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Addressing the limits of connected health — and breaking them

8 min read

How did the connected health movement begin and what are the roadblocks to access and adoption? We talked to a Health Economist about the history and future of the technology that is revolutionizing healthcare.

Inventing, producing, and marketing connected health devices requires attention to consumer trends, regulatory developments, international markets, and a variety of other fields. However, devoting resources and centering product philosophy to uplifting people who might otherwise be left out of the connected health world is paramount as there is no complete ecosystem without their participation. But when we mention people being left out of the connected health ecosystem, who are we referencing? Some might typically point to older members of the population, but this would not accurately describe everyone who stands to lose by not being part of the connected health revolution.

Health economist and author Jane Sarasohn-Kahn has spent decades researching the healthcare industry and its associated technology and limits to wider adoption. Sarasohn-Kahn touches upon various events that have led to connected health and the limits that have prevented more participation in the ecosystem, and Withings Co-founder and current President Éric Carreel responds with how he is working to address roadblocks and inviting more stakeholders into the connected health fold.

The curious case of recessions driving innovation

Addressing the limits on connected health requires a bird’s-eye view of the landscape, and Sarasohn-Kahn does so by saying COVID19 has accelerated “do-it-yourself” (DIY) care, partly evidenced by spending on out-of-pocket costs increasing by a third during the pandemic. However, according to Sarasohn-Kahn, this DIY health trend didn’t start in 2020, but far earlier. She cites the Great Recession of 2007 as a turning point towards wider adoption of connected health.

“In recessions, people are broke. We end up depending on ourselves to make life, rather than going to restaurants, doctors, etc. So, how do we avoid spending money outside of the house? We take it inside the house,” says Sarasohn-Kahn.

And a lack of money is key in the story of the Great Recession. Inflation may have contracted and recovered within 18 months, but The Great Recession’s financial effects extended well beyond as one in five U.S. workers were laid off and never received a full-time job again. In addition, from 2006 to 2016, middle income earners’ wages grew at a slower rate than low and high earners. Digital gigwork began to fill in the employment holes with Airbnb and TaskRabbit in 2008 and Uber in 2010, and all of these events together made for either no healthcare coverage or increasingly expensive plans and doctor visits.

The decrease in the number of jobs that provided healthcare meant more self-reliance with regard to personal health. Again, Sarasohn-Kahn explains the wider psychological effect on this wider national decrease in income-disparities for American workers. “We go through these recessions, feel broke or limited, and we make up for it with more self-care, with the home emerging as a health hub.” This idea of health at home was especially pronounced three years after the Great Recession as the Health Care and Education Reconciliation Act (the ACA) was not signed until the end of March of 2010 before states were mandated to expand American citizens’ access to healthcare.

The rise of the quantified self

However, the DIY home-health phenomenon wasn’t just due to financial insecurity and job loss. The increase in connected health intersected with Apple’s iPhone release the same year of the recession’s beginning, 2007, and this convergence led to wider adoption of connected health beyond the original enthusiasts known as the Quantified-Self (QS) community who would previously go to Radio Shack to buy components and “make” their own contraptions to capture health metrics. 2008 was also the year Withings was founded by engineers, including Carreel, who were looking to revolutionize the world’s relationship with health. Then in 2009, Withings engineers developed and brought to market the world’s first connected scale.

In terms of access, America was headed towards the beginnings of connected health, but the journey towards wider adoption had not been one of linear progress but a mix of deep and painful economic realities and technological advancements.

Connected health roadblocks: high-speed internet, health literacy, and data privacy and control

This most recent economic downturn is not only different with respect to its origin in the pandemic, but also the force by which it has pushed people towards the home as a health hub. Fear of visiting the doctor or actual pauses in annual physicals and other routine care have been a feature of the pandemic as well as the explosion in telemedicine. Therefore, data collection has been pushed even further to digital; but have the limits to greater access been lowered?

Ideally connected health can enable better outcomes by decreasing barriers to meaningful data for both patients and providers, but what are the limits on connected health from expanding into the future or even being accessible to people now? Sarasohn-Kahn states that one of the biggest blocks is access to broadband or high-speed internet, something the Federal Communications Commission says is not being rolled out at the rate needed for America. With almost 15% of American households without an internet subscription (or double that rate for low-income earners), access to connected health is not tenable in the absence of reliable broadband.

Sarasohn-Kahn continues by saying that health “literacy” is another major challenge, and this can be divided into four categories:

  • General reading literacy
  • Digital literacy
  • Health plan literacy
  • Medical literacy, as in understanding how to use a prescription drug regimen, etc

Regarding general literacy, the U.S. Department of Education reported in 2019 that 43 million adults (16–65) in America lack basic literacy, or more specifically, are unable to complete simple forms, consume relatively short texts, or find the meaning of sentences. Two-thirds of those adults were born in the U.S..

General illiteracy leads to additional illiteracy in the other three categories without explicit and external help from community and healthcare sources. The added weight of poverty being closely associated with illiteracy is another strike in terms of families and individuals being able to allocate personal funds for connected devices, and this can leave a large segment of the population out of the connected health ecosystem even in the presence of Wi-Fi access.

This realization led Sarasohn-Kahn to assert that access to broadband is a social determinant of health; without it, and especially learned in the COVID-19 public health crisis and #StayHome era, people could not work from home, attend school or college at a distance, seek jobs, or communicate with loved ones living elsewhere.

Data privacy and control is another limit to connected health that Sarasohn-Kahn lists. Though many of us may be vacillating back and forth between the acceptance that most of our data has been compromised at one point and the idea that we still retain some morsel of anonymity regarding our personal health information, scientists have polled segments of the population across the world and find that a majority of people would be fine sharing their health data for scientific research and even disclosing analytics for financial reward.

Forward-thinking health companies are responding to these limits on connected health by developing devices that operate with cellular service. Take Withings Health Solutions, the new B2B arm of Withings to provide digital health programs, providers, and patients the tools they need to address the limits of connected health as outlined above:

  1. Broadband access — Health Solutions provides digital health programs with smart devices including scales and blood pressure monitors that require no Wi-Fi or internet connection. Instead, devices connect through cell service thereby making a more inclusive environment for people living in rural areas, low-income households, and others who might lack access to broadband services. In addition, devices can be mailed directly to patients thereby overcoming potential issues in transportation.
  2. Literacy — The Withings devices from Health Solutions require minimal installation usually entailing one step to complete setup. However, healthcare professionals can opt to be part of the program so patients receive external help that any literacy might otherwise be impeded by. Technology is scary for a lot of people, and making it as easy to use as possible reduces barriers in literacy.
  3. Data privacy and control —Devices sold in the Withings Health Solutions range can be set up in a HIPAA compliant environment. In addition, Withings is a European company that follows GDPR rules which ensures users’ data is not abused. Finally, because patient data is oriented towards improving care, the sharing of analytics between patient and doctor follows positive inclinations based on polling conducted across segments of the population.
  4. Cost — Health Solutions promotes preventative care, which by itself is a cost-saving measure, and investments in daily measurements that Health Solutions devices provide ultimately save money by reducing instances of more serious events.

When asked about the work Withings has done to create a more robust connected health ecosystem, Carreel sums up the above by saying, “Our mission has always been to provide empowering tools for patient-centered care. To achieve better long-term health outcomes, Health Solutions is laser-focused on helping save time and money by bridging the gap with accurate data and a system that improves patient management. Reducing barriers, increasing literacy, and respecting others’ data are all key to delivering on the promise of connected health.”

Jane Sarasohn-Kahn is a health economist, advisor, and consultant that has spent three decades advising healthcare stakeholders including public sector entities, NGOs, and life science and tech companies. Jane is also the author of Health Citizenship: How a virus opened up hearts and minds, a book that explores the four pillars of ‘health citizenship’: access to healthcare, data rights, institutional trust, and love for fellow health citizens. You can keep up with Jane and her work at HealthPopuli or follow her on LinkedIn. Please note that Sarasohn-Kahn’s participation in this conversation is not an endorsement of Withings or its associated programs and/or technology.

Health Solutions is the new B2B arm of Withings which provides HIPAA-certified and GDPR-compliant devices for programs and providers to view patient analytics and implement informed care. Data points including weight, heart rate, ECG readings, blood pressure, body temperature, and more can be collected through Withings medical-grade device ecosystem.* Drop shipment of connected devices and dedicated support channels for care managers are available, and cellular capability combined with long battery life ensure that patients remain engaged in programs.

*Certain measurements are country-specific regarding availability.

Learn more about data security at Withings.

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Patrick Sheehan is a healthcare leader at the intersection of technology and care delivery, with a focus on virtual and at-home services for people with chronic conditions. At Withings, he serves as Vice President of Value-Based Care, partnering with risk-bearing organizations to design and scale programs that improve affordability, outcomes, and the care experience.

 

The Centers for Medicare & Medicaid Services (CMS) proposed a fee schedule that would drastically expand funding for remote patient management  — a move that could mark a turning point in how we think about healthcare delivery in America. If finalized, it would be more than a policy update; it would be a recognition that the future of healthcare lies in providing patients with a concierge-like experience focused on delivering care that is coordinated, comprehensive, and personalized. At Withings, we believe this shift is coming at exactly the right time. Digital health has proven it can improve access, but to truly improve outcomes and drive savings, it must go beyond the occasional video visit, the siloed widget, and the noisy data. It requires impactful patient engagement, integrated data communication, and the accessibility of evidence-based preventive care. That’s where our technology can make a measurable difference.

 

Our connected ecosystem for virtual heart health, anchored around award-winning medical devices, captures a breadth of biomarkers and patient-reported outcomes; everything from ECGs to body composition to symptom assessments—giving care teams an ongoing, comprehensive view of a patient’s cardiovascular function along with key metabolic and respiratory drivers. Paired with personalized care pathways, this actionable insight empowers patients to play an active role in their own care while enabling clinicians to deliver timely interventions. This means more healthy days at home and fewer costly, preventable acute care events.

 

The opportunity is only accelerating. Withings recently secured a large grant to develop advanced artificial intelligence that precisely detects risk based on multi-marker analysis of device-captured patient data. When applied to a Heart Failure population for example, this would enable intervention weeks prior to weight gain, and increase the likelihood of avoiding decompensation and an acute care event. It’s a leap from reactive to proactive care—one the healthcare system urgently needs.

 

CMS’s proposal creates the framework for digital health to play a cornerstone role in a future of healthcare that  places the patient at the center. This future of healthcare will be defined by its ability to predict and prevent, not just treat. With the right policies, technologies, and partnerships, we can make that future a reality now by giving patients more healthy days at home and delivering on the promise of a stronger, more sustainable healthcare system.

Interested in partnering with us?

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Introduction

Sleep is an essential pillar of health and well-being. The clinical gold standard for sleep assessment, polysomnography or PSG, provides a detailed analysis of sleep architecture but is impractical for routine or long-term monitoring. Its reliance on complex equipment, high cost, and typically in-lab application make it an intrusive process. The proliferation of consumer wearable and nearable devices offers more accessible alternatives, yet their accuracy often lacks rigorous scientific validation, particularly in home environments.

 

A recent study sought to address this gap by evaluating the accuracy and reliability of the Withings Sleep Analyzer (WSA). This contactless sleep mat, placed under the mattress, was compared directly against simultaneous PSG recordings in a large and diverse group of individuals in their own homes. This research investigates the sensor's performance in real-world conditions, offering critical insights into the current state of consumer sleep-tracking technology.

 

Methods

The study involved 117 healthy participants, with 69 women, and a mean age of approximately 40 years. Each participant slept in their own bed for one night with both the PSG equipment and the under-mattress device active. This setup allowed for a direct, epoch-by-epoch comparison of the data recorded by the consumer device against the clinical reference standard. The analysis focused on two primary objectives: the accuracy of distinguishing sleep from wakefulness and the precision of classifying distinct sleep stages, including light, deep, and REM sleep. Performance was assessed using standard classification metrics to ensure a robust evaluation.

 

Results

The investigation found that the contactless device performs effectively in identifying sleep and wake states. It achieved an overall accuracy of 87% in this core task, demonstrating a high sensitivity of 93% for detecting sleep and a moderate sensitivity of 73% for detecting wakefulness. A key strength observed was the sleep mat's consistent performance across various subgroups. The accuracy of sleep-wake detection remained stable regardless of participant age, BMI, sex, mattress type, mattress thickness, sleep quality or the presence of a bed partner.

 

Challenges emerged in the classification of specific sleep stages. The sensor's mean accuracy for staging sleep was 63%, with a Cohen’s Kappa of 0.49. The primary difficulty was in distinguishing between light and deep sleep. This led to systematic biases in sleep duration estimates; the device tended to slightly overestimate total sleep time by an average of 20 minutes but substantially overestimated light sleep by 1 hour and 21 minutes. Conversely, it moderately underestimated REM sleep by 15 minutes and deep sleep by a more significant 46 minutes.

 

Notably, a notable proportion of misclassifications made by the sensor mirrored disagreements found between the expert human reviewers who scored the PSG data, especially concerning the boundary between light and deep sleep. Furthermore, participants reported that their perceived sleep quality was significantly altered for the worse on the night they used the PSG equipment, highlighting the intrusive nature of the gold standard itself.

In a comparative context, the Withings Sleep Analyzer exhibits highly competitive performance in sleep-wake discrimination relative to other devices on the market. For the more nuanced task of sleep stage classification, its accuracy is comparable to that of similar products. This level of performance is particularly noteworthy given the systemic challenges in sleep staging.

 

Conclusion

For individuals seeking to understand their sleep over weeks and months, the primary benefit of a device like the Withings Sleep Analyzer lies in its practicality. Its contactless, 'set-and-forget' nature eliminates the nightly burden of wearing a device and avoids the discomfort that can disrupt sleep, a notable issue even with the clinical gold standard. While the sensor's accuracy in distinguishing specific sleep stages requires further refinement, its strong performance in tracking overall sleep and wake times provides reliable insights into sleep duration and consistency. This capability for accessible, unobtrusive, and longitudinal monitoring is where at-home sensors currently provide the most value, empowering users with meaningful data on their long-term sleep trends.

 

Poster Session: Time and Location

“Evaluation of a Contactless Sleep Monitoring Device for Sleep Stage Detection against Home Polysomnography in a Healthy Population”

 

Session Title: Poster abstract group 2

 

Session Date: Monday, September 8, 2025

 

Presentation Time: 6:00pm to 7:00pm (Presenting authors will be present near their assigned poster board throughout the scheduled one-hour presentation window.)

 

Poster Board Number: 531

 

Location: Posters will be displayed in the exhibit hall on Level 4 and accessible during regular congress hours.

About Marie-Ange Stefanos

Marie-Ange Stefanos is a  Machine Learning Research Scientist and a PhD candidate pursuing a joint doctorate in Computer Science and Neuroscience from Université Paris Cité (France) and Reykjavik University (Iceland). Building on her background with an Engineering degree in Signal Processing from Grenoble INP - Phelma and an M.Sc. in Machine Learning from KTH Royal Institute of Technology, her path into health research was driven by a central question: how can my technical background be best applied to solve meaningful challenges in human health?

 

Her doctoral research focuses on insomnia, where she develops algorithms using data from wearables and self-reports to identify predictive biomarkers and differentiate subtypes of the disorder. This work depends entirely on data integrity, which is why she believes the rigorous validation of consumer devices, as discussed in this article, is the essential first step in translating complex signals into reliable, actionable insights for users.

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Contact Us [post_title] => The Promise and Pitfalls of At-Home Sleep Tracking: A Deep Dive into the Withings Sleep Analyzer [post_excerpt] => Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine.But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-promise-and-pitfalls-of-at-home-sleep-tracking-a-deep-dive-into-the-withings-sleep-analyzer [to_ping] => [pinged] => [post_modified] => 2025-09-02 16:49:48 [post_modified_gmt] => 2025-09-02 16:49:48 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2034 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 2015 [post_author] => 11 [post_date] => 2025-06-12 15:39:12 [post_date_gmt] => 2025-06-12 15:39:12 [post_content] =>

Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine. Among the many challenges faced by these patients, cardiovascular disease (CVD) stands out as the leading cause of mortality—a stark reminder of the systemic stress that accompanies kidney failure and dialysis.

 

But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? An article in Frontiers in Nephrology explores exactly that—highlighting the transformative potential of digital health technologies to monitor and manage CKD5D patients beyond the clinic.

 

The Hidden Risks Between Dialysis Sessions

For CKD5D patients, the risks of CVD are amplified by both traditional and disease-specific factors:

 

  • Traditional risks like hypertension, diabetes, and obesity.

  • CKD-specific risks such as inflammation, fluid overload, protein-energy wasting and vascular calcification.

  • The dialysis process itself, which induces rapid fluid shifts, blood pressure fluctuations, and metabolic imbalances.

Current clinical care models often focus on in-center dialysis data, leaving a crucial blind spot during the interdialytic period—a time when many adverse events begin to develop unnoticed.

 

A New Monitoring Paradigm: The Withings Toolkit

The article introduces a compelling case for home-based, connected health technologies—specifically, the Withings toolkit. This suite of medical-grade, consumer-friendly devices allows CKD patients to monitor key health indicators in the comfort of their homes:

 

  • Weight, body composition and ECG monitoring with the BodyScan smart scale.

  • Blood pressure, heart rate and survey responses for added context via BPM Pro 2.

  • Sleep quality and breathing event metrics using the Sleep Rx.

All data is seamlessly uploaded to the Withings Remote Patient Monitoring platform, providing healthcare providers and researchers with real-time, longitudinal insights into a patient’s well-being.

 

Why This Matters: Real-World Clinical Benefits

1. Early Detection of Complications

Weight gain could signal fluid retention, but muscle loss could indicate protein-energy wasting. A sudden spike in blood pressure or irregular heartbeat might indicate arrhythmias or volume overload. Poor sleep patterns could reflect apnea or restless leg syndrome—conditions with known ties to CKD.

2. Personalized, Data-Driven Care

These devices enable a dynamic view of health trends, allowing clinicians to tailor treatments proactively rather than reactively. Medication adjustments, fluid restrictions, or further diagnostics can be made with greater confidence.

3. Patient Empowerment

When patients can see and understand their own data, they become more engaged in their care. This promotes better self-management, increased treatment adherence, and a stronger sense of control over their condition.

4. Systemic Healthcare Advantages

Remote monitoring can reduce emergency visits and hospitalizations, easing the burden on overtaxed healthcare systems and offering a cost-effective alternative to frequent in-person evaluations.

 

The Future: Digital Tools as Standard of Care?

While still in its early stages, this integration of digital health into CKD care reflects a broader movement toward remote, preventative, and personalized medicine. The Withings case study serves as a promising example of how everyday technology can be adapted to serve complex clinical needs.

 

However, as the authors note, more clinical trials are needed to validate these tools in nephrology settings, establish protocols for data use, and ensure equitable access across diverse patient populations.

 

Final Thoughts

As we face growing rates of kidney disease and limited nephrology resources, connected health technologies offer a lifeline—not just to patients, but to an entire care infrastructure in need of modernization.

 

The Withings toolkit is more than a gadget suite; it's a glimpse into the future of chronic disease management, where data flows continuously, care is adaptive, and patients are active participants in their own health journey.

 

References
 Article: Frontiers in Nephrology, 2023 - DOI: 10.3389/fneph.2023.1148565

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Contact Us [post_title] => Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study [post_excerpt] => Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine.But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => revolutionizing-chronic-kidney-disease-management-with-digital-health-tools-the-withings-case-study [to_ping] => [pinged] => [post_modified] => 2025-06-12 15:41:31 [post_modified_gmt] => 2025-06-12 15:41:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2015 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 2047 [post_author] => 11 [post_date] => 2025-10-06 19:26:35 [post_date_gmt] => 2025-10-06 19:26:35 [post_content] =>
Patrick Sheehan is a healthcare leader at the intersection of technology and care delivery, with a focus on virtual and at-home services for people with chronic conditions. At Withings, he serves as Vice President of Value-Based Care, partnering with risk-bearing organizations to design and scale programs that improve affordability, outcomes, and the care experience.

 

The Centers for Medicare & Medicaid Services (CMS) proposed a fee schedule that would drastically expand funding for remote patient management  — a move that could mark a turning point in how we think about healthcare delivery in America. If finalized, it would be more than a policy update; it would be a recognition that the future of healthcare lies in providing patients with a concierge-like experience focused on delivering care that is coordinated, comprehensive, and personalized. At Withings, we believe this shift is coming at exactly the right time. Digital health has proven it can improve access, but to truly improve outcomes and drive savings, it must go beyond the occasional video visit, the siloed widget, and the noisy data. It requires impactful patient engagement, integrated data communication, and the accessibility of evidence-based preventive care. That’s where our technology can make a measurable difference.

 

Our connected ecosystem for virtual heart health, anchored around award-winning medical devices, captures a breadth of biomarkers and patient-reported outcomes; everything from ECGs to body composition to symptom assessments—giving care teams an ongoing, comprehensive view of a patient’s cardiovascular function along with key metabolic and respiratory drivers. Paired with personalized care pathways, this actionable insight empowers patients to play an active role in their own care while enabling clinicians to deliver timely interventions. This means more healthy days at home and fewer costly, preventable acute care events.

 

The opportunity is only accelerating. Withings recently secured a large grant to develop advanced artificial intelligence that precisely detects risk based on multi-marker analysis of device-captured patient data. When applied to a Heart Failure population for example, this would enable intervention weeks prior to weight gain, and increase the likelihood of avoiding decompensation and an acute care event. It’s a leap from reactive to proactive care—one the healthcare system urgently needs.

 

CMS’s proposal creates the framework for digital health to play a cornerstone role in a future of healthcare that  places the patient at the center. This future of healthcare will be defined by its ability to predict and prevent, not just treat. With the right policies, technologies, and partnerships, we can make that future a reality now by giving patients more healthy days at home and delivering on the promise of a stronger, more sustainable healthcare system.

Interested in partnering with us?

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Withings On-The-Go

Our patient-centric care solution utilizes portable Withings cellular devices that are not tied to a single patient. Instead, care teams can use one device to collect and transmit data for an unlimited number of individuals. The integrated cellular connectivity automatically directs the data into the correct patient’s medical record, simplifying data collection and improving care delivery regardless of the setting.
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