{"id":5768,"date":"2025-05-16T06:53:00","date_gmt":"2025-05-16T06:53:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=5768"},"modified":"2025-05-16T06:53:00","modified_gmt":"2025-05-16T06:53:00","slug":"health-deserves-a-vision-more-capacious-than-dashboard-metrics","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=5768","title":{"rendered":"Health Deserves A Vision More Capacious Than Dashboard Metrics"},"content":{"rendered":"
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By DAVID SHAYWITZ<\/p>\n

Consumer health and wellness is experiencing a flurry of activity.\u00a0<\/p>\n

The lab testing company Function<\/a> (motto: \u201cIt\u2019s time to own your health\u201d) acquired<\/a> Ezra<\/a>, a whole body MRI company promising \u201cthe world\u2019s most advanced longevity scan.\u201d\u00a0\u00a0\u00a0<\/p>\n

Oura<\/a>, maker of the popular smart ring, recently added<\/a> an integration for continuous glucose measurement as well as the ability to calculate meal nutrition based on a photo. Oura also hired<\/a> Dr. Ricky Bloomfield as its first Chief Medical Officer; Dr. Bloomfield had previously served as Clinical and Health Informatics Lead at Apple, and is known for his expertise in health data interoperability.\u00a0<\/p>\n

Meanwhile, Oura competitor Whoop<\/a>, maker of a smart band, just announced<\/a> the latest versions of its device, with the ability to monitor blood pressure, ECG, and to assess what it describes as a measure of biological age, which it calls \u201cWhoop Age.\u201d\u00a0Whoop now says it seeks to \u201cunlock human performance and healthspan,\u201d enticing users with the pitch, \u201cGet a complete picture of your health.\u201d<\/p>\n

Towards a Personal Health Operating System (OS)<\/strong><\/h4>\n

Notice a pattern yet?\u00a0<\/p>\n

What unites these approaches and so many others<\/a>, as the industry newsletter Fitt Insider (FI) recently observed<\/a>, is they reflect an attempt to generate a \u201cpersonal health OS,\u201d intended to \u201cgive individuals agency over their well-being,\u201d and more generally, wrest control back from a health system that\u2019s often perceived (especially by young adults) as somewhere between useless and obstructive.<\/p>\n

Citing a recent Edelman survey<\/a>, FI reports,<\/p>\n

\u00a0\u2026nearly half of young adults believe well-informed people can be as knowledgeable as doctors, two-thirds see lived experience as expertise, and 61% view institutions as barriers to care.<\/em><\/p>\n

Fed up with <\/em>reactive care<\/em><\/a>, many already collect data across wearables, lifestyle apps, DTC diagnostics, and more, but most are siloed. Rolling up, Function is architecting a unified platform capable of generating clinically relevant insights from raw inputs.<\/em><\/p>\n

FI points to the proliferation of companies like Bright OS, Gyroscope, and Guava Health focused on \u201cday-to-day data management,\u201d as well as startups like Superpower (\u201cDelivering concierge-level metrics minus the PCP\u201d) and Mito Health (a \u201cpocket-sized AI doctor\u201d that \u201cgenerates comprehensive digital health profiles by merging labs, medical records, family history, lifestyle info, and more.\u201d)<\/p>\n

AI seems poised to play an increasingly central role in many of these companies.\u00a0<\/p>\n

FI speculates,<\/p>\n

A step further, end-to-end LLMs could close the loop, linking cause and effect, turning insights into actions, syncing with PCPs, and laying the foundation for an <\/em>AI-powered medical future<\/em><\/a>.<\/em><\/p>\n

This is a good time to take a deep breath \u2013 as well as a closer, more critical look at this vision of consumer-empowered, data-fortified health.<\/p>\n

A Powerful Vision<\/strong><\/h4>\n

Unquestionably, there\u2019s a lot to embrace here, including in particular:<\/p>\n

The opportunity for individuals to gather more and richer health data from a greater variety of sources, including in particular wearables;<\/p>\n

The increased possibility of relevant<\/em> insights (a key deficiency<\/a> of early \u201cQuantified Self\u201d efforts) from these data.<\/p>\n

The explicit centralization of your health data around you (Superpower\u2019s tagline is \u201cHealth Data, In One Place\u201d), a long-promised but often frustratingly elusive healthcare goal in practice. Today, still, (still!), so many patients find themselves having to beg and plead for efficient access to their own health information, data that health systems tend to view as a competitive advantage<\/a> and aren\u2019t eager to let go.<\/p>\n

A tech-enabled approach to health where you have more abundant data about you, that are explicitly in your control, and which could lead to healthier behaviors represents the sort of progress that deserves to be celebrated.<\/p>\n

At the same time, when I look at many of these approaches to health, I see two broad categories of concerns.<\/p>\n

Concern One: Plural of Fragile Data May Not Be Insight<\/strong><\/h4>\n

The first, perhaps more concrete worry, is that, to paraphrase comedian Dennis Miller, \u201ctwo of [crap] is [crap],\u201d and simply the collection of a lot of data, much of which may be fragile, isn\u2019t sure to translate into brilliant insight, even if the magical power of AI is fervently invoked.<\/p>\n

In an especially incisive \u201cGround Truths\u201d blog post focused on \u201cThe business of promoting longevity and healthspan,\u201d Dr. Eric Topol writes<\/a> that \u201cgetting hundreds of biomarker results and imaging tests in an individual greatly increases the likelihood of false-positive results,\u201d a concerning possibility.<\/p>\n

I\u2019ve discussed the challenge of false positives here<\/a>, and get into some of the details around Bayes Theorem (which informs the assessment) here<\/a>.\u00a0The OG reference in this space may be this<\/a> 2006 paper by Zak Kohane and colleagues, in which they introduce the term \u201cincidentalome.\u201d<\/p>\n

To be fair, at least some of the proponents of extensive testing recognize the challenge of false positives but feel that the opportunity to collect dense data on individuals over time enables important inflections to be observed, a point Dr. Peter Attia explicitly emphasizes in Outlive; <\/em>I discuss his \u201crisk-management\u201d mindset here<\/a>.<\/p>\n

Similarly, Nathan Price, a professor at the Buck Institute and the CSO of Thorne, has argued that close inspection (assisted by AI) of rich individual data could identify (for example) opportunities for supplement intervention.\u00a0 These interventions may not make much of a difference on the population level (hence the paucity of persuasive clinical trial data for supplements, as Dr. Topol notes in his latest book, Super Agers<\/em> \u2013 my WSJ<\/em> review here<\/a>), but could in selected individuals. (I also discuss Price here<\/a>, here<\/a>).<\/p>\n

Proponents of the \u201cpersonal health OS\u201d also might emphasize the presence of tailwinds \u2013 the likelihood of improved predictions as measurement technologies continue to get better, denser data become available, and the AI tools become ever-more capable.\u00a0 Perhaps we\u2019re not quite at the point of realizing the future we imagine, advocates might argue, but we\u2019re close enough to start to see what it might look like.<\/p>\n

<\/span><\/p>\n

Concern Two: A Constricted View of Health<\/strong><\/h4>\n

What\u2019s arguably a deeper concern about the model of health we seem to be moving towards is the degree to which it seems to be informed by a rigidly reductive mindset.\u00a0In this limited, classically managerial (or consultant) view, health becomes simply metrics on a dashboard, an ever-expanding series of parameters that must constantly be measured, quantified, optimized.<\/p>\n

A recent, beautiful essay<\/a> about our evolving understanding of and approach to happiness in the New York Times Magazine<\/em> by Kwame Anthony Appiah reminds us what we may be missing.\u00a0<\/p>\n

Around the start of the new Millenium, Appiah writes, we entered<\/p>\n

the life-hacking, self-quantifying, habit-stacking era of optimization gurus like Tim Ferriss, whose first book, published in 2007, was \u201cThe 4-Hour Workweek\u201d \u2014 \u201ca toolkit,\u201d in his words, \u201cfor maximizing per-hour output.\u201d<\/em><\/p>\n

Consequently, Appiah continues, the concept of flourishing was decomposed into \u201cmodular upgrades\u201d as we refine our \u201cpersonal operating system.\u201d\u00a0<\/p>\n

Yet it\u2019s essential to recognize, Appiah writes, that \u201chappiness is not an optimization problem,\u201d but something deeper and more substantial.<\/p>\n

I reached for a similar point in 2018, in a piece<\/a> entitled, \u201cWe Are Not a Dashboard.\u201d\u00a0<\/p>\n

Observing that the \u201cdashboard has become a potent symbol of our age,\u201d I wrote that \u201cthe ideology of big data has taken on a life of its own, assuming a sense of both inevitability and self-justification.\u201d<\/p>\n

I continued, \u201cFrom measurement in service of people, we increasingly seem to be measuring in service of data, setting up systems and organizations where constant measurement often appears to be an end in itself.\u201d<\/p>\n

I\u2019m reminded of a favorite phrase from Kate Crawford\u2019s Atlas of AI<\/em> (my WSJ<\/em> review here<\/a>): \u201cThe affordances of the tools become the horizon of truth,\u201d a reminder, in this context, that even if we\u2019re awash in tools enabling the measurement and analysis of health data, we must ensure our understanding of health transcends the limits of these tools.<\/p>\n

Of course, the point isn\u2019t to go the other way, and reject metrics completely.\u00a0<\/p>\n

As Professor Jerry Muller, author of the brilliant book Tyranny of Metrics,<\/em> explains<\/a>, \u201cI can\u2019t see how competent experts could ignore metrics.\u00a0The question is their ability to evaluate the significance of the metrics, and to recognize the role of the unmeasured<\/em>.\u201d (emphasis added<\/em>).\u00a0<\/p>\n

I also spoke to this need in a 2011 piece<\/a> entitled \u201cWhat Silicon Valley Doesn\u2019t Understand About Medicine,\u201d writing, \u201da novel technology platform that overlooks the integrated needs of patients or underestimates or fails to account for the complexity and messiness of illness as it actually occurs and is experienced by patients (and those closest to them) will inevitably fall short.\u201d<\/p>\n

Moving Forward<\/strong><\/h4>\n

To most effectively meet the needs of patients \u2013 including the vitally important goal of preventing or preempting disease so people don\u2019t become patients \u2013 it\u2019s essential to embrace the power and promise of emerging technologies, including those enabling the conceptualization of \u201cpersonal health OS,\u201d\u00a0 while not mistaking this map for the territory (as Alfred Korzybski famously instructed<\/a>).\u00a0<\/p>\n

It will be essential to establish priorities \u2013 in partnership with each patient \u2013 and identify a handful of key health parameters on which to focus on; Drs. David Blumenthal and J. Michael McGinnis discuss the topic of \u201ccore metrics\u201d thoughtfully in this<\/a> 2015 JAMA<\/em> \u201cViewpoint.\u201d\u00a0<\/p>\n

At the same time, we must hold fast to a vision of health and wellness that expands far beyond the confinement of a dashboard and aspires to something beyond the recursive optimization of metrics (as I recently discussed here<\/a>).\u00a0Our approach must be capacious enough to include, authentically value, and meaningfully cultivate other components of a healthy, flourishing life, which might include intellectual captivation, the pursuit of purpose, and social engagement with family, friends, and community.\u00a0\u00a0<\/p>\n

(Martin Seligman\u2019s PERMA model \u2014 positive emotion\/joy, engagement\/flow, relationships\/connection with others, meaning\/purpose, and accomplishment \u2014 represents a potentially useful framework [see here<\/a>, here<\/a>] for expanding our thinking.)<\/p>\n

Despite the difficulty, if not utter impossibility, of reducing some of the most important and profound components of health to an easily digested number, we must continue to value and pursue them.<\/p>\n

Even as we diligently leverage emerging technology to construct and refine health dashboards, let\u2019s resolve to work towards a more expansive, durable, and meaningful vision of health that exists beyond the sterile syntax of rows, columns, and digits.<\/p>\n

Dr. Shaywitz, a physician-scientist, is a longtime operator and investor in health tech, the founder of <\/em>Astounding Healthtech, a lecturer<\/em><\/a> at Harvard Medical School and an adjunct fellow at the American Enterprise Institute. This piece was originally published on the <\/em>Timmerman Report<\/em><\/a><\/p>","protected":false},"excerpt":{"rendered":"

By DAVID SHAYWITZ Consumer health and wellness is experiencing a flurry of activity.\u00a0 The lab testing company Function (motto: \u201cIt\u2019s time to own your health\u201d) acquired Ezra, a whole body MRI company promising \u201cthe world\u2019s most advanced longevity scan.\u201d\u00a0\u00a0\u00a0 Oura, maker of the popular smart ring, recently added an integration for continuous glucose measurement as…<\/p>\n","protected":false},"author":0,"featured_media":5767,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-5768","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/5768"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5768"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/5768\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/5767"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5768"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5768"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5768"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}