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Marcus Johnson: Hey gang, it's Friday, August 7th. Rajiv, Beth, and listeners, welcome to Behind the Numbers, The Marketer Podcast, made [00:01:00] possible by Awin. I'm Marcus. And joining me for today's conversation we have two of our health and pharma experts who joined, uh, from New Jersey. Actually no, normally New Jersey, but in our New York studio, Senior Analyst Rajiv Leventhal.

Marcus Johnson: Hello.

Rajiv Leventhal: Hey Marcus, how are you? Thanks for having me.

Marcus Johnson: And joining us from Pennsylvania, Senior Analyst Beth Snyder Bulik.

Beth Snyder Bulik: Hey Marcus. Thanks for having me.

Marcus Johnson: Thanks for being here. Uh, today's fact.

Marcus Johnson: Okay, so sugar doesn't actually make kids hyperactive. According to medical research agency, the National Institutes of Health, uh, there is no conclusive scientific evidence that sugar makes children hyperactive. Extensive double-blind, placebo-controlled studies conducted over several decades have consistently shown that sugar consumption does not alter a child's behavior, attention span, or cognitive performance.

Marcus Johnson: Wish I'd known this earlier.

Beth Snyder Bulik: I have a focus group of two that would, uh- ... would disagree with you on.

Marcus Johnson: Yeah. Well, luckily for [00:02:00] parents, no kids listen to the show, otherwise there might be an uprising. They're like, "I knew it."

Beth Snyder Bulik: It might be the excitement of getting ice cream.

Marcus Johnson: Yes, it is, and a lot of the time, yes, if they're getting it, they're, like, getting a treat, or they're around their friends a lot of the time- Right, right.

Beth Snyder Bulik: That makes

Marcus Johnson: sense ... so that's apparently what generates it. But yeah, no scientific evidence at all. Have as much, give them as much sugar as you like. That's terrible pa- ... parenting, uh, advice. Anyway, today's real topic.

Marcus Johnson: How AI is changing health wearables. All right, gang, so AI is changing healthcare for the better in a lot of ways. Uh, studies show AI models trained on over a million heart scans can accurately spot hidden heart disease patterns from standard tests, often outperforming human specialists. Studies highlighted by the BBC reveal that AI tools can increase cancer detection rates.

Marcus Johnson: Uh, lots of good work happening with AI and health, and [00:03:00] Rajiv, you just wrote some research on how AI is changing health wearables. Let's start by explaining, Rajiv, what distinguishes a wellness device, uh, h- a wellness wearable, from a medical device.

Rajiv Leventhal: Yeah, so the way I generally distinguish the two is that a wellness device is one that's really kinda just designed for the general consumer, and the medical device is designed and, and aimed at someone with a health issue, a, a, a mel- a medical condition.

Rajiv Leventhal: Okay.

Marcus Johnson: Nice.

Rajiv Leventhal: So a wellness device might promote, like, general health, fitness, lifestyle improvements, whereas think of a medical device as, okay, a continuous glucose monitor for someone with diabetes, and they might need a prescription, uh, to, you know, access that device. But as we'll talk about, the lines are definitely blurring between wellness and, and clinical.

Marcus Johnson: Yeah. Um, lots of folks have them. D- Dylan Scott of Vox, I was reading a piece, said, "Over half of Americans own a wearable or connected device, and tracks at least [00:04:00] one health metric with it." Um, so a lot of folks using them. And also, I found this, um, data from KPMG, folks can see on the screen. Uh, more people have fitness trackers or wearables in the States than gym memberships.

Marcus Johnson: So digital health adoption, um, when you look at, uh, wellness, health and wellness services that American adults regularly use, 48% say supplements and vitamins, vitamins. Uh, and second- Is fitness trackers and wearables 26%, gym memberships 24%.

Rajiv Leventhal: Well, uh, I guess that's, uh, wearing a device does not actually require you to do anything with that device.

Rajiv Leventhal: Right. A gym, a gym membership requires you to- ... to leave your, your home and go to, and go

Marcus Johnson: to the gym. You got it. That's true. That is a good point. Um, Rajiv, why are health wearables a, a compelling topic at the moment, and what's changed in the space to kind of drive that, uh, recent interest?

Rajiv Leventhal: Yeah, wear- wearables, of course, have been around for a while, but, but they're really having a moment this year.

Rajiv Leventhal: Um, not only do these [00:05:00] products now come... The, the more advanced versions of these products, uh, like the modern models, they come with, um, complex health tracking and monitoring features. So it's not just... Remember when the wearables used to, y- you'd wear one and, and the health features were counting your steps or calories burned or, uh, distance, um, for, for a run, right?

Rajiv Leventhal: But now it's, it's getting into much more complex health tracking and monitoring capabilities. So, um, electrocardiograms to detect irregular heart rhythms. It's tracking blood oxygen levels, your skin temperature, heart rate variability. Um, it's tracking your stress levels. So that's, that's one thing that's, um, really changing in, in the health wearable space.

Rajiv Leventhal: And then the other that's really, really new is that most of the top players in this space outside of Apple, ironically, but Oura and Whoop and Samsung and Fitbit and Garmin, they now all offer some version of AI [00:06:00] coaching and guidance based on the user health and activity data that the device is already tracking.

Rajiv Leventhal: The AI will, um, be able to offer personalized workout and sleep recommendations, tailored meal planning, um, 24/7 conversational support. You have a health question, the AI can answer it. So kinda similar to what you see with, like, ChatGPT and, um, Gemini, but, but y- ha- in the added layer of having that wearable product that's on you, um, that's r- that's kind of recording and tracking the data.

Rajiv Leventhal: So it really becomes, uh, kind of like a one-stop shop health platform in, in, in, in reality.

Marcus Johnson: Um, Beth, anything to add here in terms of why health wearables are having a moment this year?

Beth Snyder Bulik: Well, I mean, I, I'm more on the, probably more on the medical side 'cause I have covered pharma longer. But I think CGMs, con- con- continuous glucose monitors, are, are one of the devices that are kind of having a moment as well.

Beth Snyder Bulik: Mm-hmm. So they're a long time device [00:07:00] that's been used by people who have diabet- diabetes to track their blood sugar, but now they're becoming a bit of a wellness device, and there are some, you know, kind of, um, over-the-counter versions that are not, that are for people who'd wanna track their blood sugar, whether that's for, uh, health reasons, if they're taking a GLP-1.

Beth Snyder Bulik: Some people wanna know, like, you know, where their blood sugar is. Um, so people are taking that measurement as another sign of health or, well, not healthiness. There's some, there's some problems there, I suppose, that doctors are, are a little bit worried about people reading their blood sugar, say, like after you eat ice cream, and your blood sugar spikes, and it looks like it's dangerous, but it's not.

Beth Snyder Bulik: That's just what normally- Mm-hmm. Interesting ... happens, and you wouldn't normally know that. So- Yeah ... while there's inherent value in being able to track all those things, there's also a little bit of caution or, or, you know, um, maybe, maybe it's not the be-all, end-all, and you have to be careful about having maybe too much data.

Rajiv Leventhal: Yeah. And, and the continuous glucose monitor is a good example of a device that really is, has been for a while, a [00:08:00] medical device but now is kinda shifting into a wellness device, which, you know- Mm ... circles back to the first question that you asked, Marcus.

Marcus Johnson: Yeah. How, how much of a concern is that, what Beth was kind of touching on, that people are overloaded with data and are perhaps interpreting the results incorrectly?

Rajiv Leventhal: Yeah, I, I think it's a, it's a concern for doctors, um, because you have patient, m- more patients are kinda like ta- they're taking screenshots of, like, the, the health insights or tracking- Mm-hmm ... that their device produces, and are bringing it into a doctor's appointment. They're having anxiety, usually over, like, kinda nothing.

Rajiv Leventhal: Um, and, you know, from a doctor's perspective, it's, the data might be useful if it's tracking, like, a continued pattern or trend over a long time. But is it really useful if, you know, even if you have this advanced health tracking of, like, your heart rate variability? Well, your heart rate just normally kinda, uh, goes up and down, like, [00:09:00] without significant- Throughout the day, yeah

Rajiv Leventhal: uh, well, yeah. W- and, and that's, there's nothing significant, really actionable to, to take from that. But a person might not, the regular, you know, people don't really know that, so they get freaked out, and they go to their doctor. And, uh, their doctor doesn't really know what to do with that, and they're taking time away from their appointment to kinda try to, try to calm down the, the patient.

Rajiv Leventhal: So that- Yeah ... that, uh, drives some, you know, unnecessary, uh, I think, angst.

Marcus Johnson: Yeah. Um, i- in the piece though, Rajiv, you just, uh, as you just mentioned, you say, "Wearables now analyze and interpret consumer data to deliver more actionable health insights, moving beyond traditional metrics like step count," as you mentioned, "distance traveled, uh, estimated calories burned."

Marcus Johnson: Which health metrics from wearables are reliable enough for cl- for clinical decision-making?

Rajiv Leventhal: So that, that's the interesting part. Probably none of them, at least, at least as of now. Oh, wow. At least as of now. Um, i- well, reliable maybe, but actionable maybe not. Um, [00:10:00] for- Okay ... when I was reading the repo- or sorry, when I was, uh, researching the report, I, I read a piece on, like, what doctors think about the, you know, the clinical value of wearable generated health data.

Rajiv Leventhal: Um, and you know, they're, they're not really thrilled about patients coming to their appointments with, with this data. But, um, y- one physician that I, uh, I, I read about was, was, made a really interesting comparison to, like, traditional medical diagnostics. So if you take a diagnostic test at, like, your, your doctor's office or at a lab, whatever, um, i- i- it might say that you have an infection, and the doctor knows exactly what to do next, right?

Rajiv Leventhal: Um, but if a patient's heart rate variability, like, declines modestly or increases modestly, it's really unclear what that change means to the doctor and if they should do anything to address it. Interesting. So while, while I would say the, the data is becoming more reliable, the wearable companies have been doing a really good job at, um, pressure testing these features.

Rajiv Leventhal: Some of them are even FDA approved, some aren't. [00:11:00] But how actionable it is is a, is a different question.

Marcus Johnson: Yeah. Beth, it's so interesting 'cause people, uh, as we mentioned bef- before, a lot of people have health wearable devices. Mm-hmm. And it seems as though people want help with their wearable data. Folks can see from this chart on the screen I found from the American Medical Association, uh, this is from March of this year, patients turning to providers to make sense of wearable data, 23% seeking guidance on using wearable data to manage health, 21% asking, uh, physicians to review, interpret, and discuss wearable data, 16% scheduling a visit due to wearable data concerns to what we're talking about, 15% asking them to incorporate wearable data into monitoring or care plans, uh, physicians in Europe and North America.

Marcus Johnson: Um, what are your thoughts here on, uh, all this data being collected, Beth, and then folks not really kind of knowing what to do with it?

Beth Snyder Bulik: So now we're coming to sort of the classic problem, right? A doctor only has 15 minutes, 20 minutes to see a patient, and now the patient is bringing all of this wearable [00:12:00] data in, in as well and saying, "Okay, tell me what all of this means."

Beth Snyder Bulik: Mm. And I don't... And I think that there's probably value, and I'm sure Rajiv probably has, maybe has looked into this a little bit more, but the value of connecting that data to, um, your health records or your health report, and people are uploading their health records into ChatGPT to ask questions. So there is a lot more information, but it, I guess the key question is how useful is it, right?

Beth Snyder Bulik: How does it become actionable? How do you take the steps you took, how do you take y- the hours that you slept, um, and not only present that data to your doctor, but in a way that's going to be, that in a way that's reliable, that's actionable, and that's, that they have time to review, right?

Marcus Johnson: Rajiv, what are the, when people think of, uh, health, uh, uh, wearables, a lot of the names that might come to mind, the brands, the companies that, um, that make these devices, Apple, uh, Fitbit, I think things like that, but, um, Oura, the Oura Ring.

Marcus Johnson: What are the main devices on the, what's the market look like in terms of, [00:13:00] uh, health wearables at the moment?

Rajiv Leventhal: Yeah. There, there's different categories of products. So there's smart watches, and then there's fitness bands and trackers, and then there's smart rings. The smart ring market- Okay ... is essentially completely controlled by Oura.

Rajiv Leventhal: Uh, no, but none of the other big players has a smart ring. Mm. Apple, which is, ha- has by f- for, for a long time been the, by far the leader in the smartwatch category, um, has actually been, has trailed the other wearable companies in terms of these, like, advan- some of these advanced health features, but more so like the AI health coaching, the AI assistant, the, uh, you can import our, your medical records into our app and connect that to our wearable device.

Rajiv Leventhal: Apple has not done that, but the other companies have. Yet Apple is still, like, the, the, the big leader in terms of smart watches. Mm. Um, Fitbit, which is owned by Google, has fitness bands and trackers, which are most known for. I think they also have some smart watches. Um, and then the other two are Whoop [00:14:00] and Garmin, uh, and they have, you know, an array of, of fitness bands and trackers, and I think Garmin has smart watches as well.

Rajiv Leventhal: So th- th- Okay ... those are the top players.

Marcus Johnson: How are people deciding which one to get? Is it, "Oh, I wanna track this stuff, I get this type of form factor"?

Rajiv Leventhal: I think if you're... For a while, the Apple smartwatch was just the product to own.

Marcus Johnson: Uh-huh.

Rajiv Leventhal: Uh, and I still think that is the case. But if you're looking for, like, specific, uh, health-related use cases, like for example, oh, I can, um, y- you know, have this f- maybe I don't want a screen, so I have, like, a f- I want, just want a fitness band or a tracker on my wrist to, to, uh, monitor and, and track some of my health data, and then I also wanna be able to have, like, AI health coaching in the app, then the smartwatch, the Apple Watch for now isn't for you, then one of the other products is.

Rajiv Leventhal: And then for, like, form factor, I would say Oura has become really, really popular. Um, some people like the fact that, you know, you don't- [00:15:00] obviously you're not wearing it on your wrist, you wear it on your finger. It's more lightweight. It's not as obtrusive, and it's comfortable. You can wear your smart ring while sleeping.

Rajiv Leventhal: Yeah. I don't think you wear your fitness band or smartwatch while sleeping. I don't own one. Yeah. But I don't think so, so. Really, so yeah,

Marcus Johnson: and- Also not, it's not another screen to look at, which a lot of people- It's, yeah ... already have enough. Yeah. No, I, I think that a- Right.

Rajiv Leventhal: Yeah. I think that appeals to some people, yeah.

Rajiv Leventhal: Yeah.

Beth Snyder Bulik: Yeah, I wrote a story recently about Garmin. They came out with a, their new screen-less, um, band, and- Yeah ... there is some argument to be made that people don't want that constant input- Yeah ... that visual input. So it, like an Oura, acts more in the background. It's on your wrist, sure, but you're not checking data, or it's not, you know, buzzing you or saying like, "Pay attention to me, I have health data for you."

Marcus Johnson: Yeah. Yeah.

Beth Snyder Bulik: Um- But still collecting it.

Marcus Johnson: Right. Right. Yeah, I was wondering whether it was, uh, okay, I'm trying to get this type of data, I'll go for that form factor. Or if it's just more lifestyle, do I want, uh, to have apps on my wrist, and it can also track health things? Or do I want, do I not wanna have another screen, and so the ring makes more sense?[00:16:00]

Marcus Johnson: Um, wearable, uh, devices, Rajeev, you know ha- have evolved far beyond kinda wellness tracking. How is AI specifically helping turn them into these, as you say, comprehensive digital health hubs?

Rajiv Leventhal: Yeah, so the, the AI coaching and, like, personal health assistant type features that have recently been rolled out, it- it's sort of an extension of what we're talking about.

Rajiv Leventhal: Like, maybe the, the user, the wearable device user, doesn't necessarily need to go to the doctor, uh, to sort of interpret the data the device is tracking, because the AI, through the app, is doing such a good job of it. And I- I'm not saying that the AIs are one-on-one rep- one-for-one replacement of a doctor, but it probably can give the user the relevant information they're looking for without, you know, requiring a doctor's appointment.

Rajiv Leventhal: So, um, you know, a, a, a, a, a wearable product's AI personal health coach will use a person's data that they're tracking from the device. Uh, Beth mentioned that some of these products now allow you to, [00:17:00] like, import your medical records to the app. So you can kinda combine all of that and create a, a more of a complete profile to deliver sharper insights on what this data actually means for the user.

Rajiv Leventhal: So you can flag key trends in cholesterol levels, and provide, you know, tailored wellness guidance based on not only the wearable data, but the me- other medical data that a person, uh, provides if they choose to. Um, and, you know, prior lab results, medications, things like that. So, you know, think of a question like, "Why is my recovery low?"

Rajiv Leventhal: Or, "How hard should I train today?" Now the AI coaching is able to answer those questions, um, in a more personalized way, uh, that wasn't possible before.

Marcus Johnson: Mm-hmm.

Beth Snyder Bulik: Yeah, I think that's really the appeal, right? The personalization of AI. So if I am tracking my blood sugar because I have diabetes, I can get, um, you know, the, the questions that I want answered for that, but I can also, also track my sleep.

Beth Snyder Bulik: I can, you know, there are different ... Depending on what I want, I can find out, and not [00:18:00] only find out information or what my sleep pattern or what my blood sugar means, but what can I do about it.

Marcus Johnson: Yeah. Beth, I'm wondering if because there's so much more data to track, if it could overwhe- overwhelm people to a certain extent.

Marcus Johnson: And so I'm wondering if there's a, a future, um, a quite a near-term future, where people eventually just sign something that gives permission to their physician to just have the data immediately. So they s- they buy the Apple Watch, they buy the Fitbit, the Oura Ring, whatever, and they bas- there's a way that they can connect that with their physician, and they flip it so it's not them going to the physician, but more the physician having the data, and say, and prompting the patient, "Oh, hey, I've noticed this thing based on your data.

Marcus Johnson: Time to come in for a check."

Beth Snyder Bulik: I mean, I think that that's possible, but again, we're back to the time issue, some of that. And do the doctors necessarily want that data? Because we have talked about it's not necessarily always reliable. Mm. I guess it depends what it is. Is [00:19:00] it your, is it your blood sugar and you are a diabetic or you're pre-diabetic, and you're, you know- Mm

Beth Snyder Bulik: spiking or lowering and looking at those trends over time? That's really important to your health. Yeah. Um, I guess it, the, I guess the answer is it depends, right? Yes. Or you could work, maybe work out a plan with your doctor. That I would imagine could possibly work. Yeah Like-

Rajiv Leventhal: I think the difference re- yeah, the difference really lies in terms of is this data tied to a person with a diagnosed health condition like diabetes- Right

Rajiv Leventhal: or some, you know, cardiovascular issue. A heart, yeah. Or is it just general wellness data? If it's general wellness data, the doctor- Right ... doesn't wanna be in- informed- ... like throughout their work- ... their workday. But yeah, if it's- It does- ... if it's, if it's you're tracking something on their diabetic patient, then they probably do.

Marcus Johnson: Yeah, yeah.

Beth Snyder Bulik: Yeah. Uh- Uh, my daughter has a heart condition, and once a year she has to wear the Holter monitor, and then it tracks your data, and then that's information the doctor wants. He wants to know, like, how is your heart [00:20:00] doing, like a snapshot of.

Rajiv Leventhal: And e- and even without a screen, like some people just don't want to be reminded of their health all the time.

Rajiv Leventhal: It's one of the big reasons why people don't go to the doctor. Like, we always say it's cost. Yeah, that is a big reason, too. But another reason is like, "I don't wanna hear what the doctor has to tell me." And sometimes a, sometimes a wearable product is similar to that. Like, even your Oura Ring, right? Yeah.

Rajiv Leventhal: No, no s- no, no screen. But let's say, let's say you go out and have a few drinks with your friends, and you stay out late, and you wake up the, the next morning and your Oura Ring says, "Your sleep quar- score stunk. You got a two out of 10," or whatever, however they track it. You know, now you're gonna be in your head all day being like, "Do I really want this Oura Ring to track my sleep every time I, you know, go out and have a- Mm

Rajiv Leventhal: have a few drinks," right? So, you know, it's, it's not for everybody.

Marcus Johnson: Yeah.

Beth Snyder Bulik: Right. And what if you woke up feeling fine and Oura said, "Oh, you had a bad night's sleep." You're like, "Oh, I feel bad."

Rajiv Leventhal: Yeah. Mm-hmm.

Beth Snyder Bulik: When you actually felt

Rajiv Leventhal: okay. And now, now you're concerned. Yeah. Right. Now you're concerned. You can

Marcus Johnson: turn everyone into a hypochondriac.

Rajiv Leventhal: Yeah.

Marcus Johnson: Um, yeah, 'cause there's [00:21:00] so much data. They could ch- say there's 20 metrics for, just for argument's sake. It does seem to make more sense, as opposed to the patient going to the doctor and saying, "Here's all 20. Read it. Let me..." It make- seems to make more sense to me for the doctor to have the ability to access that if they want to, but they tell the patient, "Of these 20, based on this health thing, let's monitor this one for a while- Mm

Marcus Johnson: just to keep an eye on X." Um, and we're talking a lot about what has been driving this space forward. Um- particularly this year. Rajiv, what's holding, uh, the health wearable space back a little bit?

Rajiv Leventhal: Yeah, so from a, like, a customer acquisition perspective, these devices are really expensive. Uh, most of them are several hundred dollars, and then if you want all of, like, the cool health features, you have to pay more for, like, a monthly or annual subscription on top of that.

Rajiv Leventhal: So, uh, you know, low-income consumers, um, you know, aren't gonna be able to, uh, to afford that, and [00:22:00] those are the people that might have, uh, the, the health issues where actually this type of tracking and, like, on-demand AI coaching, health coaching, and guidance, 'cause, you know, you can't get to the doctor regularly, could help them.

Rajiv Leventhal: But our, our data shows that about a quarter of US consumers own a health wearable, but, um, only about 18% of people who self-report their health status as being in poor health or very poor health own one, so seven percentage points lower. And, uh, lower income people- Wow ... uh, about 18% in, in that group as well.

Rajiv Leventhal: So the people who need them, um, aren't the ones getting them and, uh, you know, wearable companies know this. Uh, they market their products as, like, lifestyle, as, um, lifestyle devices to, to affluent consumers. Um, Oura has a marketing partnership with, um, American Express Platinum, where, you know, if you're willing to pay $800 for a, um, uh, your American Express, Express Platinum Card, [00:23:00] you can get a significant discount on, on an Oura Ring, right?

Rajiv Leventhal: Yeah. So they're m- they're doing that on purpose because they know, um, that it's sort of this luxury lifestyle wellness-type product. But that means the people who need them the most aren't, aren't owning them.

Marcus Johnson: What's the price range here?

Rajiv Leventhal: It really depends. There's, there's different models, but it's like 200 to 500- Okay

Rajiv Leventhal: depending on which, which model you want. Uh, some of them, uh, uh, some of them are, are, like the, the ones that don't have a screen I think are a little bit ch- are, are, um, uh, they're lighter and they don't, they don't have a screen. I think they're a little bit cheaper. But yeah- Okay ... they're, they're, you know, a couple hundred dollars- Nothing

Rajiv Leventhal: on, in addition- Yeah ... to, like, a monthly subscription on top, yeah.

Marcus Johnson: Yeah. Oh, interesting. Yeah.

Beth Snyder Bulik: Um, I did- Right. You can get the basic tracking features, but you can't get those AI coaching things that we were talking about unless you pay- Ah ... for the subscription.

Marcus Johnson: Yeah, okay. I found this data, uh, folks can see on the screen, from Merge.

Marcus Johnson: Reasons US adults have never considered using digital health tools to support their health and wellness. Uh, number one was I don't think I could afford [00:24:00] them. Mm. Uh, 24%, uh, ahead of 21%, I'm not a very tech-oriented person, it doesn't fit with my lifestyle, doesn't fit my perception of myself, et cetera, et cetera.

Marcus Johnson: So cost- Yeah ... the, the main prohibitor. Um, that's all we've got time for for today's episode. Thank you so, so much to my guests for hanging out with me today. Thank you first to Rajiv.

Rajiv Leventhal: Thanks, Marcus. Happy to be here.

Marcus Johnson: And of course, to Beth.

Beth Snyder Bulik: Thanks, Marcus. Great

Marcus Johnson: to be here. Thank you. Thank you. Uh, and thanks to the production crew, John and Luigi, and to everyone for listening in to Behind the Amazon Marketing Podcast made possible by AWIN.

Marcus Johnson: Make sure you subscribe and follow and leave a rating and review if you can. We'll be back on Monday talking about the big three questions surrounding Meta at the moment. Before that, though, I hope you have the happiest of weekends.