This week we saw the acquisition of Runkeeper by Asics as the latest round of consolidation across the tracking app, wearable and athletic wear sectors. On the surface this may appear unrelated to the focus in the health IT space on Population Health Management (PHM), but we may need to rethink this assumption.

Wearables and the Quantified Self have been the focus of a considerable amount of hype for the past few years. Critics continually point to the lack of sustainable use of wearables by even the healthy, typical users of Fitbit, for example. Furthermore, those who need wearables most are least likely to use them.

“Engagement” is the first word on the lips of most who see the value of wearables in the long run, but what might that look like — and what can it tell us about the concrete realities that preoccupy healthcare organizations focused on improving outcomes, margins, and costs? Arguably, we’re in the early days of both wearables and PHM, but there are some interesting developments in this space that are worthy of tracking in the coming months and years.

One of the critical missing pieces of the puzzle in wearables and behavioral change is the lack of feedback loops based on the data collected in the app(s). Nice data visualizations may have a novelty effect in the first few months, but they eventually face diminishing returns in incentivizing behavioral change. This is what concerns those who are looking for cost-effective ways to utilizing remote monitoring. However, studies show that Web-based coaching outperforms face-to-face interactions in the clinic.

In the sports and wellness sector, we’re beginning to see new offerings:

• Performance Lab’s ARDA Coaching Engine offers quite detailed feedback in real-time for a runner, cyclist or soccer (football if you’re not American) player’s workout regimens.
• In Finland, an innovation cluster for wearables, a number of companies have offerings in this space including FirstBeat, for cardiac health, and Omegawave. These business models are threatening to change the traditional business model of the personal trainer that gyms currently use and bring this service to the masses at a much lower price point, typically in the $10-20 per month range or even included in the price of a wearable.
• In the chronic disease space, we have seen Humana partner with Omada Health, a leader in the space that combining telehealth with a coach to help manage chronic diseases. Primary care provider, Vida, offers a similar personal coaching model linked to various wearable devices. iMedicalApps highlighted the acquisition of one coaching application, Rise, last year as part of an effort to bring down unnecessary utilization rates and improve adherence rates.

These developments come at a time when hospitals struggle to keep up with the analytics challenges that the new value-based care regime demands. However, some early studies of coaching applications such as RunKeeper demonstrate an ability to move the needle. We hear terms like “behavioral economics and psyschology” and “nudge” used in virtually every mHealth and behavioral presentation, but a dearth of sophisticated use of this research to inform algorithmic development for actually existing behavioral change modality.

But with some of the more sophisticated offerings, such as those listed above, it might be time to start paying attention to coaching engines and how these will dovetail into new telehealth and PHM platforms as providers seek cost-effective ways to manage utilization rates and outcomes. As we know, integrating these efforts into the expanding array of care coordination and PHM offerings may represent a significant challenge.