Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at NYU Grossman School of Medicine in New York City.
Many of you have heard of Fitbits. These are wearable devices — some people have them on a watch — that people use to monitor different aspects of their health. It could be counting steps that they’ve walked, blood pressure, or oxygen saturation.
There are all kinds of health Fitbits around, but the next generation is here. Fitbit Gemini is a new personal health coach Fitbit that can do more things, and it’s being rolled out by Google.
The coach is advertised as giving you personalized fitness information, so helping you monitor your sleep and giving you advice about how to sleep better. You can talk to it, which you couldn’t do before, and ask health questions. It says it will help you modify your lifestyle to be healthier through better eating, and it has other interventions it will provide to a user in terms of weight monitoring and other features.
It’s the next generation and very exciting, but I do think it has some issues. For one thing, the data that these Fitbits use are based on a chatbot that is artificial intelligence (AI), meaning it just swings around the web and finds information when it’s answering your question. That’s dangerous because there’s a large amount of bad advice out on the web.
I think there isn’t really sufficient quality control yet to say, if I’m asking a question about a growth here, a pain there, or whatever, that I can go along with my Fitbit’s advice and let that guide my health. It may certainly turn up things where the Fitbit should properly say to go see a doctor, but I worry, having been around AI chat, that there’s a large amount of what they call hallucinations or misinformation that could get back to the user. Those are serious limits.
It’s also not clear what the privacy protections are. A large amount of intimate information is starting to get collected. Will Google be able to access it? There are all kinds of data dumps that companies use to advertise products back to people. I haven’t seen much in the way of guidelines about privacy and how these services are going to protect individuals’ information.
The other worry I have about this next generation of Fitbit is that it claims to be personalized, but I’m not really sure how the Fitbit is going to give information aimed at you. Is it going to be sensitive to gender? Is it going to be sensitive to racial or ethnic differences? Is it going to be sensitive to age? These have to be key aspects of personalized advice, which is a big advertising theme with these newest devices, but I don’t see them giving more than general information than you pull off the web, so I’m not sure it’s very personalized.
I do think you’re going to see many people using these, and I do think they could be useful to many people. If I’m not sleeping well, maybe it wants to send me off to get some expertise from a human before it claims to give me personalized advice about what’s keeping me awake at night. That’s what I mean when I say I’m not sure that the information is personalized and accurate.
I certainly worry if I’m talking about my sex life, mental health, or other sensitive issues that the walls are up so that third parties aren’t going to be having a chance to listen in to my chat with what’s on my wrist.
The obvious question with this next generation of Fitbit is, what does a doctor — you — say to a patient, or for that matter, to somebody who asks you at a party or anywhere else about this more sophisticated Fitbit?
I think the answer is to use them, but cautiously. They’re not to be substituted for regular checkups or visits. If you work out a plan for sleeping problems, sexual problems, or whatever, that means a real expert — not just a Fitbit. I wouldn’t advise reliance on them. They can provide interesting information.
I’m not unrealistic. They’re going to be heavily advertised and people will, for all kinds of convenience reasons, want to use them. Ultimately, you have to remind them that medicine is still best practice — not at the end of your wrist, but with a visit to the office.
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