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Fitbit.com: the first mainstream PHR?

It had been some time since I last logged into my Fitbit account, since Fitbit never reminds me of its existence, but when I helped my parents set up their new internet-enabled pedometers today, I noticed a number of new personal health trackers: heart rate, blood pressure, glucose, and HbA1c.

I have no idea how many users have taken advantage of these yet -- manual entry of thrice-daily glucose readings is almost as painful as the needle-stick, and there's no device integration yet -- but Fitbit is wisely exploiting its position as a fun and trusted personal health device manufacturer by easing users into their very own personal health record.

This is both a major win for Fitbit and a major blow to commercial and academic PHR ventures. Google Health and Microsoft Healthvault (among myriad others) really haven't been able to win over average health care consumers with either hand-populated, self-curated PHRs, or PHRs with a limited number of "official," but usually low-value, hospital or laboratory data sources. They also suffer tremendously from poor product design -- neither convincingly insinuates itself into everyday life. Fitbit's hardware and software, however, are beautiful, easy to use, and delightful.

Fitbit's "trojan horse" of a pedometer may be just the catalyst for the next personal health revolution... with a major caveat.

Openness. Those who know me might think I've just drunk too much of the open source Kool-Aid, but Fitbit could become a major PHR platform if it publishes an open, transparent, standards-inspired API without delay. Make it dead-simple to put your health data in (from scales, glucometers, treadmills, or iPhone-based urine tests) and then pull your health data out (in XML, JSON, Excel, or PDF suitable for a visit to your PCP). And not some of your data -- all of it.

If Fitbit maintains a lock on user data to force us into "premium" membership, I suspect it'll end up another flash in the PHR pan. I hope not!