Digital health philosopher John Nosta thinks we’re spending too much time on yesterday’s technology and too little time on changing the game.

Call me crazy, but I just have this funny feeling the smart watch and all the wrist-worn activity trackers are technologies that are hopelessly bound to yesterday. I’ll cite no data and make no specific accusations, but I have this visceral feeling that something just isn’t right. It’s all just yesterday’s electronics made a bit smaller and a little sexier.

Every time I put a smart watch on my wrist to track things like my steps or calories, I get a funny feeling in my gut. It’s just a “limbic” fight-or-flight type of reaction and my sense is to run for the hills without tracking my distance or altitude. Maybe I’m just a “quantified skeptic?”

Now here’s the key take-away. I think we spend too much time on yesterday’s technology and too little time on changing the game.

So, here are my three reasons that I’m failing to fall in love with wearables. And I hope I’m wrong.

1. Desire—There just doesn’t seem to be the high level of demand for these devices. Yes, a high level of interest, but it doesn’t seem to translate to either the 60-year-old couch potato or the rank and file clinician who is a central part of driving demand. 

2. Translation—The numbers extracted from these devices are nothing really new and just seem to be digital pedometers. And yes, this may not be exactly accurate, but all I’m seeing from manufacturers is a design translation of the same data. The colors and shapes are changing, but are we just rearranging the deck chairs on the Titanic? And when new features are added—like pulse oximetry—it seems more about the “availability of technology” driving this inclusion than a real and functional clinical benefit.

3. Connection—So how do I really apply this to my health or disease state? Of course, some of this data is relevant and can help. But it all seems secondary or tertiary to my needs to manage a disease or condition. Tracking activity—when most people aren’t really interested in doing it in the first place—seems strangely disconnected from the clinical imperatives.

The Future is Much More Than an Activity Tracker

In the final analysis, my sense of the smart watch is a big yawn. I see it as a collection of mediocre data that might help move the needle. Simply put, its yesterday’s pedometer connected to a battery. And not a very good battery at that! But it’s not the game changer that people want it to be. It’s time to move the smart watch beyond steps and stops and consider it in new, transformative ways. 

For me, the future of my wrist belongs to the world of disease detection and nanotechnology.

These are the fundamental shifts that don’t just foster engagement—they demand it!  Two examples quickly come to mind. And after reading them, I want you to ask yourself one simple question: Does this innovation move trackers from the optional to the essential? Let’s take a closer look. 

Today, a myocardial infarction—or heart attack—is the height of clinical urgency. The sight of a diaphoretic patient and elevated ST segments makes everyone in the room nervous. The patient, caregivers, and yes, even the physicians, are all at a higher level of concern because a life is at risk. 

However, the future promises a very different reality. 

Nanoparticles are now being studied to identify subtle chemical markers released by the endothelial cells in the coronary artery. These substances, now circulating in the blood, can indicate this event days prior to the potentially catastrophic disruption of blood supply to the heart. So, in this instance, nanoparticles could send a signal to your handy wrist device and a less urgent, life-saving stream of action could be put in place to preempt—by days—what is one of medicine’s most urgent and dangerous scenarios.

Another example relates to the detection of cancer cells circulating in your body. 

In this instance, nanoparticles could be activated by these cells and then “counted” by an external tracker—similar to a Fitbit or smart watch. This very early detection of cancer is a game-changer and establishes the concept of “stage zero disease.” Nanodetection is poised to make conventional cancer screening seem like something out of the Stone Age. By determining cells, not tumors, we can potentially attack the problem at a stage where clinical interventions can be more effective and less toxic.

Of course, these new technologies—as they become availableؙ—will not initially be for the general population, but for high risk populations. I would imagine that over time, their roles will expand to an almost prophylactic use where early, early detection shares a border with prevention.

So, ask yourself the question. 

If you could predict a heart attack days before the event, or detect (and kill) cancer cells prior to a systemic accumulation or insult, would you? My bet is yes. And you would wear, charge and enshrine that activity…no…disease tracker as if your life depended upon it. And that’s exactly my point! 

My future watch will sense subtle biomarkers for cancer, nano-mediated alerts for heart attacks, and other markers for detecting early disease and physiological trauma. It will be my guild to wellness. Until then, it’s just yesterday’s tracker with a new kimono. 

John Nosta is a digital health philosopher, nuviun strategic advisor, and lead thinker at NostaLab, He has a resonant voice from Forbes to TED, and is a member of the Google Health Advisory Board. You can follow him on Twitter: @johnnosta.

The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the authors.