A new report on wearable technology from health-tech incubator Rock Health gives entrepreneurs and others interested in the subject a good framework for understanding it. It also shows just how big a head start players like Apple and Samsung have.

Unlike some industry reports, this one isn't afraid to admit that there's a lot we just don't know, and also politely calls BS on some punditry. The obligatory chart that purports to show how big the industry might be is aptly titled "Pick a Number, Any Number;" it highlights several widely divergent predictions. In May 2013, Credit Suisse predicted that the wearables market would be worth $50 billion by 2018. At that same time, MarketsandMarkets pegged the industry at $8.4 billion in 2018, and ReportsnReports chimed in at $8.0 billion. Since then, the Institute for Information Industry in Taiwan predicted that wearables will be a $20.6 billion market by 2018.

On whether people actually use their wearables--another contentious topic--Rock Health cites Endeavour Partners research. Endeavour found that, after three months, about 80 percent of consumers still use their wearables regularly, a number that drops below 50 percent within the first year and a half. Then Rock Health polled its own (ten) employees. Here's the thing: After three months, half of them had quit using their wearables regularly. After six months, more than 75 percent had.

All of which gives the report a decent measure of credibility when it claims that wearables manufacturers need to innovate along three axes:


Right now, most fitness wearables track the obvious: heart rate, or the number of steps someone takes. They don't provide answers to basic follow-up questions, like "how do I use this data?" or "so what?" Those still need to be answered by the consumer. Improving functionality can be challenging, because you have to be good at both hardware and software--and deliver real insights to users.

The Lumoback is cited as a useful example, and one with a novel purpose. You wear the Lumoback around your waist, and it prompts you to improve your posture throughout the day, whether you're sitting, standing, running or even sleeping.


Wear two different fitness trackers, and you'll likely get two very different accounts of your activity that day. This story in The New York Times suggests you may even be better off with an old-school pedometer. Obviously, wearables have to get better at collecting information, or at using algorithms to adjust for inaccuracies.

Reliability is a hurdle because of signal processing and other technical issues. There's also the not-so-small matter of U.S. Food and Drug Administration approval, which many companies think they can dodge. But if you want information from your wearable to be accepted by doctors, it's key.

One device that does this well is the Zio patch, which uses a proprietary and FDA-approved algorithm to detect heart arrhythmias.


Wearables need to be "passive, comfortable, and provide positive reinforcement to the user," says the report. The ideal wearable is powered by a long-lasting battery, or is easily recharged, and syncing must be simple. But to make a wearable truly convenient, you need expertise in packaging, industrial design, and user experience--another tricky set of skillsets to master.

The Misfit Shine fitness tracker gets singled out by Rock Court for convenience. It runs on a watch battery, so doesn't need to be recharged. It can be synced just by placing it on your smartphone. And it's waterproof, so you don't have to take it off to swim or shower.

A greenfield for health

All this makes it sound like there's great opportunity for entrepreneurs, and indeed there is. Except for one thing: There's no single platform that the industry has rallied around.

That, says Rock Health, is where Apple and Samsung have huge advantages. Apple rolled out its health kit for developers at its Worldwide Developers' Conference June 2, as well as a partnership with health information systems provider Epic Health Systems and the Mayo Clinic. Samsung rolled out its Simband, a health tracker built on an open modular system, on May 28, and said it would partner with University of California to investigate uses for the device.

Once the industry chooses a platform, says the report, many large problems will be solved. Not only will a single platform attract more developers and consumers, but software companies won't need to design for specific devices. Hardware companies can then concentrate on a functionality, freed from the work of doing hardware, software, and integration themselves. Consumers, finally, will get more flexibility and more choice.

And, maybe, a wearable device they will use.