My Health Data Is Killing Me


We are still in the dark ages when it comes to health and fitness data. It reminds me of the early 1990s when I had a paper day planner for a calendar, a business card holder for contacts, and a map.

Then along came the Microsoft Outlook and LotusNotes platform. These two platforms slugged it out like Uber verses Lyft. Then Microsoft integrated MS Office with MS Outlook and it was “game over.” I finally had one place to find everything I needed to do 90% of my job.

I’m waiting for that moment to come to the realm of my fitness data. It’s extremely difficult for me to access my medical and fitness data as it is, and yet the recent CES conference presented hundreds of new ways to collect more of my data. There will be wearables, scales, patches, contact lenses, smartphones, watches, etc. Maybe even a drone to fly overhead and watch what I eat for lunch. It is overwhelming. How overwhelming, you ask?

Let’s start with AppleHealth (HealthKit).

There is a reason Apple gave this app out for free on iOS 8.0. I recall getting the Brickbreaker game for free on my Blackberry in 2004. I played it once on a long flight and never used it again.

There are so many ridiculous data categories in HealthKit. Note at right that I have to go past my Biological Sex every day — which hopefully doesn’t ever change — to get to my Blood Alcohol Content, which typically does change every day. After Caffeine, there are categories for Calcium, Chromium, Copper, Folate, Iodine, Iron, Molybdenum, etc. I can also track the “Number of times I’ve fallen”, which I guess is useful for some older folks. But how many older folks that fall frequently are using this app on their iPhone? And how many times per year am I gonna check my Molybdenum levels? I don’t even know what a good Molybdenum level is. So I gotta scroll past my Chromium, Copper, and Folate categories to get to my Heart Rate. If I go up a level, I get to Calories, Steps, Walking + Running Distance, and Nike Fuel. The Nike Fuel category is really great, but Nike has fired everyone and is no longer making wearable hardware, so it’s already obsolete.

The majority of the data I collect on personal fitness does not map to Apple HealthKit. So I’m tracking tons of information on multiple apps and sites. Right now, my Apple HealthKit dashboard contains the following data: Steps, Walking Distance, Weight, BMI, Body Fat, Active Calories, and Heart Rate. Like the data coming from wearables, most of this data is totally useless to me. As a reasonably healthy person, I’m not that interested in how many steps I take each day. At 13% body fat, I’m also not that concerned with minor fluctuations in BMI.

In my Bathroom

Withings data

I use a Withings Smart Body Analyzer. Fancy term for a scale in my bathroom. I weigh myself and that data wirelessly transmits to my Withings iPhone app. With two clicks I can access every weight reading for the last year. It captures my weight, Body Fat, BMI, Heart Rate, Steps, and the Air Quality in my bathroom. This information maps to Apple HealthKit, but it’s just about the only data that is useful that maps directly where it is supposed to go.

At my Doctor

My Primary Care Physician now has my medical records in a secure electronic site using Epic MyChart. At my home page I am reminded to have a Tdap/td Age 18-65. I have no idea what this is, but apparently I’m overdue for it.

My last blood test is there, but there is no history beyond that test. There are lots of cool tools like graphing and trending capabilities, but with one blood test there isn’t much to graph. Luckily I maintain the results of 15 blood tests going back to 1997. It’s a basic MS Excel spreadsheet on my desktop.

Of course, none of this will map to Epic MyChart or AppleHealth unless I manually enter it. So even with all the recent digital advances, I am still comparing my current results from Epic/MyChart to my old Excel spreadsheet. Of course, none of this data maps over to AppleHealth or any other app. So this is pretty much dead data. Once I’ve looked at my blood test results, there is no reason to go back.

I could not find any other test results or images, such as a recent colonoscopy. Maybe that’s a good thing. But what if I have chest pains during an overnight trip to Oklahoma City? How will the emergency department get my last EKG? What if I need an MRI, but I just had one last week in Atlanta? Having a cloud-based repository is not only convenient, it will reduce over-testing and excess cost from the system.

At the Gym

Flywheel Spin Class: The Flywheel app is the most useful app on my phone. It’s tied to the joint where I do spin classes. I use it 4-5 times each week. I can schedule classes, track my performance, average speed, calories burned, distance, etc. Everything maps immediately to my Flywheel iPhone app. I can also graph all my rides against each other back to my first ride in January 2014. I can look at each ride and determine the percentile vs. every other rider in Atlanta. Again, none of this maps to Apple HealthKit.



Polar Beat/Flow: I use Polar Beat/Flow and a chest strap to track my heart rate, distance, calories, exercise zones, etc. when I’m doing aerobic activity. This information does map to a Polar app on my iPhone and then to AppleHealth. In terms of improving my cardiovascular health, this is probably the most useful app. I can actually see (graphically) how hard I’m working and whether my performance is improving. But it is only useful to me at 160 heart beats per minute. For the other 23 hours in the day, it is useless to me.

FitBit: I started using a FitBit activity tracker last December. I made it to about February before I put it in a drawer. My daily steps and calories just aren’t that interesting or useful to me. And I can typically tell you whether I slept okay last night or not. The other features were useless. Surprisingly, it did not allow me to track my heart rate during exercise. This “one-dimensional” wearable category will die unless the diagnostic technology ramps up fast. Even then it will likely become siloed into different devices for chronic conditions such as diabetes, cardiac, etc. It will soon be as useful as the hieroglyphics text I used on my old Palm 3 PDA.

The prognosis

The Apple HealthKit app seems haphazardly put together. A beta user could have figured out how useless most of the categories are in a matter of days. Even for a data geek like me who tracks everything, the vast majority of the categories are useless.

Most people think Apple will just be the “repository.” But getting all my apps to sync to Apple HealthKit is frustrating or impossible. If I was a betting man, I’d say that Apple has intentionally created a site that is rather useless. A teaser, of sorts. If the consumer gets frustrated enough they will either give up or go looking for an easier way to collect and aggregate data. It would seem that Apple is merely setting the stage for one device that does it all: the Apple iWatch. After all, there isn’t much profit margin in a free app. There is a high margin in a category killing iWatch.

Then again wearing a geeky smart watch is an invitation to get beat up and stuffed into a school locker during homeroom. The iWatch will never be as cool as the iPod, iPad, or iPhone, even if Steve Jobs personally makes the pitch in a hologram from heaven.

What the world needs now is a category killer like MS Outlook. It needs to be user friendly and have a killer GUI. I need one site where my fitness and my medical data can coexist happily. A place where I don’t have to scroll past my Molybdenum levels to see results from yesterday’s spin class. Where data analytics can begin to predictively model my health risks and let me know when something is wrong. A place where I can begin to control my own data and take proactive steps towards better health. After all, what good is all this data if I cannot use it?

We need the “Domo” of healthcare.

9 replies »

  1. Hey Tom,
    I’m all about it just like others. It’s fact that technology helps to finish our work as quick as possible and collect required info at one place where we need it. As the facility increases, our expectations are going to increase but sometimes it’s not possible to collect all the required information the way you want.

  2. Why are the people who DON”T need to keep up with their “health data” the only ones who seem obsessed with it?

    (witness Tom, Casey, et. al. above. – You guys are riding bikes, weighing yourself and checking your BMI daily, and worrying about your molybdenum levels. You are the doctor’s dream. You are the definition of the “worried well,” and I mean that in the nicest possible way!!!)

    HOW I only WISH that the obese, diabetic, hypertensive, smoker with COPD and “chronic pain” who comes to my ER and can’t recall any of her 37 different meds from 9 different doctors could provide me with an ounce of usable “health data.”

    NO, I have to resort to old-fashion Sherlock Holmes methods to find out what’s going on with her: the EMT relates seeing an empty bottle of gin by the nightstand, the tech calls the local pharmacy to confirm medications (Yeah HIPAA, I Know), I scan her narcotic prescription profile and see a recent fill for oxycontin, I speak to the family about her compliance with insulin, and maybe I’m lucky enough to catch her Pri Care doc in clinic to fill me in. Why doesn’t this patient use any of these cool apps on her Obama-phone, I moan to myself . . .

  3. I agree with Eric and Andy above, that what we’re seeing with HealthKit (and to a lesser degree GoogleFit) is an alpha of what will ultimately be delivered.

    The real challenge of health data – self-tracked or contained within EHRs – is that the business model underlying that data is “catch and hold,” not “catch and release/share.” Data = $$, and letting someone else see into your wallet [data inventory] freaks out health plans, benefits managers, large health systems, et al.

    Which at least partially explains why, after saying for years that I’d happily get a barcode tattooed on my neck if it meant I never had to fill out a health history form again (similar in frustration-building to your having to navigate past your Biological Sex setting every time in HealthKit), I tattooed a QR code linked to my self-gen health history and advance directive on my sternum.

    At least that way, there’s a prayer that, should I be nailed by a suburbanite rage-driving an SUV while on one of my daily walks or bike rides, my health data might be available to the EMTs who scoop me up, and the ER where they deliver me.

    Beyond that? Health data = siloed cash. Now, where’s my 4-pound sledge … ?

  4. I agree with Eric: the problem lies in the lack of interoperability. That’s not just Apple’s fault, although it’s not doing as much for the community as it could by trying to be one-stop shop for all personal data and to have an exclusive deal with Epic. As for the range of data shown: doesn’t sound to me like deliberate sabotage, but just the overzealous attempt to do everything that one sometimes finds among product developers. (I can imagine a programmer saying, “Hey, I figure out how to add such-and-such! Let’s do it1”). Compare with Google Fit, which (at least when it first came out–that’s when I checked it) had really impoverished options. It’s Google Fit that looks like a teaser.

  5. More seriously, it is actually possible this could be intentional —


  6. Could they possibly mean biological sex WITH a male or female?

    As opposed to non-biological …

    That could change, with some frequency I suppose


  7. As you said in the article, Apple HealthKit is a repository for health data. More importantly it’s a SECURE and access-controlled repository for health data. The Health app installed on your phone with iOS 8 is a view into that data, and a way to add data into the repository, but it’s not the be-all-end-all for health information on your device. It’s up to app developers to write apps that integrate with this repository/platform in interesting ways.

    iOS 8 and HealthKit are three-months-old at best, and the vast majority of apps out there aren’t using them to their fullest potential yet. Don’t think of Health as a one-stop-shop, think of it as a hub for health information. What we should see in the future, thanks to this platform and with vendor cooperation, is more like Polar Beat/Flow, FitBit, and Flywheel all writing your active calories to HealthKit, and the Epic MyChart iOS App reading them and sending them to your doctor, so at your next check-up when he asks if you’re exercising, you both have some pretty-accurate data to back-up your answer. (And should he notice that your Molybdenum intake is at 6000% of recommended daily values, based on input from your diet-tracking app, maybe suggest a targeted change to your diet.)