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Welcome to BIOTECH NATION !!! With understandable interviews requiring no background in science, BTN attracts a wide global audience. From everyday people looking for hope in treatments in development, to bioentrepreneurs interested in the experience of their fellow travelers, to venture capitalists looking for possibilities in cutting-edge breakthroughs, to scientists simply interested in the work of others, BioTech Nation is the voice of human endeavor, driving science to new realities for everyone. These interviews are drawn directly from the public radio program, "Tech Nation", which also can be heard in numerous global radio and podcasting venues.
Every time I speak with TECHNATION Health chief correspondent, doctor Daniel Kraft, I always wonder what personal technology devices is he wearing? So today, I asked him. Well, hey, Daniel. Welcome back.
Dr. Daniel Kraft:Great to be back.
Dr. Moira Gunn:Now, Daniel, every time I talk to you, you got all kinds of stuff on, around, in. You're wearing all this stuff. What are you wearing today?
Dr. Daniel Kraft:Well, that's a pretty personal question, but, my featured wearable wearables today, I've got my my trusty next generation Apple Watch, which is certainly becoming a more integrated health care device. I've got my Oura ring on, one finger, which can track everything from sleep to activity to even help you with meditation. I've got a a new version of a different one called Ultrahuman. It's one of the earringables. I've got it on my wife's Fitbit, and I won't tell you about my under wearables, but, it's part of my,
Dr. Moira Gunn:But hint hint at it. Hint at it.
Dr. Daniel Kraft:We'll just hint we'll just hint at that.
Dr. Moira Gunn:But it's there. You have under wearables?
Dr. Daniel Kraft:I'm I'm a little, let's say, over quantified. And on my right wrist, I have this new technology out of Europe, that can do noninvasive, I mean, without a cuff, blood pressure. So lots of new ways to start measuring your physiology and behaviors using these tools. You know, and we've come a long way since 2009 when the Fitbit launched. We're really in this new era of quantified self and quantified health where we can use these new wearables and otherables to get a real picture of our health and use that both for prevention, diagnostics, even therapy.
Dr. Daniel Kraft:The idea of of of trainables and electroceuticals are kind of, on the on the cusp of of being super impactful.
Dr. Moira Gunn:Now you just said otherables. What are otherables?
Dr. Daniel Kraft:Well, you don't need to be wearing anything today to start tracking your vital signs. In fact, on the camera on your laptop or your smartphone, several companies have built platforms blending with AI and the smart cameras to pick up your vital signs. One well known platform called bena.ai, is able to simply look at your face in over 20, 30 seconds, pick up your heart rate, calculate your blood pressure, your oxygen saturation, your heart rate variability, kind of your stress level. So that's an example where you don't need to be wearing anything.
Dr. Moira Gunn:Just by looking at you.
Dr. Daniel Kraft:Just by looking. It's a whole still.
Dr. Moira Gunn:Just your camera looking at you.
Dr. Daniel Kraft:The Wi Fi, in our houses can be modified. Professor Dina Katabi out of MIT developed a form of Wi Fi that can measure the vital signs, the sleep patterns of, 10 or more people in the same room. So you can tell even who someone is by their WiFi, almost radar based blueprint. Cameras now can track you around the house, a little bit dystopian, but they can tell if you're wearing something, what your behaviors are. Are you upright?
Dr. Daniel Kraft:The many wearable and other devices have microphones in them. So voice is a biomarker. You might hear my voice as a little hoarse and coming over a cold, but voice could be a biomarker. The sound of your voice can pick up signs of very neurologic disease. The sound of your cough can predict if it's cold or croup or COVID or tuberculosis.
Dr. Daniel Kraft:So when you think about wearables and otherables, it's going well beyond what's on the wrist, even to incidables technologies that are being implanted underneath the skin, or can be puncturing the skin. This new era of continuous glucose monitors, for example, that are part of our new sort of toolset to to measure health, disease, and track therapy, and even be used for for public health measures.
Dr. Moira Gunn:I have to say that we kinda focus on the sensor itself, the device itself. And, none of these are are sitting there just collecting data and it's going nowhere. Every single one of them, at some level, have the capability to send that data out so some other technology can analyze it so that a professional can look at it or so you can look at it. So we have to get a look at it in a bigger on a bigger landscape, if you will.
Dr. Daniel Kraft:Well, I think the the art of the possible is that many patients or humans are willing to share their digital exhaust, their their digitome, I like to call it, with their clinicians if if it would be useful. Now you can connect your Fitbit or Apple Watch or connect to Scale or Blood Pressure Cuff often through Apple HealthKit or in the Android based platform, so that you can start to integrate and have all that data collected and have it in one place. The challenge today, many of us are quantified selfers, we might be on top of looking at our data and our sleep score. But now it's unlocking where you can send that through your, to your medical provider, into your medical record. The challenge is most clinicians, most doctors like me don't wanna see your raw data.
Dr. Daniel Kraft:They kinda want the actionable insights. So part of this near future is that your wearable might be reporting that your resting heart rate is a 120 when you're sitting down. It might be the sign that you might have atrial fibrillation, might give you a little nudge, kinda be a check engine light, and have you see your primary care doctor or your cardiologist to do a workup. There's been many examples where folks have sort of seen something off with the wearable data and they've picked up a significant, let's say cardiovascular condition. We're gonna move to an era where this is gonna sort of create a bit of a baseline because most people don't have an average temperature of 98.6.
Dr. Daniel Kraft:Many folks are half a point to a point lower or higher. Just like your temperature might not be the average, your resting heart rate, your resting blood pressure, your heart rate variability, all those things are gonna be personalized to you. And hopefully part of your virtual physical exam or your in person where we'll be interrogating your digital exhaust so we can see problems early and head them off at the past.
Dr. Moira Gunn:I think something that, is very concerning for people is when they have an event, such as a heart attack, anything. Some some diabetic event that, might have sent you to the hospital, or surgery, certainly an insult there, or anything like that. Around that time is when you're really concerned. Am I on the comeback trail? Is there a second event that's about to happen that, you know, I got sent home from the hospital or from my doctor's office?
Dr. Moira Gunn:Seems to me a lot of these kinds of of technologies can make us, not only be more successful, but can make us feel better about the kind of care we're getting.
Dr. Daniel Kraft:Well, feel better, but also feel much more engaged in our care paradigm. The the the new drug is the empowered engaged patient who's often on top of their not just their health data, but their health insights. Some folks might have diabetes, and they're tracking their blood sugar with a patch. But now many folks who have normal metabolism are looking and wearing continuous glucose monitor patches. And just this month in March of 2024, the FDA approved the 1st over the counter nonprescription needing, continuous glucose monitor, which will be coming out later this year.
Dr. Daniel Kraft:So we can start to get a look at our metabolic health. And back to the point of, let's say, after a surgery or or an acute or chronic medical event, you can use small data from something like your Fitbit. My friend, Stefano Bini, who's a professor at UCSF Orthopedics sort of did a small study when they sent folks home from a total knee replacement. They looked at are they walking more each day and doing better or walking less? And those folks were walking less and expected.
Dr. Daniel Kraft:They could call them, intervene, maybe get them more physical therapy, prevent them from having a fall or other elements. So it's a really a new era where folks can engage with not just the data, but the insights, personalize that to them, and use that as as as part of their whole, care journey.
Dr. Moira Gunn:Does your wife know that you have her Fitbit?
Dr. Daniel Kraft:I well, the Fitbit knows that I have it because we kind of joke, you know, the old adage, if you do 10,000 steps a day, that's good for you, which is true. But it turns out it doesn't need to be 10,000. It might be closer 4 to 6000 depending on your age or medical condition. And some folks are being rewarded for walking, let's say, 10,000 steps. Some, health insurance life insurance companies give you a lower premium if you're showing you're walking 10,000 steps.
Dr. Daniel Kraft:So the joke is you might, put your Fitbit on your kid or on your dog or in the laundry, washing machine to give you extra steps. But in fact, something like our gait is very personal. It's almost like a fingerprint, and you can tell who's wearing your Fitbit or Apple Watch. And in fact, the new generation of some wearables can tell you if your gait is off, you have a risk for a fall, or if you're a bit unbalanced. And so, really interesting applications about who's wearing the wearable.
Dr. Daniel Kraft:And again, it's going beyond your list. We're now in the era of sockables that are sensors that could go into your socks that are helpful to attract the health of a diabetic in their foot. In many cases, some diabetics can feel their foot, might get foot injuries. Or an era of earables. So many older folks are wearing hearing aids, and they can be enabled to track your vital signs, track a fall, even provide you kind of a a digital AI assistant to remind you if you're lost or who you're talking to.
Dr. Daniel Kraft:We're seeing, not just wearables that need batteries, but some of them are powered by battery movement or some can have embedded ultrasound devices. So there's a whole new spectrum of these wearables and other bulls that can measure almost every element of physiology behavior. The trick is getting them paid for, regulated, and integrated into the workflow of the patient and the caregiver and the nurse and the data flow so we can really glean insights from that, that are really impactful.
Dr. Moira Gunn:So your wife's Fitbit knows you're wearing it, but your wife might not know. Just ask. Let's
Dr. Daniel Kraft:just keep that. Let's just keep that.
Dr. Moira Gunn:Between us and every the millions who listen, okay. It'll just be us.
Dr. Daniel Kraft:On that on that point, a lot of people ask me, what's the best wearable for me? And I think the wearable that is good for you is the one that you're gonna engage with, that you can keep the battery charged, that fits your lifestyle. So people don't wanna sleep with anything on, or just want something on their ring or their wrist is fine. As I've mentioned, I think before, I built a platform called digital.health. So if you go to digital.health and look up wearables or any condition, you can find a whole set of solutions that might be a good match for you.
Dr. Daniel Kraft:And what's interesting is these wearables often started as consumer type plays to track your steps and your sleep. But now they're moving into kind of the the medical and the health realm. So for example, a wearable ring I mentioned called Oura has done studies with UCSF where they they were able to show after someone gets their COVID booster, the Oura ring could pick up their titer based on changes in heart rate, temperature, heart rate variability.
Dr. Moira Gunn:They're tighter? What do you mean what do you mean by tighter?
Dr. Daniel Kraft:How well your, antibodies responded to the to the booster or the the vaccine. And so that's you might recall when you get your vaccine, maybe for the flu shot or COVID, you might feel a little bit lousy for a day. You might have a little bit of a Your heart rate's a bit higher. Your sleep might sleep might be a bit off. And those sort of digital biomarkers can be integrated into predict, number 1, how you responded to vaccine or also if you might be infected.
Dr. Daniel Kraft:Michael Snyder, a professor of genetics at Stanford, pioneered the ability to use a smartwatch during the pandemic to predict who had COVID 1 or 2 days before you're PCR positive. So these are gonna become public health measures. We'll start to look at our whole neighborhood and our wearable data and maybe know, here's a hotspot. And you might wanna stay away from that zip code, or that individual, in the future. And so I think it's an interesting time for wearables and otherables to kind of move us to this era of continuous, proactive, personalized data.
Dr. Daniel Kraft:And That data becomes insights and knowledge that we can use as individuals and as consumers to optimize our health span and prevention and screening to pick up diseases early, stage 0, not stage 2 or 3. And if you have a chronic or acute condition, everything from diabetes to post op from a surgery, We can use the data and insights to really guide our follow ups and tune our therapy, whether that's a drug, a digital therapeutic, or beyond. So, the era of wearables is going far beyond the Fitbits, all the way, I'll just mention to wearable exoskeletons, right? They're now folks who might be paraplegic, given quadriplegic. They can strap on the ultimate wearable, an exoskeleton that can help them move around.
Dr. Daniel Kraft:Just last week, I tried on a prototype, out of MIT Media Lab, which you attach to your shoe and gives you a little bit of boost in your stat. That's gonna help folks who are normally able walk or run faster, or maybe someone who's in their nineties have the energy to walk as far and as fast up Mount Kilimanjaro as a as a 30 year old. So exoskeletons are even blending to the era of wearable jet suits. I get to try flying 1, that are being piloted to see if they can help rescue folks in mountains. Eventually, we'll get to the era where maybe our paramedics and rescue folks wear jet suits to to get us out of trouble.
Dr. Daniel Kraft:So, when you think about wearables, it goes in in lots of exciting routes.
Dr. Moira Gunn:Well, getting you out of trouble. Let's hope your wife doesn't hear this segment. So she'll say, there's my Fitbit. I knew it was around here someplace. Hey, Daniel.
Dr. Moira Gunn:Thanks for coming in. We'll see you soon.
Dr. Daniel Kraft:We'll see you soon. I'm I'm glad I'm getting your credit on our steps.
Dr. Moira Gunn:Thanks for coming in.
Dr. Daniel Kraft:Thanks, Moira.
Dr. Moira Gunn:Technation Health chief correspondent, doctor Daniel Kraft, is the founder and chair of NextMed Health on the web at nextmed.healthanddigital.health. More information about Daniel at danielcraftmd.net.