When Corporations Monitor Your Health Devices

I really value my Fitbit watch. I like being able to track my steps and I like having a record of my workout activity. In fact, I like the fact that I can easily share my activity data with my health coach. The other day we used this data to help figure out why I had lost weight two years ago but was having trouble shaking off a few pounds right now: it turned out my daily activity was way higher back then that it is now — and it turns out there’s a solution to that.

Having that ability to make data-driven decisions about my own health is extremely valuable. Being able to collaborate with a professional in using that data is really useful too — just as long as I know they have my interests at heart. That is definitely the case with my coach. I trust her and part of the reason I can trust her is that I paid her organization, Arivale, for their services. (Note: Arivale has since gone out of business, an interesting story perhaps for another day).

Keeping an Eye on You

What happens when that business model becomes muddied, however? That is the question I began asking myself after learning that Fitbit’s new Inspire watch is available “exclusively through Fitbit corporate, wellness, health plan, and health systems partners and customers of their organizations, participants, and members.”

As Fitbit has come under growing pressure from Apple and now Xiaomi, it is increasingly looking for calmer seas within the healthcare market. Apple, too, is developing partnerships with healthcare providers like Aetna, as a way to build acceptance for the Apple Watch. In Fitbit’s case, it has a whole business unit called Fitbit Health Solutions aimed at partnering with employers and health plan providers.

Let’s be clear: figuring out how to get these health-monitoring devices into the hands of more people is a good thing. My Fitbit watch has made me more conscious of my activity levels and that is an important contributor to my long-term health. So these health partnerships could be a very good thing, as long as they are structured the right way.

My Data — Not Yours

There are two primary differences between my Fitbit watch and a normal watch. The first is that it has a bunch of sensors like an accelerometer, gyroscope, and heart rate sensor. The second is that these sensors feed that data into a service tether to a cloud-hosted Fitbit app. Those differences are what make my Fitbit watch a “service tether.”

A service tether is embedded intelligence, connected to the cloud so that a product can communicate with the company behind it. Service tethers turn products into services and generate a lot of very valuable end user data in the process. Nike’s new self-lacing shoe, the Adapt, is a perfect example.

With the new Inspire line, Fitbit is potentially twisting this model so that they aren’t the only ones with access to the resulting data stream. The technical aspects of how that’s done aren’t what’s interesting here; what is are the terms of that business model. In particular, what are the terms of the End User License Agreement (EULA) with regard to access to and ownership over the data coming from my body and moving through my watch?

This will be something to monitor over time. Fitbit’s existing public EULA links to a Privacy Policy that doesn’t appear to include anything too unusual with regard to sharing individually-identifiable data with partners. While there are obvious benefits to sharing that kind of data with a healthcare partner, there is also obvious risks of abuse — the clearest example being using activity levels from my watch to change my insurance premiums.

From a bigger perspective, there are many other thorny questions having to do with the commercial value of the data I provide through this and a growing number of other service tethers. These contributions of intelligence are increasingly being aggregated by companies into massive, anonymized datasets that can be used to train machine learning systems, which makes them immensely valuable.

As these systems become ever more lucrative, as a society, we will need to pay more attention to who actually owns this data. We will also need to begin asking hard questions about who benefits from our contributions to these new containers of our collective intelligence.

Machine-based Collective Intelligence and the Human Experience