So Appy Together

Siri, the iPhone’s sassy personal assistant, was just the beginning. Right now, behavioral scientists are racing to develop a new generation of apps and programs that can mimic compassion, concern, and sympathy—technology they hope we will form relationships with, even fall in love with. Janelle Nanos goes inside this brave new world to find out how our ever-smarter phones are changing what it means to be human.

By Janelle Nanos | Boston Magazine |

Jason Jacobs is one of the developers in the race to build the ultimate dashboard. Jacobs is the founder of FitnessKeeper, maker of the RunKeeper app that first got me hooked on self-tracking, so I meet with him to find out where things are headed next. He says the future is in creating a single program that puts in one place all of the personal data that right now is being kept in different devices and apps. Without that, he says, it’s up to the user to make sure all of her various gadgets and programs are accurate, up-to-date, and (er) honest.

So this past June, RunKeeper launched a tool called the Health Graph, which lets data junkies sync up all of their numbers in one place. Just five months later, the company received $10 million, much of it in venture funding from Spark Capital, the local outfit that has supported Twitter, Tumblr, and Foursquare. This is exciting stuff for Jacobs, and as he talks about it, he touches his hands to his temples, as if he’s trying to keep his mind from being blown. “If you’ve got all this data in one place, you can build a self-optimizing system,” he says. “And then if it knows all my data and what my goals are, it’s like, Tell me what to do. The system can become more predictive and prescriptive over time.” I like running with my phone, but now it’s going to tell me what to do? Technology is supposed to allow us to do more in our lives without thinking about it, not do the thinking for us, right?

This gets even more complicated when it’s not just our physical health that these devices are monitoring, but our emotional health, as well. Ginger.io, a team spawned from MIT’s Media Lab, has developed an app that notices when you’re not texting as much with friends or haven’t left home for days at a time, and can tip you or your doctors off to the onset of depression. And the Waltham-based tech firm Affectiva, another Media Lab spinoff, has a wristband called the Q Sensor that measures your emotional peaks and valleys throughout the day. “It tells you things that your body is feeling that you’re ignoring,” says Affectiva cofounder Rosalind Picard, who also heads MIT’s Affective Computing group. Right now, the Q Sensor is being used to help children with autism better monitor their emotions, but Picard says it could someday become a consumer device.

So yes, in theory, my phone could one day pick up on the fact that my stress levels are rocketing at work, and suggest that I go out for a walk to take a break and catch up on the exercise I’ve been slacking on…so long as it’s not a bar I’m walking to (which it would know about thanks to GPS), because, really, that isn’t the best way to deal with my problems, is it? And I’m just supposed to smile and obey?

“It’s dizzying for the average consumer to sort this out,” says Joe Kvedar, a physician who runs the Center for Connected Health at Partners HealthCare. Kvedar’s a bona-fide self-tracker — he clips a pedometer to his slippers when he wakes up in the morning and just installed a treadmill desk in his home in Medfield. But he’s frustrated by the lack of insightful layers on top of the data to help us make sense of it all.

What apps need, Kvedar says, is something called a feedback loop to both explain things to the user and provide a degree of accountability. Why? Let’s return to the car dashboard for a moment. A speedometer should be enough to stop us from speeding, but researchers have found that one of the best ways to get people to actually slow down is to post those signs on the side of the road that tell you how fast you’re going. Kvedar thinks a tool like Siri is heading in the right feedback-loop direction. “I’m just waiting for someone to do an integration between Siri and some kind of an activity monitor,” Kvedar tells me. “I think that could be very powerful.”

  • Andrew

    One thing I worry about is that these apps can further exaggerate the relevance of surrogate or intermediate outcomes to our health, so that we are pushed to produce the best lab test results, instead of living the most healthful lives that fit with our goals and values.

    Too many patients are already obsessed with the test. For example, a survey of people with diabetes found that one in four considered their hemoglobin A1c levels to be a more important outcome than even death, stroke or heart attack!
    (Murad MH, Shah ND, Houten HKV, et al. Individuals with diabetes preferred that future trials use patient-important outcomes and provide pragmatic inferences. J Clin Epidemiol. Jul 2011(7):743-748.)

    Such distortions occur when the first thing clinicians talk to their patients about is their test results. Patients know they’ll get gold stars for good lab tests and a harrumph for missing the mark.

    Sure, people with diabetes should be aware of hemoglobin A1c, heart attack survivors should track their LDL, and so on. But we should not let these numbers consume our attention far out of proportion with their actual usefulness to promoting health.

    Smartphone apps are great at tracking numbers, but can any track how many times we…