Numbers Aren’t “Health”

Digital technologies geared toward supporting Health are growing at a rapid clip. Almost every day a new product is launched, promising some form of Health or Healthcare utility.

As the technologies evolve – especially devices that do the heavy-lifting that once required expensive interventions – their proper development, implementation, and proper understanding of their specific roles/functions become paramount.

There is one prominent keyword used in the marketing of these #DigitalHealth technologies that can be a source of great misleading hype (intentional or unintentional). That term is “track”.

A common tagline or general claim of these products is something along the lines of “X can track your health”.

But numbers and qualitative metrics, aren’t “Health”.

“Health” is such an encompassing term as to be so vague it has no meaning. Health derives from “whole”. You hear its origin in words like “heal” and “holy”. The cheesy idiom “the whole is greater than the sum of its parts” applies here – the sum of numbers and quantified “selves” doesn’t quite get to the “Health”.

When you hear “this is healthy for you”, what does that mean? Water is “healthy for you”. It’s also “deadly for you”. It’s not the water that keeps you healthy: its water’s proper homeostatic processing within an organism’s system – its unique panoply of molecular, topological, and volumetric properties working as the body’s protective systemic armour under the right conditions that determines the life drive. Hypervolemia can kill you. Uncontrolled Pulmonary Edema isn’t a fun way to go.

Numbers are helpful guides, but they can be misinterpreted, and can lead to misdiagnosis or missed diagnosis. They can provide a false sense of being “healthy”.

So here’s the main point: it’s one thing to claim “X tracks pulse, weight, and oxygenation”. That equation specifies the exact metrics being tracked. It’s another to declare that “X tracks your Health” says nothing. There’s no specifics and even the term “Health” isn’t defined. It’s not a falsifiable proposition. You can count your steps, but the numbers don’t help you if you’re about to run into a brick wall.

Marketing Digital Health and other technologies and software that support our health (in whatever way it’s defined) is an essential activity in the evolution of Healthcare.

Bad marketing and sloppy thinking and vague claims might sell products. But in the long run, it’s counter-productive for the industries in the markets, generates problems for HCPs in proper diagnosis, treatment and management, and unsafe for consumers.

Smart, experienced, and knowledgable marketers know how to create copy that simultaneously sizzles and states facts.

Don’t be afraid to call out the amateurs. Who knows: it might even be healthy for you. That’s not a falsifiable proposition…still it could be fun to terrify a startup unicorn with a healthy question mark.

The Connected World and Its Disconnects

Internet of Things
The Connected World, strung together by the “Internet of Things” (IoT), is one of the hottest topics of conversation and commerce. The “things” take the form of hardware (gadgets, circuit boards) and software (social platforms, digital health records). It seems every industry has thinkfluencers and marketers determined to connect everything to the Internet – toasters to Twitter, pacemakers to spreadsheets, milk cartons to grocery delivery services and so on.

Many of the *concepts* of connecting things are useful.

For example, here’s a breakthrough idea: connect a 3D-printed liver to a monitoring system that checks liver function and configures adjustments to the artificial liver’s tiny digital gadgetry.

The problem – and it’s an all-infiltrating one the entire of the Connected World – is the virtually endless lists of Disconnects. (Think of the issues with a digitally-fatty printed liver – they could dwarf a lifetime of alcohol abuse.)

What do I mean be “The Disconnects”? Well, let’s list them:

  • The disconnect between IoT hardware and software updates (or lack thereof)
  • The disconnect between government regulation and manufacturing and coding
  • The disconnect between security practices and insecure configurations
  • The disconnect between the Internet’s original purpose and the fast-evolving purposes created in the Connected World
  • The disconnects among communication protocols
  • The disconnects among IoT manufacturers
  • The disconnects along supply chains and vendors
  • The disconnect between speed-to-market and need-to-secure
  • The disconnect between IoT software and patches (if they even exist)
  • The disconnect between consumer safety and corporate capitalization
  • The disconnect between product malfunction and self-repair
  • The disconnects within manufacturer teams (Executive Leadership, Product Development, Security, Customer Service, etc.)
  • The disconnect between our use of technology and our slavery to it
  • The disconnect between tinkfluencers and reality (this is painfully wide)

That’s the short version. The Disconnects Lists goes on…perhaps infinitely so.

The Connected World has its promises. But all technological promises in the long run break, and they break in unpredictable ways. The Connected World brings forth Disconnects we haven’t as a species fully explored, processed, formulated theories, nor developed universally-adoptable models for continual forward-thinking, safety, maintenance, etc.

The “Connected World” project is here to stay, even discounting the hype and thinkfluencing.

So what to do?

That’s a big question, and I don’t have all the answers. My purpose here is to point out the digital version of Civilization and Its Discontents.

Therefore, I propose that where we should start our thinking is with the Disconnects, then move towards the Connects.

Idea-generation and deployment for IoT is a task with enormous ethical, moral, economic, security, health and safety responsibilities.

But without considering – deeply, diligently – the disconnects, then the Connected World will be nothing of the sort. It will be a nightmare without morning. It will become the Disconnected World. Good luck with putting the pieces back together.

Cognitive Bias, Emotional Clarity

Cognitive Bias Codex - 180+ biases, designed by John Manoogian III (jm3)
2016 was the year of cognitive bias bifurcation in America (in particular cognitive dissonance). I won’t go into the details of the election, but @ScottAdamsSays has it down pat.

We know – or should know – that the mechanisms governing evolution via natural selection weren’t “seeking out” brains free of fallacy, bias, sterility of emotional inputs and outputs, nor brains operating like computers.

And yet, here we are: billions of years since the first self-replicating polymer, sensory nervous systems capable of a wide array of tasks from developing mathematical understandings of our world, constructing logic circuits out of silicon and electrons, and even algorithms like the scientific method capable of dissecting the wonders of consciousness itself into manageable chunks of knowledge. It’s as if Thelonious Monk composed us out of entropic notes of molecular vibrations.

And yet (again), here we are: believing in strange ideas, miscalculating simple probabilities, stuck in our own reality tunnels, spending almost all waking (and dreaming) hours in non-logical worlds shifting from moment to moment. It’s why two equally intelligent people from similar backgrounds can have diametrically opposing political views – each fully incapable of considering that their minds are programmed by their own or others’ cognitive biases and emotional charges.

Add Social Media to the mix and the moron is the medium. Apply Symbolic Logic to any Facebook thread and the chance of finding the comments passing through any of the truth functions approximately 0%. Curiously, the Hungarian composer Ligeti, who witnessed the terrors of Fascism and Stalin, also showed us how susceptible we all can be to the metronomic submission to ideologies.

In almost every element of life, emotion trumps reason. That isn’t necessarily a bad thing: Emotion evolved out of and over the substrates of natural selection, and enables us to achieve powerful feats. We’d die without emotion. (Perhaps any future “artificial fully-consciousness” being won’t survive without some capacity for emotional capacities that may be necessary to process external and internal sensory data.)

How many medical diagnoses and treatment plans are impacted everyday by cognitive bias? One? Dozens? Tens of thousands? Think of the costs in human health, economic waste, and forgone hypothesis-testing to challenge practices!

Except for short durations, we continually deploy cognitive biases and we persist in emotional ingongruity. Self-attention is a necessary but not sufficient condition for Cognitive Objectivity and Emotional Clarity. But as we travel up the exponential curves of technological changes and their ramifications, our elbow room for cognitive bias and emotional fog narrows as our need for cognitive prowess and emotional clarity expands.

Why? Well, until now we could believe in almost anything and still get by because the reaches of damage were limited. If one believed that people who don’t pray to the Spaghetti Monster should be executed, the ability to execute non-believers had technological, geographical, psychological, political, cultural and other upper-bounds.

Today one person or small group, armed with the right kind of weaponry (be it technological or persuasive) can bring down fundamental infrastructures, inflict mass casualties, or infect millions of minds with their delusions in short order – a cunning manipulator who can program minds with triggering words can do a lot with Twitter. Sounds outlandish – but it could be argued that we have our first Twitter President.

So what to do? Well, we can work on our self-awareness of how our nervous systems work. Here are some practical steps:

Lastly:

The heart of civilization does have a story to tell – it’s just a matter of using our brains as filters against the horrors and discontents of childhood wounds. The heart pounds, and the brain listens. Sometimes. One flash of clarity can reveal a world you never knew existed, a place to explore unimagined opportunities.

Ironically, it may be that the right kind of advances in so-called AI might temper our cognitive biases, while freeing us up to do the hard work of emotional clarity: creation. Then again, that may be magical thinking – a cognitive bias of mislead technocrats.

In the meantime, challenge yourself.