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Victoria Musheff: Although, I wouldn't recognize it anymore. It's changed a lot.

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Victoria Musheff: Good news.

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Victoria Musheff: We've got a couple of minutes. We don't have anyone online. Yet. Yet. We'll see. They're probably on their cell phones, and they're wondering, am I doing the right thing?

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Victoria Musheff: Yeah, that's right.

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Victoria Musheff: I always have to make sure

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Victoria Musheff: Well, while we got a little dead air space,

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Victoria Musheff: May 9th and May 16th, those are Saturdays, We're having an open house, At the Parks Mill.

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Victoria Musheff: Fighter Lewis Preservation Project. And,

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Victoria Musheff: I'll, I'll give you a, yeah, if you can send that stuff. I'll give you the instructions so that they can go online and find the, find the registration form. Okay. And, we'd like to have a bunch of these folks come.

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Victoria Musheff: Is this different than the annual walk that you… where you sign up and you take a walk to see the lilies, or is this… We don't do an annual walk, but it's all a walk. Right.

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Victoria Musheff: Well, you go there, you park, you walk in.

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Victoria Musheff: You can emble about the mill building itself, you can go down along the creek, you know, if you can't get into Creek Coast.

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Victoria Musheff: It's slick, and liability does not allow us to…

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Victoria Musheff: Yeah, we have you in there waiting.

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Victoria Musheff: All right, I'm judged up, man. Oh, thank you. Yeah, some of the stuff I'll take… I wish.

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Victoria Musheff: And that's… that's what the spider lily looked like, absent… absent the tiger falling in the middle. It's about that size, too. Minus the tiger.

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Victoria Musheff: Okay.

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Victoria Musheff: Sometimes we have live music from many Fridays, if you would like to learn how to play the harmonica.

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Victoria Musheff: You have an expert.

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Victoria Musheff: So, Debbie, it's 10, I think we should go ahead and get started. I think I might have to introduce… Oh, did you introduce them? Yeah.

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Victoria Musheff: Tell me when you're ready. Welcome, everybody.

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Victoria Musheff: Hi, I'm Marge Kondraski, a member of the Wellbeing Committee here in the wellness, area at the Emeritus College, and it's such a pleasure today to have and introduce Dr. James Gilmore.

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Victoria Musheff: from, as an Associate Professor of Media and Technology Studies and Graduate Coordinator in Clemson's Department of Communication. He received his BA in Film and Media Studies.

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Victoria Musheff: and an MA in Film and Television at the University of California, Los Angeles, in 2013.

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Victoria Musheff: PhD, Communication and Culture at Indiana University in 2008. His research explores the dissemination of

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Victoria Musheff: media, and communication technologies with a focus on how institutions use technologies to learn about human behavior. He is the author, most recently, of Bridges of Order, Wearable Technologies and the Manufacturing of Everyday Life, University of California Press 2025.

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Victoria Musheff: He is currently editing the DeGuire Handbook of Wearable Technologies in Society.

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Victoria Musheff: To be published later in 2027, and has published anthologies, a book on how comic book characters go digital, and co-edited a double issue of cultural studies on infrastructural Politics.

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Victoria Musheff: Dr. Gilmore has served as an expert source for publications such as Wired, The Verge, and The Observer.

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Victoria Musheff: As well as interviewed with a number of local radio programs and podcasts. Dr. Gilmore, thank you so much for being here and sharing your information about your phone and your health. Thank you so much.

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Victoria Musheff: Thanks for the introduction. It's really nice, to be here with all of you this morning. Is the audio okay? Is this voice level good? Great. Just like to make sure… I'm happy to shout, but I don't want to blow your ears out. So the title that I am…

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Victoria Musheff: working with is your phones, then in parentheses, and wearables, and your health, because phones and wearables are increasingly working together, to allow people to track and monitor health in different kinds of ways, and that's where a lot of my, emphasis and expertise is. So, my plan for today is to spend, about half of… I was told to kind of do 45 to 60 minutes of talking and

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Victoria Musheff: then about 30 minutes of question and answer, but we can break up the 45 to 60 minutes into questions as we go, whatever you all are most comfortable with. But I thought about I'd do about half of my talking time talking about my work on the relationships between health and mobile wearable media, answer some questions that I received from your committee, Marg sent me a list of many different things that you all wanted me to talk about, so I have some thoughts on

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Victoria Musheff: a number of them, and then questions that you have as I talk will sort of go from there. But I think kind of…

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Victoria Musheff: It's useful to kind of,

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Victoria Musheff: You mentioned a little bit in the sort of intro, and I appreciate that, it was great. A little over a year ago, I had this book, Bringers of Order, come out through the University of California Press. This is a book that I worked on for about 8 years. It began as my doctoral research, it became my dissertation, then I worked on it for years.

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Victoria Musheff: After I started working here, after I received my PhD, and it's a book that is really, at its core, trying to teach people about what wearable technologies do, so that they can understand, sort of, when you wear an Apple Watch Fitbit.

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Victoria Musheff: earpods, a GoPro camera. What is this device doing, and how does it intersect with things like health, or work surveillance, or law enforcement, things like that?

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Victoria Musheff: earlier this academic year, Clemson World graciously featured, the book in this article, Smarter Than Your Watch, which is, I think, what turned, you all on to me. So, this was an article that was… they sort of challenged me to come up with, you know, what are…

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Victoria Musheff: what are four things that you wish people would know if they don't have time to read your book, what would you like them to know about? And it sort of was, if you read the article, thanks. I think they did a really great job, and it's in the… it's online if you want to go and read it after this. But what I was really trying to focus on in writing that was

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Victoria Musheff: reinforcing what I see as the value of technical literacy. And what I mean by that is that if we understand a bit about how our technologies work, and how we can use them, then we can avoid some pitfalls that might emerge around them. So, I like to begin in the height of COVID-19. I know we all love to think back to the summer of 2020, but I think it's a really instructive time for us to think about when we talk about mobile

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Victoria Musheff: and wearable media, because they played a really key role in the pandemic, and the way that we talk about mobile and wearable media now is really rooted in some things that happened during the spring and summer of 2020.

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Victoria Musheff: If you can rewind your mind a little bit, you may…

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Victoria Musheff: recall that, especially in South Carolina and a lot of areas around the country, we couldn't really get tested for COVID-19. That was part of the anxiety. There was no, widely available public testing. You often had to go to a hospital and wait in line all day, and it was really like you couldn't go to the pharmacy or order tests to have at home very easily. So there was a lot of anxiety, not just about the pandemic generally, but how do we test

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Victoria Musheff: to see if we, you know, have contracted COVID-19. And we began to see stories like this emerge. So this is from Wired, which is an incredibly popular mainstream technology magazine, from April 14th, 2020, so about a month after the country kind of went into lockdown mode. Can a wearable detect COVID-19 symptoms before they appear? A leading question. They didn't even answer it until about

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Victoria Musheff: 14th paragraph, where they said, probably not, but for 14 paragraphs, we're sort of talking about this idea of, well, what if we could get our terminology? Yeah, that's a…

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Victoria Musheff: key frame in technology journalism. We promote something that's impossible before saying it's not actually possible. But we did start to see op-eds like this emerge, too. This is from late May in 2020 in the Washington Post.

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Victoria Musheff: wearable tech can spot coronavirus symptoms before you even realize you are sick. Again, these stories start to enter the mainstream, and what's interesting about this one is that the columnist here, Jeff Fowler, he's someone who, as he discloses in this op-ed, was wearing wearable technologies and working with companies to try and prove whether this was possible. So he was promoting an idea that I think is a little bit of a conflict of interest, but the big one was

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Victoria Musheff: the NBA partnered with a company called Aura. If you do not remember this, the NBA went into a bubble in Orlando, Florida, so that they could continue their season, and they needed to monitor whether an athlete contracted COVID-19. The way… one of the ways they decided to do this was through partnering with a smart ring company called Aura. You can see the smart ring on the athlete's finger in this image.

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Victoria Musheff: The idea of Aura

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Victoria Musheff: was this, again, this sort of myth, or this hope, that if you wore a piece of technology all day long, even when you're sleeping, and you only took it off to recharge it, that it would be able to learn about your body so well that it would tell you if you were contracting COVID. This idea was so persuasive to the NBA that they bought thousands of these rings for the players to wear.

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Victoria Musheff: But this entire idea that Oura Ring could detect COVID-19 symptoms was based entirely on anecdotes. There was this well-popularized story at the time, at least in the circles that I read news in, it was popular, of individuals like this Finnish entrepreneur, Petri Hallman, who wore an Oura Ring, and he was traveling in Europe from sort of the early days of the pandemic.

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Victoria Musheff: came home.

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Victoria Musheff: felt off, he couldn't quite figure out what was going on, and he was resting, and his Oura Ring told him, it looks like you're getting sick. And then he went and got tested for COVID, and it turned out he had COVID, right? So, this sort of… these were anecdotes that began accumulating among Oura Ring users of my ring told me that I was getting sick, and that led to the CEO at the time, Harpreet Rai, going on news networks and talking about

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Victoria Musheff: how this brain can tell you if you're contracting coronavirus.

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Victoria Musheff: Because it will tell you if you're getting sick, before you even know if you're getting sick. And mainstream outlets like CNBC gobbled this up and reported it as if it were fact, but crucially, it wasn't the way that they said it was, right? It was an exaggeration.

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Victoria Musheff: There were a number of research institutes around the country trying to figure out, can we use

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Victoria Musheff: wearable devices and smartphones to track COVID outbreaks? Can we understand people's health through these, tiny little tools? One institute was West Virginia University's Rockefeller Neuroscience Institute. They were trying to develop a whole platform they could give to hospital staff, so they could track whether or not COVID broke out among the nursing staff, and they could isolate it very quickly.

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Victoria Musheff: And they developed a whole platform that used multiple different things, including a mobile app that they developed for smartphones. They sent surveys to hospital workers every morning and evening, asking them how they were feeling. And they did use wearables. They did use Oura Rings, but the Oura Ring was one of about 5 different pieces of data that they were collecting

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Victoria Musheff: But that didn't stop the CEO of Aura from saying, West Virginia confirms that the Oura Ring can, detect COVID before it appears, to the point where it's important to emphasize that there was no peer-reviewed scientific research to support any of the claims that Aura's CEO and other journalists were making, or that the NBA was making in the entire calendar year of 2020. It's only been in the last several years

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Victoria Musheff: that Aura has been able to demonstrate some consistency in actually predicting the onset of illness. So, this kind of…

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Victoria Musheff: I also… it's nice to say that I also played some part in this story, because The Verge interviewed me in the summer of 2020, and I went on a whole screen about how they were saying things that they had no basis in saying, and they were exaggerating all of their claims, and I'm not gonna play that now, but it's on YouTube, and I like that. But I bring this up at the start of this talk, because COVID-19 was a massive turning point in how we think about wearable tech.

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Victoria Musheff: specifically, but also phones and health more generally. It really propelled this idea that we should be using our phones and our wearables to understand our health and empower us, to the point where now we see wearables taking increasingly center stage in conversations about public life at the federal level. Last summer, RFK Jr. and a… this was a

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Victoria Musheff: House, committee meeting, said that his vision is that every American is wearing a wearable within 4 years.

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Victoria Musheff: persistently growing idea that we should be using these things to track our health. So, one of the things that my research focuses on is why do so many people think that wearables can solve these problems, and then also, what can they actually do, and what can phones actually do when we use phones to understand things about our health?

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Victoria Musheff: The answer that I've come up with to this question

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Victoria Musheff: It's a concept that I use in a lot of my work, and other people in my area use as well. It's a fancy concept called datification.

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Victoria Musheff: What does it mean? Datification is both a process and a belief.

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Victoria Musheff: And if we understand datification, we can understand a lot about what our phones do, and what our wearable devices do as well. So datification occurs when parts of our body and our behavior are converted into what we might call computational, often quantified, data.

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Victoria Musheff: The best example I can give you of this is a step. When Fitbit says, you've taken a step, that converts

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Victoria Musheff: into a data point, one step. And as I'll talk about in a couple slides, we know how Fitbit calculates that. It's not actually calculating the steps that you take, it's doing a lot of other fancy stuff that we'll get to in a few minutes. But it's this process where the things that we do are converted into some kind of data.

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Victoria Musheff: How many hours a day you've been standing, how many steps you have taken, how far you have traveled, how long you were sleeping. We are increasingly compelled to convert our behaviors into data, and with that comes datification as a belief.

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Victoria Musheff: That the development of big data will lead to intrinsically better knowledge.

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Victoria Musheff: And there are… there's lots of evidence that it does, and we'll talk about some of that over the course of this morning. But there are problems with datafication and limits to what it can do that part of what I'm doing today is talking about things to be mindful of when we use phones or wearables to monitor our health, try to learn more about our health, right?

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Victoria Musheff: What you see here is the inside of a Fitbit, and I'm not going to go into detail on what all the different sensors are, or how the circuitry works, because that would take a lot of my time and probably be a little bit boring for a lot of us, but we can see how, you know, these devices aren't just screens that show us numbers. They're very complex circuitry that involve multiple different kinds of sensors working together all of the time.

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Victoria Musheff: And I don't think that we as individuals living in the world need to understand all of the science behind it, but it is fascinating to me how little we actually understand. And I include myself in this as well, because it wasn't until I started researching these things properly that I learned anything about this. We're actually kind of discouraged.

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Victoria Musheff: to learn about what goes on under the hood of our phones and our wearables. And if we understand that this stuff is being used to produce what a step is, we can understand that data don't just exist. Steps… step counts, at least anyway, don't just exist, they are fabricated. I don't mean fabricated in the sense of, like, they're a lie, right? We didn't take the step, but they are fabricated in the sense that they are made. Data are…

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Victoria Musheff: produced. There's a phrase that we use called raw data is an oxymoron. No data is purely raw, it's all made from something. The act of humans creating data means that it's not totally

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Victoria Musheff: raw. So here, I want to talk a little bit about how Fitbit works, because I think Fitbits and step trackers are kind of the…

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Victoria Musheff: the mainstream of how we think about how can we be monitoring our health, right? So, this is a Fitbit, or a version of… they come in all different shapes and sizes at this point, but it's sort of the classic model, the Fitbit, that shows you

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Victoria Musheff: how many steps you've taken, over the course of a day. You can measure things like your heart rate with it. It can see, you know, how far you have traveled. Some of them can get notifications from your phone sent to them. They're very fancy little devices. An Apple Watch and Samsung Gear and lots of other devices use these sort of things as well. Fifth, it's been around since about 2008.

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Victoria Musheff: When I first arrived on the scene, it was heralded for motivating people to want to exercise.

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Victoria Musheff: This is Fitbit's launch website. It's very cluttered, very sort of difficult to parse. There's a lot of, like, stuff on this homepage. But you can see how from the beginning, you know, they're asking, they're pitching this device in terms of helping you answer questions. Did I get enough exercise today? How many calories did I burn? Am I getting good quality sleep? How many steps and miles did I walk today? All under the idea of.

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Victoria Musheff: If we use these devices, we might be a little healthier.

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Victoria Musheff: Fitbit has become so popular that we see organizations all the way up to the CDC having full articles giving you tips for getting your steps in, a phrase that Fitbit has popularized, right? You have to get 10,000 steps per day, supposedly. The 10,000 step,

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Victoria Musheff: threshold that they said is the goal that people should get every day, it's completely arbitrary. It was a marketing decision. There's no actual science behind 10,000 steps, although

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Victoria Musheff: You know, walking is good, and if you can walk, it's good to walk, but there is no actual magical reason why 10,000 steps, other than, when Japanese companies were developing pedometers in the 1970s, 10,000 steps sounded very catchy in Japanese. I can't remember the specific Japanese phrase, and I wouldn't dare to say it, even if I did, because I'm not good at pronouncing Japanese, but it is a barking tactic more than anything.

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Victoria Musheff: So…

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Victoria Musheff: what is a step? And here's where we're going to start to get a little bit technical. I'm not going to go deep on this stuff, but part of why I talk about what is a step is because I really think that we can all be more empowered when we understand a little bit more about how these things work, right? It helps us when we look at a Fitbit or an Apple Watch and we use it to count our steps, if we know

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Victoria Musheff: well, what does this step mean to this device? So, over here on the right, this is just a copy-paste from Fitbit's website that explains this, and then over here is my sort of distillation of it. So…

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Victoria Musheff: a step to Fitbit is basically, like, a calculation, right? It's a calculation between three different things.

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Victoria Musheff: The first thing is a 3-axis accelerometer. An accelerometer is something that measures velocity. It's looking for movement. It can… the velocity accelerometer in my Apple Watch can tell that my body is moving in space, and it can see this happening, right?

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Victoria Musheff: And then there's also an algorithm.

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Victoria Musheff: You hear the word algorithm all over the place, there's lots of different kinds of algorithms, but the way that I like to think about what algorithms are is sort of like the computer version of an if-then statement. If X happens, then Y happens. And then Fitbit will also calculate your stride length based on when you set up your Fitbit account, and you tell it, you know, I'm a male, I'm in my mid to late 30s, and I am 5'10 and just

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Victoria Musheff: tall, right? It's gonna assume what my stride length is based on the information that I give it. So it's saying, you know, we assume that your stride length is gonna be

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Victoria Musheff: We got this… Right?

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Victoria Musheff: And it's going to assume that a step will occur if my velocity has changed some amount of time, right? So the accelerometer is picking up my velocity all the time, and if I wasn't tethered to a microphone, I might be walking around the room while I'm giving this example, but I want to be sensitive to the very intricate tech setup that you have here. I'm standing foot while I'm giving this example. You can visualize me walking, right?

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Victoria Musheff: The accelerometer says, look, velocity is changing.

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Victoria Musheff: And the velocity changes enough, the algorithm says, oh, if velocity changed enough, then a step has occurred, and then it logs it.

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Victoria Musheff: As a step.

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Victoria Musheff: Right? And for the most part, they're pretty accurate at this point. You know, these devices have been around for nearly 20 years, at least the Fitbits have been around for nearly 20 years at this point, so they're pretty precise at this point, but if you've ever, you know, if you wear a step tracker, and you've ever taken a road trip, and you've been in a car for 4 hours, and you look down when you get to your destination, it says you've gone 2,000 steps today. You say, well, how's that even possible?

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Victoria Musheff: It's because when you hit bumps in the road, it's logging that as the step, because it doesn't know any better. It's assuming that velocity, it's seeing this sudden change in velocity, and says, oh, that's a step, right? There we go, right?

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Victoria Musheff: So, steps are mathematical.

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Victoria Musheff: they're computational when we talk about using phones or wearables to track this kind of stuff. This is going to be a common theme in what we talk about, is understanding that a lot of these things, they're incredibly useful, but they're also based on combinations of different sensors and algorithms working together to tell us about our health, right? So they don't reflect reality.

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Victoria Musheff: They're instead a construction of what likely happened.

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Victoria Musheff: So, it's inferring… a step seems to have taken place here. Now, what you may be thinking, at least if you weren't thinking it yet, you're about to, because we're going next.

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Victoria Musheff: These are designed to work better with some people rather than others, right? It's a very real problem that Fitbit, especially in its early years, was developing these step tracking algorithms with people who are, for lack of a better word, normal. Their bodies had normal gates to them. They moved around the room a way a normal person would.

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Victoria Musheff: But lots of people don't walk normally, right? People have different capacities for stride length for all sorts of reasons. Some people use wheelchairs, or they use walking assistance like a cane. And Fitbit works less well with those individuals, because Fitbit still struggles with how to record movement that is achieved when using a wheelchair, because of the way that it's relying on an accelerometer to measure velocity.

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Victoria Musheff: Right, so even though a wheelchair user might be interested in getting a sense of, you know, how much

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Victoria Musheff: am I exerting each day as I move around? How far am I going when I am moving? Fitbits are not useful for that. For people who walk with some kind of walking assistance, and their steps are not

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Victoria Musheff: Normal stride length.

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Victoria Musheff: they might not work as well for those kinds of people, which is something good to keep in mind if you are, you know, if you're somebody who has what we would call a non-normative gait. You don't walk kind of the normal way that people do, but you want to use a Fitbit, and you find yourself frustrated by, well, this doesn't seem to be, like, you know, I know I walked more than this, what's going on here? That's probably why. The system doesn't… it's not picking up your movements and steps, and that's not

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Victoria Musheff: not a bad thing, right? It's, again, when we understand how the technology is built a little bit, it helps us understand it better.

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Victoria Musheff: I have blood oxygenation sensors here, because these became

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Victoria Musheff: really important during COVID-19 as well. So, Apple Watches at this point and a number of other wearable devices can measure your blood oxygen, the amount of oxygen in your blood, and they use that with an optical sensor that I'll talk about a little bit later. And when COVID-19 was raging, you know, there were recommendations for, you know, if you were worried about your vulnerability.

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Victoria Musheff: to COVID-19, it was good to do a blood oxygen test at home, and if your blood oxygen dipped below 90%, you might want to seek medical care, right? So, I remember when I contracted COVID, I was using my Apple Watch to measure my blood oxygen pretty regularly to make sure that I was, you know, not dipping into that danger zone, and that works, again, better for some people rather than others.

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Victoria Musheff: We know that blood oxygen sensors

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Victoria Musheff: have limitations for people based on skin pigmentation, and they have for decades, and Apple hasn't been able to solve that problem. There was actually a lawsuit in 2023 that alleged that Apple Watch had racial bias built into the device because the blood oxygen sensor and other sensors couldn't produce accurate readings for individuals with darker skin pigmentation.

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Victoria Musheff: And that lawsuit was actually dismissed. And the reason that the judge dismissed it was because we have known for decades that this is a problem, and a lot of nursing textbooks will teach nurses to account for statistical errors when they are using blood oxygen monitors for people with darker skin pigmentation, because it has been well documented and they can't figure out how to solve them, right?

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Victoria Musheff: So, again, if you buy these technologies and set them up to track your health without interrogating them at all, you might find yourself frustrated or flummoxed by why am I getting the results that I'm getting?

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Victoria Musheff: But if we start to understand some of their, you know, limit… I won't go so far as to call it bias, but limitations in how they are designed, that can empower us to sort of understand, you know, what we can use them to do, right? And the pulse oximeter uses the nail bed as opposed to the wrist. Yes. And the wrist is not as effective, yeah.

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Victoria Musheff: Yeah, that's an important distinction. But we do increasingly see stories like this one, right? My Apple Watch saved my life, right? This is from the Financial Times, from

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Victoria Musheff: A few years ago, and we see stories where Tim Cook, an Apple CEO, talks about how he wants Apple to be a company that can save your life, and I think that that's…

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Victoria Musheff: part of why I'm here today is to talk about that phenomenon of how does Apple, and I'm going to sort of default to Apple when I talk about a lot of this stuff, because they are, I think, the most popular smartphone, and Apple Watch is the most popular wearable at this point, but I know there's a plethora of devices, but that's just kind of what I'm defaulting to for the sake of streamlining the talk.

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Victoria Musheff: So…

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Victoria Musheff: we have to ask things like, how does Apple Watch monitor you? What can you use Apple Watch to do, and is Apple Watch actually effective at doing these things? Apple Watch, or Apple, has worked with the FDA to obtain clearances on a number of different sensors inside of the watch, right, that actually do make it not medically

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Victoria Musheff: accurate, but about as accurate as you can get on a consumer-grade device. And what I mean by that when I say consumer-grade is the kind of device that you can buy on Amazon, or at Target, or Best Buy, right? Something that's going to cost you

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Victoria Musheff: hopefully, you know, several hundred dollars, but it's not medical grade, something that you would use in a hospital. But Apple has been able to get clearances on their electrocardiogram, which they use to help measure atrial fibrillation, AFib, and heart rate variability, and they most recently obtained clearances for their hypertension notification feature, right?

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Victoria Musheff: So they can also tell if you are exhibiting patterns in your body that indicate that you might be susceptible to developing hypertension, right? The atrial fibrillation, was sort of the…

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Victoria Musheff: crowning achievement of Apple when this got cleared in 2018, they really promoted this as a massive achievement, because they were able to use the watch to detect patterns in people's blood flow to see if whether or not, you know, they were susceptible for irregular heartbeats and things like that. So how does this work? A lot of it's done through the flashing LED lights on the underside of your

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Victoria Musheff: Apple Watch. So if you, wear a smartwatch.

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Victoria Musheff: you've ever taken it off and looked on the underside of it and wondered, what are these things? You might have seen the flashing lights, you know, like, what is this exactly? What's going on? It's a process that I mispronounce every time I say it, but it's the process on the top line that I'm going to call PPG. And PPG is really central to how a lot of these things function, right? So, these green lights, and there's also red lights as well, but the green lights are

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Victoria Musheff: really, used to capture the flow of blood in your wrist, right? So there, it's an optical sensor that is sort of constantly measuring

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Victoria Musheff: how much blood and how quickly blood is flowing in and out of your wrist to develop a baseline of how your body is functioning, right? And if your baseline changes suddenly.

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Victoria Musheff: the Apple Watch is triggered to send you notifications, right? So if you have ever been in a stressful situation, and your Apple Watch sends you a notification saying, you know, your heart rate has spiked suddenly, right? That's derived from this kind of data that it's gathering constantly. It does this passively. You don't have to ask it to do it, it's constantly doing it, right? So.

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Victoria Musheff: It also has difficulties with darker skin pigmentation, so although they've been correcting that more and more with each iteration of the Apple Watch. But it has been demonstrated to be effective at identifying irregular heart rhythms because it's pattern-based, right? So, Apple realized that, you know, a lot of the algorithms that they were developing to work with these sensors, algorithms are looking for patterns, right? They understand human behavior.

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Victoria Musheff: and bodily behavior is primarily pattern-based. So, if we can develop a system that's constantly measuring, you know, blood flow, and we see disruptions in the patterns, well, we can have an algorithm that will trigger sending a notification to the wearer saying, hey, something's going on here. You might want you to be aware of that.

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Victoria Musheff: Right? So again, we don't need to understand, I think, all the… Science and engineering behind

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Victoria Musheff: how these devices work, like, under the hood, but if we understand that, you know, these are monitoring our health based on optical heart rate sensors, using this process to look for patterns in blood flow, it can help us also understand how things like the fall detector work.

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Victoria Musheff: The fall detector is also a life-saving health monitoring system that Apple has developed for a number of years. My mom had a friend that she grew up with whose life was indeed saved by the Apple Watch Fall Detection notification system. He was working out in his home gym on a treadmill and had some kind of event where he passed

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Victoria Musheff: out and fell onto the treadmill, and his watch contacted emergency services on his behalf, and they came to his house and saved his life. So, these things do work, and if we understand how they work, you know, it can help us understand, like, their utility. So the fall detection system also uses accelerometers to measure steps and distances.

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Victoria Musheff: But here, it's looking at a gyro… it combines it with a gyroscope sensor that's used to detect sudden changes, right? So, I'm not going to do it now because it's a hard floor, but my watch, you know, it has this feature built into it, and the gyroscope sees that I've been stable this entire time, right? My pattern has not changed at all. But, if I were to suddenly fall to the floor, if you came up and pushed me down.

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Victoria Musheff: And I just fell over hard. My…

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Victoria Musheff: my altitude would change so suddenly, with such velocity, that it would trigger this notification, right? So this is also governed by an algorithm, one of those if-then systems that says, if…

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Victoria Musheff: you know, the altitude data and the velocity data change very quickly with the wearer, then we can assume that a fall has taken place. It'll summon this thing that says, it looks like you've taken a fall, and it'll say this to you. It'll have… give you an option to either say, I'm okay, or to call SOS, and if you, if you do nothing, it'll call 911 on your behalf after 10 seconds. It starts counting down.

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Victoria Musheff: 10, 9, 8, so if you've passed out, after 10 seconds, the watch will call 911 on your behalf, and it has an automated message that it will say, you know, it says, because it knows your location, if you have location services enabled, it says, this is an Apple Watch located at, you know, whatever the coordinates or address you're at are, my wearer has taken a fall and is unresponsive, and it will trigger an emergency response

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Victoria Musheff: on your behalf, right? So, you know, we have other technology like this. The Life Alert button is a very classic example, but with Apple Watch, we see this sort of stuff integrated in some potentially really helpful ways, right?

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Victoria Musheff: So, this is coming to kind of the end of the first part of what I was planning to talk about today. Our… and kind of why I've been talking about all of this to…

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Victoria Musheff: the key takeaways. I think it's important to acknowledge that these devices that we use, they contain a lot of different kinds of sensors, and if we understand health tracking and health monitoring is based on sensors.

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Victoria Musheff: that we can understand a little bit better, like, how they're doing the work that they're doing, especially that they interact with these algorithms that are kind of looking for changes in our behaviors. So, I think that this is very empowering stuff to learn about, and that it can help us understand sort of the capacities as well as the limitations. If we are confused by, you know, when a device tells us something, hopefully this helps explain

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Victoria Musheff: Why that might be happening, but also can help you,

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Victoria Musheff: you know, feel very confident about, what some of these devices can enable. My big kind of takeaway here, if you want a nice, clean statement that sounds a little academic, is that datification of bodily health is about extremely robust pattern detection, right? The idea that our bodies, when they are functioning well.

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Victoria Musheff: they have repeating patterns to them, right? Our heart rate, our blood pressure stays the same, our movement stays basically the same, and if you wear a device over time, it learns what your baselines are, right? And then when those baselines are violated, that triggers the different kinds of notifications that we see.

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Victoria Musheff: Does anyone work until he learns in?

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Victoria Musheff: Yeah, but it will learn that, so it'll have, like, an automated normal baseline, but it'll adjust that as you wear it, right? So, it sort of has an expectation of what is the normal heart rate, like, heart rate range for a human when you give it your demographic information. When you set it up, it might ask, what is your age?

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Victoria Musheff: What is your sex, and it will infer your, like, your normal heart rate based on that, but after 3 to 7 days of wearing it, it sort of understands what your baseline is. So, if you bought the watch and wore it and then had a heart attack later that day, it might not recognize… it would hopefully recognize a heart attack, but if you had some kind of, you know, massive spike in blood pressure, it might not recognize that and just put it on.

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Victoria Musheff: But after 3 to 7 days of wearing it, it would be able to sort of tell

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Victoria Musheff: Where spikes are happening, and be able to intuit what might be happening to give you information. So…

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Victoria Musheff: that's kind of the first half of what I had, and then I've also tried to answer the various questions that you all had for me. So this is kind of just… I tried to, again, just do as many as I could. He gave me a very long list, which I appreciate, but trying to give helpful information, and if I haven't interpreted

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Victoria Musheff: correctly what you were asking me for. Please ask, you know, additional questions.

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Victoria Musheff: So this is just kind of going through the list. One of the first things that I had noted was

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Victoria Musheff: technology apps that will be useful, and then in parentheses, we heard that there are apps such as looking into one's ear for earwax accumulation. This is actually really interesting because it's an opportunity to talk about what your phone can do with connected devices, right? So, there is no single app that will do this for you that I'm aware of, so I don't think that you can take your phone and hold it up to your ear, and it will look at your

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Victoria Musheff: earwax accumulation, but there are a number of pretty affordable, autoscopes, or, like, like this one, shown, this is called Sue Ear, right? And there are a number of ones like it. I just picked this one because it looked pretty, and I liked it when I was looking around for answers here. But this device, this little wand, has a Wi-Fi transmitter in it, and a lot of them have a Bluetooth

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Victoria Musheff: transmitter in them, so they will pair with your phone, right? So, you can… This one. Yeah? I don't have that brand, but I have one. Do you like it? You know, it's really interesting for, you know, I wish I'd had it without my children were young. Yeah. Because it would have been a much easier way to look into their ears, and they would have found it interesting. Yeah. As opposed to the…

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Victoria Musheff: of the scope that I was using.

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Victoria Musheff: But… I…

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Victoria Musheff: didn't like the instructions that came with it. In other words, it comes packaged with a lot of Pieces.

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Victoria Musheff: but no instructions about what any one of those pieces is used for. But it does… but the one I've got does have an attachment that you can use to look in the nose, as well as the ear,

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Victoria Musheff: So, I mean, there's some pieces to it that are certainly nice, but I…

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Victoria Musheff: I had no medical information. It didn't solve anything, other than saying, yes, there's wax or no, there's wrong. Yeah, so that's a really good point, and that a lot of these things, and Apple is guilty of this, too. Apple is weird because you can buy an Apple Watch, and it doesn't come with hardly anything. It comes with a slip of paper that sort of tells you how to turn it on and put it on your wrist, and there you go, right? They offload a lot of this stuff onto their websites.

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Victoria Musheff: Now, which can be useful, but also frustrating, because their logic is, well, we don't have to print instruction booklets.

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Victoria Musheff: but also we can keep it up to date, but then if you're someone who likes a paper instruction booklet to refer to, it makes it harder for you. So I know for Apple,

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Victoria Musheff: for a lot of the stuff that I'm talking about today, when I talk about Apple devices, you can go to support.apple.com, and there are decades worth of message boards that can help with answering different kinds of questions. I haven't been to Sueer's website to see how, you know, what quality of instruction they're offering, but that is true for a lot of these things, is that they want you to go to their website, and they might have an instruction manual.

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Victoria Musheff: It was useless. You know, literally, if I had no background other than showing me earwax.

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Victoria Musheff: It would have, you know, literally…

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Victoria Musheff: So, and I thought about people that don't have any health background, what they would see, and what they might do. And I think…

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Victoria Musheff: Because it gives you little things that you can use, supposedly, to remove the earwax. If you don't know what you're doing, you could really hurt your ear. And so, it wasn't,

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Victoria Musheff: It was a little bit… in some ways, it made me uncomfortable.

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Victoria Musheff: But on the other hand, for someone who has no resources and no one to help them, it's not a bad thing.

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Victoria Musheff: Yeah, there's a point that I'm gonna make.

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Victoria Musheff: somewhere in here, which is that these… I think that these devices are often best used in consultation with a primary care physician, to get a sense of, do they have recommendations for which one you should order, or what can you look for with them? Yes. It's a great teaching tool, though, for, you know, primary care office, in terms of people that are continually bringing their little kids in and stuff like that.

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Victoria Musheff: this is normal, see the light reflex and the, you know, how it's clean behind the drums and that kind of thing. Yeah, absolutely, absolutely. Does that sensor actually see an image? Yeah, so it… if it works correctly, what it says it does, I haven't tested one myself, is that it does have an optical cable that will transmit an image of your ear that you can look at on your phone, so it gives you a

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Victoria Musheff: way, kind of, if you're by… if you're living alone and want to check earwax accumulation, you can kind of

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Victoria Musheff: have the image ported into your

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Victoria Musheff: phone, and you can watch it through the Southear app, right? So, the… The bone itself

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Victoria Musheff: can't do this, but there's lots of other devices that will hook up to your phone through Wi-Fi or Bluetooth. One of the other, things that these are really useful for is being able… a lot of them will keep records for you on the app, right? So if you do a, you know, maybe this… you can record, you know, looking at your ear, so if you want to look at accumulation over several months and see what's going

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Victoria Musheff: you can take a video, store it on the app, take another video, store it on the app. If you're worried about earwax accumulation, you can, you know, actually get data that you can go back and refer to over time.

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Victoria Musheff: Did it not change, or… No.

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Victoria Musheff: So, I also had, this one, monitoring lots of things, such as steps, glucose, AFib, blood pressure. I have, I think, a couple things

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Victoria Musheff: to touch on this, I've already talked about some of these things, I'll talk about more as I go through, but kind of what I just said. With a lot of these things, they have very seductive appeals to them, kind of like with the Oura Ring and its ability to tell if you're getting sick. You know, there's advertising that's going to promote this stuff as being able to do things that it might technically be able to do, but I think it's really best to.

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Victoria Musheff: talk to the primary care physician on what you should be monitoring and what you should be looking for, because you can think, like, you know, I need to get this to monitor potential AFib. Okay, if you're doing that, you know.

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Victoria Musheff: ask your doctor, what should I be looking for here? If I'm using an Apple Watch to look for AFib, and I'm testing for AFib, what should I be mindful of? Because, like somebody said, you know, if you haven't been trained in this stuff, you don't necessarily know what you're looking for. And the watch and the phone can be helpful, and they can send you notifications, but if you don't know how to interpret them, you might be at risk of misunderstanding.

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Victoria Musheff: the data. An example of this that happened to me is after… I got COVID twice. I got in the last day of wave that came through over the summer, and after it passed, and I was trying to get out and walk again, I was still very winded from having COVID and taking a week off to recover from it, and I was, you know, I was trying to go, like, a couple miles, and my Apple Watch sent me a ping that was like.

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Victoria Musheff: I'm very worried about your, you know, your heart rate. It, you know, it tried to, like, diagnose me with some kind of condition. I was like, well, I know that that's not what's happening here. It's that I was really sick for a week, and I haven't been exercising, and now I'm trying to exercise, but the Apple Watch just saw, you know, you used to have this baseline when you were moving, and now it looks like this, and something is really wrong.

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Victoria Musheff: And I didn't panic when I saw that, because I can intuit why it would be telling me that, right? So, if getting this kind of

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Victoria Musheff: you know, data is sort of daunting, I think it's useful to talk, with care teams about, you know, not just, you know, should I buy an Apple Watch to track AFib, but… or risk of AFib, but, you know, how does it work? How can I be using this, right? Sleep tracking, for instance, is increasingly popular. More and more devices are saying, wear this and you'll understand your sleep health.

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Victoria Musheff: Again, a lot of that stuff is just based on pattern detection. It has sort of triggers for assessing when your body enters into, you know, deep sleep, when your REM cycles are occurring, but they're really looking at patterns for hand movement, right? If you're wearing an Oura Ring, if your hand is moving while you're sleeping, that's a cue for restless sleep. It's looking at where your heart rate, settles into sort of a sleeping zone for

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Victoria Musheff: heart rate, has other variables that assess the sleep quality.

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Victoria Musheff: And like I've sort of been saying over and over again, if you know how that data is

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Victoria Musheff: it can hopefully help you interpret it. Does Apple require you to do a monthly fee to maintain that data? Are they… do they have a subscription fee? I think you can do… there's…

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Victoria Musheff: I think you can do a lot of it for free. There's tiers with having Apple subscriptions, but I think most of the health stuff, you can… you're free to upload to it. Because I don't have an Apple Watch, but my Apple phone, like, with the blood pressure checking or something like that.

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Victoria Musheff: They basically give you, like, a trial basis, but then they really want you to provide, you know, they want to charge you to maintain any of that data. So the basic…

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Victoria Musheff: levels of data, like the… how much you've been walking, your heart rate, which I think might be stored up to, like, 30 days, and then it resets just so it doesn't have… they don't have to store everybody's heart rate for decades.

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Victoria Musheff: That stuff should be free at this point, if you're doing it through an Apple Watch, and then I think you can pay to have more advanced features tracked and stored. Yeah, I actually don't…

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Victoria Musheff: have that data off the top of my head. That is a very good question. I only ask that because you said that the blood pressure stuff was added, or approved in

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Victoria Musheff: Yeah, so the hypertension notification feature was approved in 2025, and there shouldn't be an additional fee to access that, because it's all based off of that same optical sensor data. So, on the phone, it was using the camera. Yeah.

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Victoria Musheff: And, and your finger on the camera light. And… but after… but basically, they were asking for money. Yeah. As opposed to… so… and then the other thing was that I was surprised at the standards they were using for defining hypertension, because it wasn't…

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Victoria Musheff: But I'm seeing in the least recent literature about the standard for that. I thought it was a little high. Yes. In other words, it was…

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Victoria Musheff: telling you that you were pre-hypertension way before you were pre-hypertension. Yes, that's a wonderful point that anticipates something else in one of these slides, which is that these are consumer grade, and they are better… so they have these lines in them that say.

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Victoria Musheff: these are not diagnostic tools, even though they're product diagnoses, right? So, they're very useful at providing

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Victoria Musheff: Baseline understandings, but that shouldn't be confused with

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Victoria Musheff: you know, a diagnosis that you would receive from a medical professional, and we've seen in the years since the AFib detector has been approved, people over-self-diagnosing for AFib, right?

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Victoria Musheff: my watch told me I had atrial fibrillation, so they go to their doctors wanting to be tested, and they don't have it, right? So, these are imprecise devices, and just because your watch tells you you have a condition doesn't mean that you have a condition. They are useful, but they are not authoritative. Because again, if we just think about how they work, right? They are using, sort of.

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Victoria Musheff: one to two sensors on the underside of the watch, and pairing that with the algorithm and the software, and that's how they're making all these determinations. So…

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Victoria Musheff: They received enough clearance from the FDA to say.

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Victoria Musheff: you can market the hypertension… the hypertension is called a notification feature, right? It's not called a diagnostic tool, and that's a very… it sounds like that sounds like the same thing. It does sound like the same thing, but from a classificatory standpoint, it's two entirely different things, right? This is also true with the Oura Ring that I talked about earlier. Oura Ring has not pursued FDA clearance for anything their device

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Victoria Musheff: does. In fact, their current CEO, whose name I'm blanking on, has lobbied for the FDA to create an entirely new category of recreational monitoring devices that they could apply for clearance through that, because they are not willing to have their device subjected to that

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Victoria Musheff: level of review that the FDA currently does. And when I say… and this is also, like.

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Victoria Musheff: when the FDA has cleared Apple's sensors, right, they have cleared it on that level of, you can say that you can perform scanning functions, and that you can notify people about possible concern, but you cannot make the claim that the Apple Watch

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Victoria Musheff: can diagnose you with hypertension, right? So they're advertised, it's one of the reasons why you don't see a lot of the health features in Apple's advertising, because they have to be very careful about how they make those claims, right?

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Victoria Musheff: Well, and hypertension and AFib, you can go in and out of those problems. They're not… it's not something that, you know, if you're in AFib, you don't stay in AFib, you go in and out of it, but… and also with blood pressure, you know, if you're running around, your blood pressure's gonna go up. When you're lying down and resting, it's gonna go down, and so…

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Victoria Musheff: You know, but it's good in terms of the alerts that they need to be concerned about it. Yeah, absolutely. So they perform good functions as screening tools.

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Victoria Musheff: But they have limitations, and they shouldn't be taking the place of care teams, right? So… Do any of these instruments have, GPS? Yes, they do. So, smartphones have GPS, and, I can figure out where this is… I can jump over to… I have a nice little…

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Victoria Musheff: I'm just gonna skip a whole bunch… I'll bounce back and forth, because I have slides for a lot of this stuff. Here we go. So, yeah, they have GPS built into them, so when you use maps, either on… so, most Apple Watches, I think all Apple Watches, can use Apple's map.

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Victoria Musheff: app, and then you can use Google Maps or Apple Maps on your phone to get around, and that works through a process called trilateration, which is a fancy word for using multiple data points to figure out where you are. So the phone

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Victoria Musheff: is emitting a location signal. If you have location services on, you can turn that on or off, depending on your level of comfort with transmitting that signal. But if you have location services on, the phone is constantly emitting a signal, or the watch is constantly emitting a signal, if you have that turned on on your watch. And when you go into Google Maps, and it shows you kind of where you are on the map, it's doing… this is a

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Victoria Musheff: the figure that I got from another academic study that just kind of illustrates it well. It's triangulating your position against 3 to 4 data points, and so GPS works through measuring time delays between the signal that's coming out of your watch and global positioning satellites in the sky.

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Victoria Musheff: and or cell towers that you're nearby, and or Wi-Fi, if your watch or your phone is connected to Wi-Fi. It's going to default to Wi-Fi first, because

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Victoria Musheff: we can… the router for the Wi-Fi is going to be within several hundred feet, so that's the best approximation of, okay, if they're connected to this Wi-Fi network, which is located here.

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Victoria Musheff: then we know that they're probably there, right? But if you are out on the road in a rural area, it's probably going to default to

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Victoria Musheff: satellites, because there may not be cell towers around, but if you're in an urban area, there may be more cell towers, so it'll default to the cell. So it's going to look for the closest available 3 to 4 data points, and it's doing that constantly, right? So when you are using Google Maps with your phone, and it's showing you driving down the highway, it's because it's constantly looking for that signal. So it's doing that in, you know.

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Victoria Musheff: faster than I can say these words. It's doing that dozens of different times, right, to triangulate, where we are, which is very cool, I think. But, yeah.

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Victoria Musheff: Great traveling in France. Oh, absolutely, yeah.

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Victoria Musheff: And you can reach his quick turn, but…

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Victoria Musheff: Yeah. Yeah, absolutely, and the watch can do that as well, so you can ask

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Victoria Musheff: the watch to give you, you can pull up directions on your phone, and then put the phone in your pocket and get the directions. You know, when it tells you, you know, turn right here, that can come up on your watch, so you don't have to be constantly fiddling with your phone while you're walking around, which is neat.

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Victoria Musheff: Yeah.

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Victoria Musheff: Well, my dog here has… he has a wearable. Very cool, yeah. No, the pet wearables are great. It's called FiDog, and it, it, it keeps… it'll track, it'll track him, and, if he's lost.

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Victoria Musheff: It'll… it'll pull me out of where he is. Go get him. Yeah, there are a lot of, a lot of devices to make for animals, for children, trackers for young children as well, that, have…

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Victoria Musheff: It's been a very, kind of, successful industry. Go back to some other… Things that we were… Asking about…

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Victoria Musheff: Somebody asked how to talk into Siri. Siri's also really cool. I'm not gonna say its name, because the risk of triggering everyone's devices at once. So, this is an automated assistant that Apple has been developing for, I think.

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Victoria Musheff: 16 years now. I think it was first introduced in 2009, 2010 on the phone. It's also on the watch, so it can perform different kinds of functions for you, such as calling somebody, setting timers, opening apps, if you're in a… if, you know, if you say, open maps and, you know, tell me how to get to X address, it can do that for you. But to…

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Victoria Musheff: use it effectively, I think it's important to know, kind of like with the Fitbits and the Apple Watches, just a tiny little bit about how it works.

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Victoria Musheff: So when Siri was first developed, its workflow pattern looked kind of like this image. So it basically, without going too deep on it, it kind of takes your voice and automatically converts your voice into a data file based on all of the different fragments of sounds that you have made, and it pairs those with possible commands that Siri can execute.

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Victoria Musheff: And then it… once Siri identifies a possible command to complete, it then goes into the phone automatically, completes the command, and then spits back to you kind of what you have asked it to do. So it's trained on, speech recognition, which

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Victoria Musheff: did work better for some people than others. If you have a deep southern voice, and you've been trying to use Siri in the early 2010s, it didn't work very well for people with deep southern voices, because it was trained on fairly neutral English accents. So people who have heavy accents, or some non-English languages.

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Victoria Musheff: Siri just didn't work very well for a number of years, and it's been around long enough that they've been able to train it to work pretty well with most dialects, but at this point, Siri looks kind of like this, if you just like having a visualization.

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Victoria Musheff: for it, it works similar to how a lot of the stuff I've been talking about works, right? It takes our voice, it converts it into data, it matches that data against different kinds of algorithms to try and figure out, through a speech recognition system, what you're trying to ask it to do, right? So, I'm just gonna port to the next slide real quick, because it explains this in English instead of in, like, in sentences rather than an image.

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Victoria Musheff: But talking with this assistant entails knowing how to prompt it, and what its capacities are, so if you just say, you know, hey, SIRI, do this for me, it may struggle to understand what you are talking about, because it's all about

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Victoria Musheff: prompts that it's capable of doing, right? So, if I asked it to call Martin Scorsese, if only, right? That's a specific phrase, and that depends on Siri being able to process several different things. So, if you say call, you can break that down into various kinds of sounds that work together to produce the word sound, which is what

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Victoria Musheff: these, like, voice recognition systems do, and that's part of why you have to enunciate when you talk to them, because they don't understand if you are kind of speaking very quickly, or slurring over your words for whatever reason, they may struggle to understand what you're asking, because they break down words into basically every single phonetical component of the word. So if you say call, and then you say name.

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Victoria Musheff: call that understands it's a phone-based prompt, and if you have a name, like Martin Scorsese, it'll look through your contacts for a name that matches the sounds that you have just made, and then it will say, thanks, calling Martin Scorsese, and then you'll see on your phone that it's already completing the call for you, right? So it's really wonderful to be able to shortcut different kinds of tasks that you're trying to complete.

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Victoria Musheff: You know, instead of using your thumbs.

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Victoria Musheff: you're performing these functions through your voice. This, you know, it had problems with different dialects and stuff, as I've already said, but…

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Victoria Musheff: it's a… the way to make it work is to realize that you have to enunciate with it, and to understand that it's basically data-find Your Voice to make it work. And so it's taking the commands that you give it, it breaks it down into different kinds of phonetical data, and then connects that with what it's capable of doing. So, yeah.

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Victoria Musheff: Hopefully that's a little… some useful tips on how to talk to Siri.

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Victoria Musheff: Someone also asked about texting 911, which is really important when using,

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Victoria Musheff: phones and watches, so they can call… they can make emergency calls. We've already talked a bit about the ball detector and how that can make emergency calls on your behalf. If you did not know this, when you go to turn off your phone and you hold the

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Victoria Musheff: the power button that's on the right side of the iPhone, if you hold that down.

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Victoria Musheff: Let's see if I know to it. It's not even good, though.

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Victoria Musheff: No, Siri, I didn't want you. Yes, I'm into it right now, but that's fine.

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Victoria Musheff: it will send up a screen that looks like this. So, if you've linked your medical ID to your phone, it'll have that option. You can power it off, or you can do an emergency call, so you can slide that to connect directly to emergency services.

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Victoria Musheff: And if you don't, respond, if something happens and you're disconnected, they call you right back, which I've had.

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Victoria Musheff: people have told me it's happened to them, they tried to call emergency services, and something got messed up, and they retain a record of the call, and they call you right back, which I think is really great. You can actually text 911 through your phone, by just going into a message app.

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Victoria Musheff: And then when you go into messages and you hit plus, like, you're gonna create a new message, you just type 911, you can type in what your emergency is.

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Victoria Musheff: This currently isn't supported in all locations. Don't think it's currently supported here, so if, you know.

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Victoria Musheff: don't default to the calling before the texting, but that's for people who are in some kind of emergency where they are, for whatever reason, unable to use their voice. They're trying to expand that feature, right? So again, the fault detection system will automatically call emergency services, but the phone has a nice shortcut to where you can hold down the power button on the side to bring up an option to call emergency services if you can't

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Victoria Musheff: open the phone and type in 911. That provides sort of a shortcut for doing that, which… Very useful.

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Victoria Musheff: I also had someone ask how to take a screenshot. Screenshots are easy peasy. If you just have the iPhone open to anything that you want to take a screenshot of, on the left side of most iPhone models at this point is volume up and volume down, and on the right side is the power button, and if you hit volume up and power button at the same time, it will take a screenshot, and then the screenshot is stored in

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Victoria Musheff: your photos. When you go into photos, it should be right there, and you can pull it up and look at it or save it for future use.

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Victoria Musheff: That's the easy one. Some of these are complicated questions. This one's easy. I like easy questions.

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Victoria Musheff: I have to say, I do that by accident all the time. Oh yeah, me too. It's a real problem. I go through my camera roll, and I'm like, what are these things? I don't have no idea what this stuff is.

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Victoria Musheff: Someone also asked security for phone slash watch, and I hope that this is what you were asking about. If it's not, let me know, and I can go deeper on some of this stuff, hopefully. But I took this to mean, what are things to keep in mind with security, or are these secure? If you're in the Apple ecosystem, Apple is a pretty secure company. They take security pretty seriously. If you are storing or trans…

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Victoria Musheff: A lot of your health data is stored locally on your phone or on your watch, which is important. Increasingly, companies use cloud storage to store a lot of this stuff, where it's

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Victoria Musheff: Cloud storage just means that it's living in a remote server somewhere, so they are stored locally on your phone, on your watch. They're not stored in remote servers, which is good for keeping your health data protected. And if you transmit health data for whatever reason, if you are downloading some of it off of the app to send to a doctor through, you know, your MyCare platform, Apple uses end-to-end

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Victoria Musheff: encryption for transmitting health data, if you choose to do that, which means that it's going to encrypt that both when you send it, and then it will be decrypted upon arrival, so that when it's traveling from location to location, it's very difficult for a hacker to intercept it, or if something were to happen to it, you know, it's very hard for that sensitive information to be leaked, right? If you use Apple to do the

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Victoria Musheff: Things like face scans or fingerprint scans to open your phones or your tablets or your computers.

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Victoria Musheff: That stuff is all stored locally on the device, so Apple doesn't have, like, a giant server of face scans that are living somewhere in California. That's all stored locally on the phone, and Apple… Apple has designed the phone, so they actually can't get access to the face scans that you put onto the phone.

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Victoria Musheff: Which is great.

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Victoria Musheff: But if you are someone who is worried about maybe you're buying a new device, or…

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Victoria Musheff: you know, your doctor is asking you to try a new sensor, and you're worried about it, you know, data privacy and security is obviously very important, especially when we're looking at health monitoring. So there are kind of three things that I try to look for when I'm looking through a terms of use policy or a privacy policy to understand if I feel comfortable with something. And those have to do with data protections, data retention, and data sharing.

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Victoria Musheff: At this point, it's basically impossible to not encounter some problematic use of data, somehow.

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Victoria Musheff: the world functions right now. But taking that top to bottom, data sharing are clauses in terms of use or privacy documents that say, like, we, the company, have the right to

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Victoria Musheff: share your anonymous data with third-party providers, or advertisers or, you know, our own internal team to help improve devices. And even though they might say we're doing that in an anonymized way.

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Victoria Musheff: most anonymous data sets can be de-anonymized relatively easily if you know how to do that work, so if you are worried about, you know, data that's being collected about you being shared for whatever reason, it's good to look for language like that in terms of use policies, and

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Victoria Musheff: You can search for the phrase data sharing in them, that's one that's used.

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Victoria Musheff: as well as data retention. That means how long will this company hold on to your data? So a company like, Facebook, for instance, they have every interaction you've ever made on Facebook stored for forever, basically, until you delete your account and ask them to wipe it. It's there, right? But other companies will have clauses, like, we will,

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Victoria Musheff: you know, wipe your data every 30 days, right, so that there isn't this record. And if we're talking about health tracking and health monitoring.

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Victoria Musheff: You may want to have an app that has

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Victoria Musheff: historical records of your data for months and years. That might actually be useful if you want to be sure that it's being monitored, over time. But if it's sensitive data, and you're worried about it being, you know, intercepted or shared without your consent, it's important to look at a data retention policy and see, you know, is this data going to be, you know, erased every 30 days automatically so I don't have to worry about what's happening to it?

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Victoria Musheff: And then data protections are similar to this stuff. It's mostly, like, how does the company write about what it does with your data? The best companies are very clear about this, and worst companies are very vague about it, right? So they might say things like, we will… if it's vague, it might say, we will use your data to ensure efficient operations of our company. I don't know what that means, right? But if a company says, you know, we use your data for

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Victoria Musheff: training improved… for training and improving our algorithms, and we feed it, you know, anonymous.

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Victoria Musheff: Samples of people's heart rate data to make sure that it's accurately reading heart rate data.

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Victoria Musheff: you might not be comfortable with that, but at least you have clear information on what they're doing, right? So, I tend to go with vague is bad, clear is good, as an indicator of how seriously a company takes data protection. That's not always the case, but it's a useful heuristic. I prefer companies that will voluntarily delete my data, and I prefer companies that don't share my data to

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Victoria Musheff: body, but that's few and far between at this point. That's one of the ways that companies like Google make money, is sharing data about us to people who want to buy that data. So, that's sort of the unfortunate reality of where we are, but I always try and be mindful of understanding who might get their hands on my data, even if it's anonymized, and is my data going to be living in a server farm for decades, or is this company going to automatically

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Victoria Musheff: delete it every month or three months. So, those are things that I keep in mind for security that may be useful to you, and I hope that that was a correct interpretation of this request. If there's more I can try to answer, but… Yeah.

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Victoria Musheff: I think that… I think that was a good question, because there's a… particularly the more they ask for, you know, for long-term data for you to have a subscription, then the question becomes, what are they going to do with it? And we already know with genetic testing that there are, those databases are…

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Victoria Musheff: Full of information, and… I think some people have some security issues with that, 23andMe, maybe?

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Victoria Musheff: Yeah, them are… I can't remember if them are ancestry. There's 23andMe now. But yeah, those are… and you know, you've given them…

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Victoria Musheff: access to your spit, right? It has all sorts of information about you encoded into it. So, yeah, I mean, it's a very… I take this stuff pretty seriously.

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Victoria Musheff: And I think it's really important to be mindful of. So, someone also asked about preparing to use telehealth. This is how I interpreted this. Again, if I misinterpreted it, let me know and I can talk more about this, but you are probably increasingly using telehealth. I know I'm sort of increasingly using telehealth. I have providers ask me all the time, do I want an in-office meeting or a telehealth meeting?

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Victoria Musheff: I prefer in-office, because I like talking to people face-to-face, but they won't be used telephot because it's more convenient, I guess. But I took this to mean, like, what are things to keep in mind when you are getting ready to have a telehealth meeting with a provider, or what are some things to keep in mind for accessing a telehealth platform?

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Victoria Musheff: So, the platforms that I've used and that I've seen around here, they're accessible through MyChart or related health platforms, depending on who your provider is or where their… what network their hospital or their care center is in. They may have a dedicated link in MyChart they'll point you to. I've had some doctors

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Victoria Musheff: When I set up the appointment, they asked for my phone number, and say, can we text you a link before the meeting starts?

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Victoria Musheff: And that link, you can click on it, and it will open it in your phone. So if you're doing it through your phone, which is how I'm thinking about this, since it's what we're talking about today, that can be useful for having everything located on the phone. They text you the link, you click the link, it takes you to the platform, it opens the conversation, but using your phone to meet with a doctor can be kind of awkward. So things that I think about when I… hopefully I'm not doing virtual conferencing

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Victoria Musheff: my phone, because it is awkward, right? But things that I think about when I'm using it are trying to control for, three different variables, light, sound, and camera angle, so…

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Victoria Musheff: if I'm meeting with a doctor, and I'm trying to have the doctor, you know.

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Victoria Musheff: both get a good look at me, but also feel like I'm having a professional conversation. I'm probably not even going to be holding the phone in my hand, because I have… my hands shake, so I feel like I'm not… it's hard to have a conversation, so I'm going to set up and prepare for that telehealth meeting by propping that, so I'm not going to prop it up here, it's going to fall right over. But propping it up against, you know, a stack of books, so it's kind of sitting out

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Victoria Musheff: my desk, and I have it propped up, and, you know, we know that, you know, the camera's on the top of the phone, so we're talking into the camera, and then the microphone is on the bottom of the phone. So if you set the phone down like this, you risk having worse sound delivery, actually, because you're garbling the microphone. So you might be getting a better camera angle, but having a worse sound angle. So if you can.

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Victoria Musheff: when you're doing video conferencing, and you're using your phone, having it kind of at an angle like this, and then sitting in a way where your, you know, upper torso looks splattering as you would like it to look, or get it to look, but then that also means that you're having good audio communication as well, and the speakers are down on the bottom for an iPhone as well, so that when you're listening to, the physician who you're talking with, you should hopefully be able to hear them.

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Victoria Musheff: better. I also think about light. A room like this, that side of the room would be fine. I think this side of the room would be terrible for doing a My Health visit or a telehealth visit, and being outside is probably going to be pretty terrible. Even if you think, well, it's a beautiful, sunny day, I'll go outside for my telehealth call. It's probably going to be a terrible experience more times than not.

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Victoria Musheff: As the sun…

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Victoria Musheff: Now, it may be nice to sit in the sun, but the sun may be very harsh on you, the sound can be very easily distorted by wind. So what I recommend, and this is coming also from… I do some podcasting, because that's kind of how I teach podcasting to students as well, is looking for a room that is not too big, and being able to sit somewhat close to your phone, or wherever you're talking from, but not kind of

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Victoria Musheff: Right on top of it.

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Victoria Musheff: you're sitting right on… I'm not gonna do it, but if I leaned up, like, all the way up to the microphone, and I started talking with the voice I've been using, you would blow it out, right? It sounds okay, because I'm using a conversational voice, and I'm maintaining a distance of

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Victoria Musheff: 4 to 6 inches right now, but if it was right on top of it, it would blow it out, and it would make the kind of… you would all be begging me to just stop. You say, back away, back away, right? Your phone works the same way. You've probably heard this when talking with people, right? You can… if you're screaming into the microphone, it becomes very difficult for people to have a conversation with you. And similarly with, like, light and sound, if you're in a big room like this, the sound is going to echo.

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Victoria Musheff: There's really nothing here buffering the sound. These images, these beautiful things that are hanging in frames on the walls around me, there's nothing that's buffering the sound off of them. They're hard surfaces, so the sound is going to be bouncing around, which may be distracting if you're trying to talk to a physician. And then… so you want to try and not be in too big of a room.

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Victoria Musheff: Bedroom, home office is good if it's, you know, not too big of a room.

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Victoria Musheff: being conscious of where the microphone is, where the camera is, these can help you have a comfortable conversation with the physician and help the physician see and understand you as well. If there's anything else you want to ask about preparing for telehealth, that's how I interpreted the request, but I know there's lots of different components of using telehealth, so I'm happy to try and do my best with answering that, but…

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Victoria Musheff: I don't do a lot with telehealth communication, so I'll do my best to answer any other questions.

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Victoria Musheff: I was… I was wondering, with telehealth, I know a lot of people are using it. I don't understand exactly how the

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Victoria Musheff: the assessment gets done that might be needed. It was a telehealth thing. The only thing I've ever used it for was actually a conference call where they were giving me, sort of, the results of testing. In other words, it was… rather than a phone call, it was a…

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Victoria Musheff: almost like a… more like a Zoom meeting, as opposed to what I would consider a…

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Victoria Musheff: diagnostic kind of discussion. And I'm not sure, whether there… if you're really good at telehealth, if there's

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Victoria Musheff: I mean, are they trying… I guess if they've got… if you've got sensors in, or they're using sensors, they may have your…

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Victoria Musheff: data from your iPhone may have been sent to them, or something like that.

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Victoria Musheff: I don't really understand how they get the physical component. Well, a lot of times, it's like, let me just look at it, and they're doing what they can. I mean, obviously, it's not as good as in person, but sometimes just seeing what the person is complaining about…

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Victoria Musheff: Yeah. It's more like a camera. It's more like a comfort than a, than a…

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Victoria Musheff: Yeah, so in my field, we call that patient-provider communication, and I'm not an expert in that area, so I'm not entirely sure how it works, but I've had it used for, talking with my doctor about referrals, or, like, getting reports from lab work, with mental health counseling, things like that, that can… but if they need to, you know, physically examine your body, or physically, you know, get your

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Victoria Musheff: Blood pressure or things like that, then yeah, they're… they'll ask you to come in if you can.

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Victoria Musheff: But sometimes, like, looking at a rash or whatever, you know, they could see it well enough to be able to distinguish something like that, or, you know, does it need to be followed up, or does it need to be biopsied, or whatever, you know, just with the camera.

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Victoria Musheff: Not ideal, but I found. I was thinking about, you know, they've done some robotic surgery from one visit, and things like that, but that implies that they're still in the room with the person as well, and that somebody else is somewhere else, but they're… they're using technology.

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Victoria Musheff: Yeah, I think that would go beyond… you would need to have, like you say, the robot in the house with you, providing you care. Beyond just telehealth, that's really… Yeah, telehealth, as I understand it, is a form of patient-provider communication where you're interfacing through a phone call or a video conference platform to discuss elements of care, yeah.

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Victoria Musheff: I also… did that one…

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Victoria Musheff: I had somebody ask about how to use Wallet on phone, so I… I personally don't use the wallet app a lot. I'm old enough to still like being analog with cards that I carry, and I… so, you know, I kind of know how it works, but I, you know, it's maybe not a crypto guy? Nope, not a crypto guy. And I… I like the feel of a credit card and a gift card in my hand, so…

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Victoria Musheff: And I miss, paper airplane tickets. That's… Did you know that, Juan? Absolutely. I have a new question. On the, where you said, the,

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Victoria Musheff: We accessed my group.

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Victoria Musheff: A lot of people, like, defied phones and all that, and all that, because… was there any,

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Victoria Musheff: if you turn the GPS on all that, is it constantly using up battery life and all that? I usually keep feeding all that as a…

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Victoria Musheff: Yeah, so, you're…

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Victoria Musheff: your phone's battery is going to drain faster with however much you have running in the background, so GPS is a signal that's always running in the background, but the emission of a GPS signal at this point is not going to use a significant amount of battery. If you have an older phone, you know, phone batteries will depreciate over time, as all batteries will, so if your phone is

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Victoria Musheff: 4 or 5 years old, then yes, having the GPS constantly turned on may impact your battery. What's gonna impact it more is if you are, you know, using Google Maps for an entire 2-hour trip somewhere. Having that app open and constantly having it, because it has… when it…

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Victoria Musheff: is showing your car moving down the highway with the nice blue arrow, it's not just pinging the GPS signal, it's also getting the information back from the satellites of where you are located, and it's processing that against

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Victoria Musheff: traffic data, it's looking at what is the surrounding speed limit, it monitors how fast you're going. It's monitoring, you know, how long until you get to where you're going. So Google Maps is constantly running all of those calculations as well, so that's why if you have that open for any amount of time, you might notice your batteries are up to… How about security? Well, if Google knows you're going down a road, you're away. Is it fairly secure that the

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Victoria Musheff: Someone's not watching, like, hey, you're not home today.

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Victoria Musheff: in your after… is it… is it just, you know, just a normal risk, or is there a…

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Victoria Musheff: Sure, if you are… there's…

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Victoria Musheff: who would be watching, I guess? Who are you concerned about watching, or having access to? So, if you are broadcasting your… if you're using the Google app.

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Victoria Musheff: that's processed through Google, so it might be routing that information through a Google server somewhere, but there's not a Google worker who is, you know, reviewing all… it's happening automatically with machines. The odds of somebody

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Victoria Musheff: looking at your phone and tracking where you are in real time is pretty slim, unless your phone has been hacked in some other way. My question is, sometimes you're walking down the street, another store, and it's on us, and it says, hey.

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Victoria Musheff: We got a sale going on right there. How did they know I was here? They had to look at my phone to know from Google Maps that I was going by the store, and if they're talking to me.

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Victoria Musheff: Who else is knowing where I am? Sure, so that works through a system called Radio Frequency identification. So your phone, that's how, like, to go back to the…

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Victoria Musheff: wallet, that's how, when you go to scan your… I guess those were through… when you go and pay with Apple Pay, and you press your phone up to a pay beacon, and then it processes your payment automatically, it's the same principle. Those stores that have that have beacons set up at their entrance that are emitting a signal, so that there's a phone that passes by that has its location services on.

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Victoria Musheff: is given permission for location services to be on. It's really just a, like, an automated notification. It feels very creepy and very invasive, but really all it is is, like, a digital version of a sales clerk standing at the front of the kiosk saying, hey, come on in here. It's just an automated message that is going out, and your phone moves in front of that message.

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Victoria Musheff: and then it pings it onto your phone, right? Now, another way that you can use, like, automated… like, the GPS, but it's… but you turn it on for a particular app, so it's not on for every… you don't have to have it on for everything. Yes.

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Victoria Musheff: And so, if you have it turned off for some things, would that cut down some of that?

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Victoria Musheff: Sure, and I… I recommend… so, most apps that you download will default to have location services on. I manually turn off location services on all of my apps until I need them. So there are apps like Instagram that will default to having location services on

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Victoria Musheff: Because one of the things that Meta wants to collect off of Instagram posts is the geolocation of where those posts were. Why do they want that? For any number of, you know, tests that they're running on where users are active, and they can sell that data to marketers, and…

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Victoria Musheff: Experience, yeah.

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Victoria Musheff: So that's getting us into the perils of data brokerage. But, if you turn location services

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Victoria Musheff: if you start by going into all of your apps and turning it off, and then only turning it on when you need it on, that would cut down on battery depletion. The thing that's gonna start depleting your battery more in an everyday sense is just having a ton of different apps open at one time, right? So, when you are

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Victoria Musheff: done using apps, and I'm just gonna kinda… I don't know how legible this is gonna be to anybody, but if you, this is just my email here, and on the bottom, I can pull up like that, and these are all the different apps that I have open right now, and I can just go, like, look up, and it makes an app.

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Victoria Musheff: turn off completely. So if you don't do that, all the apps that you've had open are just running in the background, waiting for you to go back to them. You could do it from any… anything, or you have to have some app open. That's a… that's a navigation feature of Apple.

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Victoria Musheff: So, if you hold on the bottom and just kind of move up.

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Victoria Musheff: from where you are, you should see all the apps that you have that are still open, and those are running in the background, waiting for you to go back to them. And that creates a depletion of battery resources over time, because those apps are still using a percentage of energy to stay running. Yeah, and…

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Victoria Musheff: you know, Apple doesn't really tell you that, and this goes back to one of the things we were talking about, you know, half an hour ago or so, that, you know, a lot of this stuff is…

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Victoria Musheff: not explicitly told to us or talked to us in an instruction booklet, because the default of, we'll keep everything running in the background, makes it easier for apps to constantly be on, and this, that, and the other, and that's kind of how it has been engineered, but… yeah.

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Victoria Musheff: Little shortcuts and hacks we can learn.

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Victoria Musheff: Well…

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Victoria Musheff: Okay. But you can't do it, okay, so, what did you do? Okay, so that's just an app open. So, you hold on the very bottom, and you pull up like that, and you don't let go until it looks like that, and then you can

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Victoria Musheff: Go… Well… Well, it'll do it. Now it's closed. I'll try to check it to see what's happened.

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Victoria Musheff: So, okay, so good grief. Okay. Okay, so you probably haven't, you know, fully removed yet. 10,000 million out, son. 10,000 million.

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Victoria Musheff: And I have Facebook pages, I can't get closed either, okay, so I'm just gonna… I don't have the Facebook on my phone.

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Victoria Musheff: Okay, so he went. Okay, you pull that up to see what's open, and then to turn it off, you go swipe from the side?

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Victoria Musheff: It's good to know what those… I think you have on yours closed. I don't see anything on here.

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Victoria Musheff: Okay.

377
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Victoria Musheff: Just couldn't know what that little black line is done above. I just thought it was just knocking the edge, but it's actually doing something.

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Victoria Musheff: I'll try to explain what I've been doing.

379
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Victoria Musheff: Actually, that's called Safari, isn't it?

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Victoria Musheff: Yeah. Because we really don't have wallet for. So you don't… I don't use a wallet either, except for one thing. I have my CUID card on there. I don't use that. I don't even use that. You don't even use that. No.

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Victoria Musheff: That's interesting. I still use my… carry on my plastic CUID card and scan in with that, but, like, we know that Clemson stores all of the records of how we as employees use that CUID card. We don't know exactly what they're doing with it, but, there are door logs that they keep, so every time you use the CUID card to scan at a beacon to come in, or if you use it to

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Victoria Musheff: you know, pay for a meal at a dining hall. It stores those access records for all of us. What will they do with them? Why are they collecting them? I don't know, they won't say, but they are.

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Victoria Musheff: AI, but who knows on AI alone? You know, the one thing you haven't really talked about a little bit are some of the apps that do fall on the iPhone. I have hearing aids, so I don't have a Fitbit for my hearing aids.

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Victoria Musheff: count steps. Question pool. Sure. I mean, I don't see how they put all of the little sensors that I saw in your Fitbit in that, but it counts steps, it counts stairs, exercise.

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Victoria Musheff: It does how much socialization you're doing, and it's all of these things that it's…

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Victoria Musheff: keeping records of, and it's sort of… it's interesting, but… and I know they're working on adding blood pressure and heart rate and all those things into the same kind of devices so that you don't have to wear

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Victoria Musheff: a watch to get it, but you're getting it through something else. Yeah. The nice thing is that the Bluetooth piece of it allows you to hear your phone through your hearing aids and all those things, so you can do…

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Victoria Musheff: You use your phone differently with the gate. Yeah. And I assume that there… I know some of the,

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Victoria Musheff: the, diabetic testing of things and drug things offer you Bluetooth to your phone. Yes, they do. Yeah, the developments in hearing aids have been pretty remarkable.

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Victoria Musheff: It's in part…

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Victoria Musheff: the image that I showed of the inside of a Fitbit at the beginning, that was from about 10 or 12 years ago at this point, so those sensors have only gotten smaller in the intervening years. There were people who were working on these

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Victoria Musheff: They call them hearables.

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Victoria Musheff: in, like, 2012, 2014, aspiring to fit, like, 30-some sensors inside of a hearing aid. So these things get smaller, and the same sensor can perform multiple functions. Like, the accelerometer can measure lots of different kinds of, activity data, so that's one sensor that can get lots of different kinds of data points. But, yeah, even Apple's

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Victoria Musheff: AirPods have been really instrumental in that space, where now they can't act as, you know, hearing aids, but for people who have low levels of hearing loss, or who have auditory processing issues, I have low levels of auditory processing issues in very crowded spaces, so I'll wear… if I go out to eat somewhere, I'll wear AirPods, and I'll put my phone

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Victoria Musheff: next to my wife, and she… if she's talking, the phone picks it up and then sends it to my ears, because otherwise I have a hard time hearing her moving across the table. So that's, yeah.

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Victoria Musheff: And how do you open? You open them on your iPhone, your iPod? So they're the AirPods, those little wireless hearing devices, so when you…

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Victoria Musheff: connect them, they connect automatically to the phone through Bluetooth, and then the settings for the AirPods and the phone have a feature called Live Listen. So the Live Listen feature turns your phone into a microphone, basically. So if you were in a crowded area and I was having trouble hearing you, I could put my AirPods in instead of my phone next to you and

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Victoria Musheff: It would audit, sort of, The way that it works is that there's an

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Victoria Musheff: algorithm that filters out noise, so it looks for the human voice that's near to where the phone is, so if you're talking right next to the phone, it picks up on that, and it starts to filter out other noise, the same way that noise-canceling headphones work. It looks for, like, white noise, basically, or shades of white noise, and it tries to filter them out.

400
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Victoria Musheff: So that you can hear more clearly.

401
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Victoria Musheff: Yeah, they're really neat. Apple's been in that space since, like, 2018, and they don't

402
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Victoria Musheff: advertise it, hardly at all. It wasn't until a year and a half ago, almost two years now, that they started, like, actually advertising that AirPods can do that, and they've actually developed, kind of like with the

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Victoria Musheff: AFib stuff that we were talking about earlier, you can do hearing loss tests, with your AirPods now. So you can check yourself, and it can run, like, a basic hearing loss test for you to see

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Victoria Musheff: you know, what do you score with Apple's hearing test? And as all the other ones, it's a notification feature, it's not a formal diagnostic system, but for people who are worried about hearing loss or have low levels of auditory processing issues, they're, you know, relatively affordable devices, for sure. Yeah.

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Victoria Musheff: I do see that we're nearly at 11.30, so I'm not sure if there was anything else that I could talk about, but I do want to go to my…

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Victoria Musheff: My last slide here, this just kind of summarizes my philosophy around all of this stuff, and why I spend time talking about things like sensors and algorithms and

407
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Victoria Musheff: GPS tracking, because I do believe that, you know, a lot of us don't know how many of these things work. Again, I only know by virtue of spending time studying them, and I'm not a computer engineer, I don't spend time actually building these devices, I study them as a social scientist. And I do think that if we can improve our understanding of how these things work, even by 10%, 15%,

408
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Victoria Musheff: That helps empower us to really get a sense of, you know, well, if it's actually working this way, how does that help me understand the data better? How does that help me understand their limitations better? And once we have a handle around that, it can improve the way that we use them for health outcomes, which is clearly something that's extremely important for all of us in different ways, so…

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Victoria Musheff: Yeah, I'm happy to answer any remaining questions that you have, but I… since it is just about 11.30, I want to be sure to thank you for inviting me and giving me the time to come in and talk to you this morning. Oh, thank you.

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Victoria Musheff: If there are questions online, please unmute yourself, and

411
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Victoria Musheff: We'll be glad to, before Jim leaves.

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Victoria Musheff: We've got a few people, I think they're just beginning to sign off,

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Victoria Musheff: Jim, thank you so much. This was wonderful. You all threw a lot of different things that you wanted me to cover, so I hope… I know it's kind of all over the place, but I hope it was what you were looking for. It was exactly perfect. Don't y'all think? Excellent, excellent. Thank you. I have a question. Yeah.

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01:32:02.470 --> 01:32:06.059
Victoria Musheff: So, you touched upon this.

415
01:32:06.480 --> 01:32:09.979
Victoria Musheff: But I'm hoping you can maybe elaborate a bit.

416
01:32:10.260 --> 01:32:17.950
Victoria Musheff: I'm increasingly feeling like, with the newer… maybe it's the sign of my age, maybe it's the sign of technology, but…

417
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Victoria Musheff: Wow.

418
01:32:20.790 --> 01:32:25.880
Victoria Musheff: And as I accumulate more devices, and they are smaller and smaller.

419
01:32:28.600 --> 01:32:33.790
Victoria Musheff: The interface between them and me the…

420
01:32:35.320 --> 01:32:46.199
Victoria Musheff: visibility of the functionality is getting harder and harder for me to discern. I just bought a smartwatch a couple days ago.

421
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Victoria Musheff: Supposedly, I can track 136 different

422
01:32:52.790 --> 01:32:56.040
Victoria Musheff: Physical act… types of physical activity on this.

423
01:32:56.460 --> 01:32:59.730
Victoria Musheff: So far, I've figured out the walking one. Yeah.

424
01:33:00.790 --> 01:33:02.739
Victoria Musheff: I guess what I'm getting at is…

425
01:33:03.170 --> 01:33:11.620
Victoria Musheff: There's so much functionality embedded in such tiny devices, and As you mentioned, you know.

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Victoria Musheff: I was supplied in the box with a sheet this big, 20 pages long.

427
01:33:20.720 --> 01:33:25.540
Victoria Musheff: One of the pages was in English, I mean, every page was a different language.

428
01:33:26.510 --> 01:33:28.929
Victoria Musheff: How do you recommend…

429
01:33:29.350 --> 01:33:42.849
Victoria Musheff: I mean, I think younger people learn this… pick up this stuff because they just look at the person sitting next to them in class and say, hey, how do you do this? But for those of us who are kind of a bit more isolated now.

430
01:33:43.800 --> 01:33:49.010
Victoria Musheff: How do we… Figure out how to…

431
01:33:49.650 --> 01:34:01.809
Victoria Musheff: take advantage of the huge amount of functionality in their devices that isn't visible on the device, and isn't explained by any of the old-fashioned kind of stuff, like an instruction manual. Yeah.

432
01:34:01.810 --> 01:34:15.070
Victoria Musheff: That's a really important question, and I want to answer it by starting with a historical anecdote, because I think we're seeing these problems emerge because of decisions that Apple made in the 1970s, actually. So, when…

433
01:34:15.110 --> 01:34:33.399
Victoria Musheff: Apple was first developing computing, you know, they were faced with questions about, you know, how do we make our computers things that people want to buy? In the 70s and the 80s, computing was mostly hobbyists, and really, you know, techy people were doing computers because they were building their own computers. Apple's whole gambit was.

434
01:34:33.590 --> 01:34:49.160
Victoria Musheff: What if you didn't have to understand how a computer worked to own a computer? And they still have that philosophy. I have this… I've been having this tablet up here to help me see my slide notes. I can't open this tablet. I can't go inside of it to play around with it. You can't do the same with your phone.

435
01:34:49.160 --> 01:35:04.430
Victoria Musheff: You can't do the same with your watch, you can't do the same with your computer. It voids all the warranties, like, Apple legally won't allow you to do that, and that was great for accelerating, you know, more and more people using computers in the 80s, the 90s.

436
01:35:04.430 --> 01:35:08.029
Victoria Musheff: But now, we have this problem, where…

437
01:35:08.030 --> 01:35:30.720
Victoria Musheff: you know, people don't understand how this stuff works. So to dispel one notion that you had about younger people understanding this better, they don't, right? It might seem like they do, but I interface with dozens of Clemson undergraduate students every semester, and one of the things that I hear most at the end of class meetings from them is, I didn't understand how that worked.

438
01:35:30.720 --> 01:35:40.190
Victoria Musheff: And this is true of social media platforms, smartphones, wearables. There is a depreciated literacy around all of this stuff.

439
01:35:40.190 --> 01:35:50.960
Victoria Musheff: Even amongst my colleagues, who have advanced degrees in related areas, we just don't have solid understandings of how these things work, and my understanding is

440
01:35:51.100 --> 01:36:10.420
Victoria Musheff: still pretty limited, because so much of this stuff is hidden behind, you know, corporate NDAs and intellectual property claims and things like that. So, I say that to say, what you're describing isn't a problem with you or any of you in the room, it's like a social problem that we, like, are now living in. But what do you do about it?

441
01:36:10.830 --> 01:36:24.079
Victoria Musheff: You gotta spend some time on Apple.com, if you're using, or whoever makes… whoever is your manufacturer, and if it is Apple, support.apple.com, I'll say that again. Apple has…

442
01:36:24.620 --> 01:36:46.619
Victoria Musheff: decades worth of forums where people are asking a lot of the questions that you all asked me to talk about today, and they get answers either from Apple IT representatives, whose job is to moderate those forums and answer questions as they come up, but other Apple users can contribute as well.

443
01:36:46.620 --> 01:37:01.860
Victoria Musheff: So, if you say, you know, I'm a person of such and such an age who just recently started using a watch and having a really hard time figuring out how to record swimming, right? I'm a swimmer, I want to be able to figure out how to record laps, right? I can't figure out how to do it.

444
01:37:01.990 --> 01:37:08.189
Victoria Musheff: someone's already probably asked that question on one of Apple's support forms, and I think…

445
01:37:08.190 --> 01:37:33.169
Victoria Musheff: Apple's… support.apple.com is fairly intuitive to search through. They have a search bar at the top that you can just plug your question into and see if other people have asked it, and if they haven't, you can create a new post asking that question as well, just using the Apple account that you would have. And if you have a Samsung watch, I haven't looked at Samsung's forms, but I imagine it's probably the same sort of thing, and that's a very real problem, because

446
01:37:33.170 --> 01:37:34.310
Victoria Musheff: as you say.

447
01:37:34.800 --> 01:37:44.460
Victoria Musheff: that stuff should be in the packaging, but it's online, right? You have to go to these forums and look up the answers, but the answers are there if you can spend

448
01:37:44.460 --> 01:37:49.039
Victoria Musheff: You know, an hour, if you kind of make a list of everything that you want to know about.

449
01:37:49.040 --> 01:38:11.659
Victoria Musheff: and then spend an hour on the support forum for the company that manufactures your watch, and just ask your questions into that search bar, I'm gonna bet that you can find answers to 75-80% of them within an hour of doing that, which is labor-intensive, and yeah, I agree with you. There should be a book that comes with it, but once you figure out that forum support hack.

450
01:38:11.860 --> 01:38:36.600
Victoria Musheff: I think it can make the work of, like, learning how to use the device a lot easier, because once you, you know, figure out how to do 3 or 4 things that you want to do, hopefully that leads you to understanding more of how the interface functions, so you can find more of what you want to do. So, hopefully that helps. I think something that, to me, you know, when you showed that little thing about the things that are running in the background, I had about 50 things running in the background.

451
01:38:36.600 --> 01:38:42.840
Victoria Musheff: I had closed all of those when I left that app. Yeah, you didn't. They're running in the background, waiting for you to return.

452
01:38:43.320 --> 01:39:00.030
Victoria Musheff: Just do the whole… hold your thumb down on the bottom and move up, and then swipe up, and then it's closed. Okay, so just X-ing out doesn't get me out. Nope. Unfortunately, it doesn't. Really? See, now that to me is not intuitive. No, it is not.

453
01:39:00.190 --> 01:39:11.639
Victoria Musheff: That's correct. That's correct. The key then is when you reopened it, and thought you were reopening it, you came back to the same site you were on, and you was like, oh, wait a minute!

454
01:39:11.640 --> 01:39:25.010
Victoria Musheff: I didn't call that because that same site's still up. Yeah, that's the way every, you know, that's really frustrating. The only thing about the help support I'll add, too, is that when you ask the question, you should put your model in with the question, because…

455
01:39:25.210 --> 01:39:36.640
Victoria Musheff: Yeah, that's a good point. They'll say, go to this, you'll say, my screen doesn't show this, or this doesn't have this, and it drives you, like, okay, what model… Yeah, that's a good point, thanks.

456
01:39:39.380 --> 01:39:43.259
Victoria Musheff: Thank you. Yeah, thank you all, I appreciate it.

457
01:39:44.550 --> 01:40:02.599
Victoria Musheff: I just figured out what I'm gonna do this afternoon. Sure. I'm glad that it was helpful. I'm just, you know, I'm not trying to write my kid out of impression. They have different expectations.