Health tracking could mitigate pandemic-related risks, but will employees see it as an invasion of their privacy?

Serial entrepreneur Surendar Magar has made a career out of developing ways for humans to use devices remotely. “I’ve pretty much spent my life untethering things, from computers to phones,” says Magar, one of the early pioneers of both Wi-Fi and the digital signal processing technology used in smartphones, and now the CEO of California-based company LifeSignals.

Twelve years ago, Magar’s own experience of being in hospital, wired up to various devices, made him wonder whether there could be better ways for hospitals to monitor patients, including after they are discharged. Now after a decade of research, LifeSignals has developed a thin, disposable patch that uses an integrated biosensor to monitor a range of vital signs. The patch sticks to the user’s chest, recording data including respiration rate, skin temperature, blood pressure, posture and even electrocardiography (ECG) ­– the electrical signals produced by contractions in the heart wall.

Before Covid-19, Magar’s sole intention for the patch was to try and revolutionise telehealth, allowing doctors to monitor patients remotely and use the continuous streams of data to detect potential warning signals. But in recent months, the patch has also caught the attention of an unexpected source of customers: the corporate world.

With the pandemic forcing businesses around the globe to embrace remote working on an unprecedented scale, large corporations have been seeking ways to allow employees to return to the office in a safe way. Several want to use the patch – which can detect a fever – to screen staff remotely. Magar says that while the interest initially took LifeSignals by surprise, it is now working with eight companies to launch corporate health-tracking programmes in the coming months. These companies initially intend to use the patches to monitor employees for early signs of Covid-19, with those showing signs of illness recommended to stay at home.

The patch can monitor vital signs, sending data to both employee and employer

The patch can monitor vital signs, sending data to both employee and employer

Data from the patch will be transmitted to an app on each employee’s phone so they can see it. The app will also send the data to the company’s occupational-health department, where they can view it on a dashboard. “Even if you have 1,000 employees dotted around the world, you can see their health status, and whether they are clear to return to work in a certain sense,” says Kim Ramessa, product marketing manager at LifeSignals. “It’s to mitigate the risks as much as they can for the people who are showing symptoms, and catch them as early as possible as well.”

This kind of corporate health tracking is part of a wider trend of companies exploring new ways of monitoring their employees, typically with the goal of optimising performance. Reports have already suggested that silent snooping has been exacerbated by the pandemic, with some employers turning to surveillance technology to check staff are actually working while at home. (For instance, earlier this year reports flagged up a facial recognition tool developed by consultancy PwC that logs when employees are away from their computer screens. PwC said the technology was a prototype aimed at helping the investment banking sector meet compliance obligations while staff were working from home.)

Now, as companies adopt health tracking technologies as a means of controlling Covid-19, might the corporate world also use them to collect data on a more permanent basis in the future?

New ways of monitoring staff

Health tracking schemes are not entirely new; a number of major corporations have attempted to integrate wearable devices into employee wellness programmes. One of the first was BP America, which introduced a programme in 2013 providing FitBit bracelets to staff, collecting information relating to fitness, sleep quality, fatigue levels and location.

But now, because of Covid-19, academics researching the relationship between global capitalism and individual rights feel that health tracking will inevitably become more mainstream in the working world, through ever more sophisticated wearable devices. “The tendency to develop policies that monitor the health and fitness of employees is likely to grow further,” says Ivan Manokha, a researcher at the University of Oxford who is studying transformations in workplace surveillance with the rise of new employee monitoring technologies.

Detecting signs of illness early could help companies keep more workers healthy during flu season

Detecting signs of illness early could help companies keep more workers healthy during flu season

This could have some advantages. As well as keeping the office a safer place in future – for example, during seasonal influenza outbreaks – company HR teams could use the data collected by wearables to develop personalised wellbeing strategies for their employees. This is already taking place at Expo 2020 Dubai, where more than 5,000 construction workers are part of a scheme using wearables called Whoop Straps to monitor cardiovascular health and sleep disorders. The data collected has already identified individuals who need to take precautions at work, due to underlying conditions such as heart-rate variability.

In the long term, participating in schemes that monitor health and fitness data may help employees reduce their risk of developing lifestyle-related diseases such as obesity and diabetes. As an example, the collection of this data may facilitate various corporate training programmes which aim to get employees to lead a healthier lifestyle. For employers this might translate to fewer sick days, and vast cost savings in the process.

“The use cases for wearables in health tracking are multiplying,” says Chris Brauer, director of innovation at the Institute of Management Studies, Goldsmiths, University of London. “There are potential roles in nutrition programmes, culture or behaviour change programmes, and even leadership coaching."

The risks of intrusion

Not everyone may be comfortable with the use of their data in this way, however. Some may well consider it intrusive, both from a privacy and ethical standpoint. In 2019, the Electronic Frontier Foundation, a San Francisco-based non-profit organisation that advocates for consumer privacy, warned that the more employers know about their employees’ off-duty hours, the more potential control they have over their lives.

To understand how this might happen, it is worth reflecting on one of the first forms of employee health tracking which began at the start of the 20th Century. In 1913, the Ford Motor Company was struggling with rapid worker turnover in its factories, after introducing a moving assembly line. To try and retain more staff, its solution was to double wages. But the higher salaries came with a strict condition – the adoption of a healthy lifestyle.

Ford established a sociology department to monitor whether workers were complying with its rules. Investigators would make unannounced home visits, and even attempt to solicit information from neighbours. Those deemed insufficiently healthy immediately had their wages cut. But by the early 1920s, the scheme was forced to end. Competition from other car manufacturers made it too costly to maintain the higher salaries, while staff had increasingly begun to revolt against their employer prying into their private lives.

A century on, this case study remains a relevant indicator as to how health tracking can ultimately backfire. While surveys have indicated that employees may initially buy in to this kind of monitoring – a 2017 AXA Health Tech & You State of the Nation survey showed that 57% of working adults would be willing to wear a health tracking device and share data with their employer if it was provided free of charge – some researchers believe the increased scrutiny will inevitably have negative consequences.

Ford experimented with its version of employee health monitoring 100 years ago - but workers ended up resenting it

Ford experimented with its version of employee health monitoring 100 years ago - but workers ended up resenting it

Manokha points out that employers being able to collect and analyse sensitive health information through wearables could have serious ethical consequences. One example could be employees who are found to have certain health conditions being denied promotion opportunities, or even being made redundant.

He says management’s ability to monitor staff has already reached historically unprecedented levels in many companies, leading to significant intensification of work, accompanied by increased stress, anxiety and burnout. “It is in this context that worker health monitoring by employers has emerged,” explains Manokha. “In addition to being productive, it puts increased pressure on employees to adopt healthy lifestyles, to be in a good physical shape. Employees’ bodies, in addition to their labour, are becoming the focus of attention. The problem with this is not simply the violation of worker privacy, but the increasing objectification of employees.”

For companies themselves, there is a fine line to tread. If they try to exploit health data too much, there can be legal consequences. Recently-introduced data protection laws such as the European Union’s GDPR do offer employees some protection. For one thing, any employer tempted to sell the data accumulated – for example to an insurance company – could face paying substantial damages. “Selling on health data would be unlawful, not only under data protection law but also under the laws of confidentiality,” says Oran Kiazim, senior data protection advisor at international law firm Bird & Bird, which has 29 offices across Europe, the Middle East, Asia-Pacific and North America. “An employer doing so would run the risk of civil claims, where compensation across a data class could be costly, on top of the potential damage to reputation or brand value. In certain circumstances, there can even be criminal liability.”

Employees who refuse could be seen as non-cooperative, or not sufficiently devoted or motivated - Ivan Manokha

Kiazim points out that employers can also face serious sanctions if they process or misuse such data in any way without notifying their employees. It is also unlikely that any company could make it compulsory for staff to provide health data, or comply with a health tracking programme against their wishes.

However, there is still a risk that employees who are reluctant to partake in such monitoring could then face difficulties in the workplace. “Employees who refuse could be seen as non-cooperative, or not sufficiently devoted or motivated,” says Manokha.

Crossing lines

To try and prevent health tracking schemes crossing ethical lines, and eroding trust between employee and employer, some industry figures believe that organisations need to work with third-party vendors who specialise in managing wellbeing data. These vendors would hold the data independently under strict privacy rules, and work with employees directly to change their lifestyles.

“In this scenario, the employer would only ever have access to a population-level view of their overall workforce, and the kinds of wellness interventions they are using or the employer should consider offering,” says Mary Henderson, senior vice-president of product strategy and innovation at Chicago-based data analytics company Blue Health Intelligence. “The best practices dictate that an employer never sees any individual’s health-related information, and they have iron-clad data privacy policies.”

But to what extent large corporations may follow these best practices remains to be seen. With the current job climate, and high rates of unemployment, companies who wish to pursue health tracking are unlikely to face serious opposition from their staff.

“In the current context in which the competition for jobs is more and more intense, when people need to keep their jobs at all cost, these schemes are unlikely to backfire,” says Manokha. “From the point of view of employees, it is perhaps not their primary concern right now.”

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