A blood pressure gauge — a sphygmomanometer — has been pretty well understood since the late 1800s. It consists of a cuff to squeeze the arm, sensors to read the pulses, and a dial/read-out to display the results.

This Christmas, I got my Mom a “QardioArm” — a BP gauge updated for the modern smartphone era. It has all the requisite parts, with the main distinction that the display is now an app on the tablet/phone. And one other critical requirement that apparently medical professionals have been desperately lacking for centuries: the “cloud”.

You see, even though the cuff and the app communicate locally via Bluetooth, you cannot actually use the device for even the most basic of functions until you register for an Internet account. Why?!? I hold a pretty damn powerful computer/controller in my hands. I can’t imagine that it truly needs the aid of the Internet to be more capable than what a basic BP gauge fundamentally needs.

Where does this device-enabling account live, aside from somewhere in the cloud? Presumably on some Qardio-owned asset, but the Terms & Conditions don’t specify exactly (while advising of all the info they collect and with whom it will be shared). So now I have personal medical data, and personal profile info, somewhere out on the Internet. Yet another account to remember. Yet another password to forget. Yet another data breach in the making.

Why is the Internet required in the first place? The short answer is that, inexcusably, it shouldn’t be. There should be a way to use the cuff locally with the full power of the Bluetooth-controlling phone solely behind it all. If there is to be an Internet component, it should be optional. Qardio would argue that the cloud is for device portability and long-term retention of reminders and history, but I don’t subscribe to that as an absolute necessity. It’s not as if smartphones lack local storage. If mine can hold gigabytes of MP3 songs, I’m sure it can keep a record of alarms and a few thousand heartbeats.

Oh wait, what’s this? Over there, under the ‘Q’ menu. “Followers”? “Following”? So now my vitals are suddenly a social component to be posted? Is this really necessary? Not everything needs to be shared amongst friends these days, and maybe I don’t want my data risked on the Internet if I have no intention of ever going public. The “Internet-of-things” does not mean every “thing” has to be Internet involved. Why can’t a thing just be a thing?

Qardio already has my money for the cuff, so creating a tracking account is not some concession in privacy that I make for using a freemium model. And don’t get me wrong: it is an excellent product. But what if the company goes under? Does the device suddenly stop working because the account can no longer be found? Am I to believe that the cost of the back-end storage/sync infrastructure will be shouldered by Qardio for years, purely out of the goodness of their own hearts? Or will they try to leverage Follower connections to further monetize and network their product? Perhaps they will push ads for Benazapril when hypertension is detected??

Going beyond Qardio, this idea that every app needs a cloud sign-in bugs the heck out of me. I cringe every time I come across a Tempo (a calendar) or Pearltrees (an Evernote/Pinterest’ish scrapbook) which force me to create a login just to test the basic functionality. Today’s smartphones are more powerful than my first PC, but it is as though the Internet has made them more like dumb networked terminals. Social can be engaging and the Internet can certainly be empowering. But they also could (and should) be optional in many situations.

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