Image from the Amazon Website

#Design #Fail for #Digitalhealth: Who Benefits from Health Monitoring: You or Amazon?

There are a zillion tools and wearables in the marketplace to support a new approach to supporting health. Tools like the Apple Watch, the Fitbit and the Samsung Galaxy Watch help you track your steps, track your activity, or track your sleep! It was inevitable that Amazon would come out with its own health monitoring tool instead of just selling other companies’ tools in its marketplace. But this is the biggest #design #fail for health tech I have seen thus far.

The Amazon Halo Band is a new health tracking bracelet that is coming out from Amazon. Read the article and watch the video about this tool from Washington Post reporters Geoffrey Fowler and Heather Kelley.

Here is the first strange feature:

1. It records you intermittently with a microphone!

It apparently monitors your tone of voice using artificial intelligence.

Why would a fitness tracker need to monitor your tone of voice?

According to the Verge,

“The microphone on the Amazon Halo Band isn’t meant for voice commands; instead it listens to your voice and reports back on what it believes your emotional state was throughout the day. Once you opt in, the Halo app will have you read some text back to it so that it can train a model on your voice, allowing the Halo Band to only key in on your tone and not those around you. After that, the band will intermittently listen to your voice and judge it on metrics like positivity and energy. It’s a passive and intermittent system, meaning that you can’t actively ask it to read your tone, and it’s not listening all of the time.”

Watch the Washington Post video of Geoffrey and Heather asking about what they each had for breakfast.

Heather: “My husband made pancakes this morning. They were delicious. And he made me a cup of coffee to go, cause I got to come here. And then I had a banana. It was all very delicious.”

This is what shows up on the application screen in real-time based on the tone in her voice: “Interested, focused, knowledgeable”.

https://www.washingtonpost.com/technology/2020/12/10/amazon-halo-band-review/

Heather in response asks what he had for breakfast. Geoffrey replies: “Nothing nearly as exciting. Um, I had a cup of coffee and an apple.

“Friendly, appreciative, warm” shows up on the screen.

https://www.washingtonpost.com/technology/2020/12/10/amazon-halo-band-review/

Heather then shares the variety of words that the tracker has used to intermittently describe her tone, including “irritated, confused, angry, happy, stern, warm, friendly, friendly, anxious, happy, uncomfortable, stubborn, dismissive, annoyed, skeptical.”

Seriously? Is this a joke? Tell how this could be even marginally useful?

And then for the second strange feature:

2. It uses the smartphone camera to perform a body scan

According to the Verge:

“The app instructs you to wear tight-fitting clothing (ideally just your underwear) and then stand back six feet or so from your camera. Then it takes four photos (front, back, and both sides) and uploads them to Amazon’s servers where they’re combined into a 3D scan of your body that’s sent back to your phone. The data is then deleted from Amazon’s servers. Once you have the 3D scan, Amazon uses machine learning to analyze it and calculate your body fat percentage. Amazon argues that body fat percentage is a more reliable indicator of health than either weight or body mass index.”

Photo from https://www.washingtonpost.com/technology/2020/12/10/amazon-halo-band-review/

But according to Brian Chen from the New York Times after he did a scan on himself:

“The Halo said I was fatter than I thought — with 25 percent body fat, which the app said was “too high.” I was skeptical. I’m a relatively slim person who has put on two pounds since last year. I usually cook healthy meals and do light exercises outdoors. My clothes still fit. I felt body-shamed and confused by the Halo.”

Apparently Amazon has done internal studies to validate the scan results but which have not been published yet, but he did note that the body fat estimates he received from alternative methods were much lower: 19% using the Fitbit scale or 20% using skin-fold measurements.

Even if accurate, the advice it gave was the following:

“it said my 25 percent body fat level was too high and well outside the “Healthy” zone (roughly 12 to 18 percent). It also said healthy results were associated with longer life and lower risks of heart disease.”

How useful is that kind of advice? And guess what you have to pay $3.99 a month to get that less than useful advice!

When I read about the Halo, this is what I tweeted.

https://twitter.com/joyclee/status/1337860826502467584

I appreciated the reply from John Costik, a dad who has made many open source DIY contributions to health technology (Nightscout) that actually solved key problems for a global community of individuals with diabetes. (A Patient-Designed Do-It-Yourself Mobile Technology System for Diabetes, JAMA. 2016;315(14):1447–1448).

https://twitter.com/jcostik/status/1337876384467783687

I do have to acknowledge that the Halo does do some standard tracking tasks, like counting walking and running activity, measuring sedentary activity, and monitoring sleep and temperature.

But why make a device with these key features that serve no real purpose for the user and their health, in addition to being judgmental and body shaming?

Here is the assessment of the Washington Post reporters:

We hope our tone is clear here: We don’t need this kind of criticism from a computer. The Halo collects the most intimate information we’ve seen from a consumer health gadget — and makes the absolute least use of it. This wearable is much better at helping Amazon gather data than at helping you get healthy and happy.

As Thomas Goetz and Stephen Downs of the Building H project describe,

“It’s time to tap technology and innovation to make life healthy by default. This is not wearables and coaching apps.”

It’s not this wearable for sure!

I tweet and blog about design, healthcare, and innovation as “Doctor as Designer”. Follow me on Twitter and sign up for my newsletter.

Disclosures: Medical Advisory Board for GoodRx.

Here are some of other previous posts about health technology and bad design:
Creating a Culture of Health: Design that Goes Beyond the Mobile Application
The ROI on Design for Healthcare

Joyce Lee, MD, MPH, Physician, Designer, Researcher. #learninghealthsystems; #design for #ai; and the maker movement http://www.doctorasdesigner.com/