technological hubris exists around all such studies, which suggest that only compute-proven features of any complex system are worth thinking about. As humans however, we instinctively know there is ‘more to it than that’.

And indeed, there is more — sometimes it seems like the world is moving so fast that, as we live in the moment, it becomes easy forget how short is our existence on this planet. But what happens to our online identity when we die? While not unexpected, given his decade-long battle with cancer, the death of Robert Ebert, long-time film critic for the Chicago Sun Times, was¹³ nonetheless sudden. Just two days before he died, the writer published a blog, titled “A Leave of Presence,” which announced his intent to work a bit less hard. “I’ll see you at the movies,” he wrote, little expecting those to be his last words. Following his passing, Robert’s Twitter feed has been taken over¹⁴ by his wife Chaz and colleague Jim Emerson, both of whom he had asked to contribute. “Last week R asked me to tweet new stuff on re.com. Never dreamed it would be memorials,” Jim tweeted. Both have also been contributing to his blog, and his wife updated his Facebook page, as right and fitting.

Some of us may be lucky enough to have partners, family members and colleagues that adapt our better-known digital presences – our blogs, Twitter and Facebook pages – and turn them into memorials¹⁵. But this requires time, care and in some cases, technical ability. And indeed, who knows what such sites will have become in even a few years’ time, when our fickle race turns its attention to the next big thing? And what happens to all the data accumulated about our living selves? At the moment, with data quality as it is, it festers in databases and on email lists. Perhaps our online identities are merely the vapour trails of human existence, data points destined to languish as mere background noise in the ever increasing information mountains we create. So what if, in the future, we can still catch a glimpse of the day-to-day doings of friends and heroes alike, snapped in that moment just before we logged off for the last time, our unfinished email conversations and online scrabble games held in eternal limbo.

Or maybe, in this barely started business we call the technology revolution, some bright spark will come up with a way to bring together the different strands that we created in life, enabling¹⁶ e-commerce vendors to mark accounts as ‘deceased’ and take them offline, even as they archive and clear away the detritus of our digital lives. The challenge, in the fast-moving world of technology, is assuring a such a service will exist when it is needed – four of the seven services listed five years ago for this purpose no longer exist. Perhaps (as some have speculated¹⁷ and now tried¹⁸) we will reach a stage where our personalities live on, beyond our physical deaths. This is still the stuff of science fiction – potentially a good thing. Until then, the only real answer is to create a presence in life which one would be happy to have in death. Because, for now, the information we create online is not going anywhere, fast or slow.

While we live at least, over the next decade we will be able to know more about ourselves and others than we ever could. Our every action is, to the information mountains we are creating, the digital equivalent of firing a bullet into a grapefruit. Every move we make, every interaction, every purchase, every login, every click and scroll sends off alerts in all directions, defining us not only in terms of login/password combinations but also casting behavioural shadows that we are only just learning how to tap. As in sport, increasing knowledge about ourselves will inevitably lead to changes in our behaviour, akin to a very human version of Heisenberg’s Uncertainty Principle. As time passes, we shall have to come to terms with the fact that the data-rich world we are creating is akin to stumbling upon a new dimension, driving the requirement for, and acceptance of our virtual identities. We are, to all intents and purposes, becoming our online representations. Are we losing or augmenting ourselves? As we shall see the answer, potentially, is both.