Posts with «health» label

EU investigating Meta over addiction and safety concerns for minors

Meta is back in hot water for its methods (or lack thereof) for protecting children. The European Commission has launched formal proceedings to determine whether the owner of Facebook and Instagram has violated the Digital Services Act (DSA) by contributing to children's social media addiction and not ensuring they have high levels of safety and privacy.

The Commission's investigation will specifically examine whether Meta is properly assessing and acting against risks brought on by its platforms' interfaces. It's concerned about how their designs could "exploit the weaknesses and inexperience of minors and cause addictive behavior, and/or reinforce so-called 'rabbit hole' effect. Such an assessment is required to counter potential risks for the exercise of the fundamental right to the physical and mental well-being of children as well as to the respect of their rights."

The proceedings will also explore whether Meta takes necessary steps to prevent minors from accessing inappropriate content, has effective age-verification tools and minors have straightforward, strong privacy tools, such as default settings.

The DSA sets standards for very large online platforms and search engines (those with 45 million or more monthly users in the EU) like Meta. Obligations for designated companies include transparency about advertising and content moderation decisions, sharing their data with the Commission and looking into risks their systems pose related to areas such as gender-based violence, mental health and protection of minors.

Meta responded to the formal proceedings by pointing to features such as parental supervision settings, quiet mode and it automatically restricting content for teens. "We want young people to have safe, age-appropriate experiences online and have spent a decade developing more than 50 tools and policies designed to protect them. This is a challenge the whole industry is facing, and we look forward to sharing details of our work with the European Commission," a Meta spokesperson told Engadget.

However, Meta has continuously failed to prioritize the safety of young people. Previous alarming incidents include Instagram's algorithm suggesting content that features child sexual exploitation and claims that it designs its platforms to be addictive to young people while suggesting psychologically harmful content, such as the promotion of eating disorders and body dysmorphia.

Meta has also famously served as a hub of misinformation for people of all ages. The Commission already launched formal proceedings against the company on April 30 due to concerns around deceptive advertising, data access for researchers and the lack of an "effective third-party real-time civic discourse and election-monitoring tool" before June's European Parliament elections, among other concerns. Earlier this year, Meta announced that CrowdTangle, which has publicly shown how fake news and conspiracy theories move around Facebook and Instagram, would be completely shut down in August.

This article originally appeared on Engadget at

An insulin pump software bug has injured over 200 people

The US Food and Drug Administration (FDA) has issued a Class I recall for the t:connect mobile app on iOS, which is used to monitor and control the t:slim X2 insulin pump used by people with diabetes. It was supposedly the first smartphone app that can program insulin doses that the FDA had approved. The agency issued the highest level of recall it could, because the app had serious software problems that could've have caused life-threatening conditions or even death. In fact, while there were no mortalities reported, the FDA received 224 injury reports as of April 15. 

According to the agency, version 2.7 of the t:connect mobile app had a bug that initiated a cycle wherein the app would crash and then would be relaunched by the iOS platform again and again. That apparently led to excessive Bluetooth communication that would drain the pump's battery and cause it to shut down earlier than the user would expect. Insulin pumps like the t:slim X2 are designed to automatically deliver insulin under the user's skin at set time intervals and whenever needed. They're supposed to take on the burden of managing the user's sugar levels so that they can go about their day without having to stop and inject themselves or if they're prone to getting hypo or hyperglycemia. 

If a pump shuts down without warning and before the user expects it to, it could lead to the under-delivery of insulin. As the FDA explained in its recall, that could result in hyperglycemia and even diabetic ketoacidosis, a life-threatening complication caused by the inability of the body to turn sugar into energy due to the lack of insulin. Tandem Diabetes Care, the company behind the app and the pump, sent all affected customers an emergency notice back in March. It advised them to update their app, to monitor their pump battery level closely and to carry backup insulin supplies. The FDA's recall notice could reach potentially affected customers who may not have seen the manufacturer's alerts, however, or who may have brushed it aside. Malfunctioning insulin pumps had been linked to multiple deaths in the past, so users may want to keep a close eye on theirs regardless of the brand. 

This article originally appeared on Engadget at

GPT-4 performed close to the level of expert doctors in eye assessments

As learning language models (LLMs) continue to advance, so do questions about how they can benefit society in areas such as the medical field. A recent study from the University of Cambridge's School of Clinical Medicine found that OpenAI's GPT-4 performed nearly as well in an ophthalmology assessment as experts in the field, the Financial Times first reported.

In the study, published in PLOS Digital Health, researchers tested the LLM, its predecessor GPT-3.5, Google's PaLM 2 and Meta's LLaMA with 87 multiple choice questions. Five expert ophthalmologists, three trainee ophthalmologists and two unspecialized junior doctors received the same mock exam. The questions came from a textbook for trialing trainees on everything from light sensitivity to lesions. The contents aren't publicly available, so the researchers believe LLMs couldn't have been trained on them previously. ChatGPT, equipped with GPT-4 or GPT-3.5, was given three chances to answer definitively or its response was marked as null. 

GPT-4 scored higher than the trainees and junior doctors, getting 60 of the 87 questions right. While this was significantly higher than the junior doctors' average of 37 correct answers, it just beat out the three trainees' average of 59.7. While one expert ophthalmologist only answered 56 questions accurately, the five had an average score of 66.4 right answers, beating the machine. PaLM 2 scored a 49, and GPT-3.5 scored a 42. LLaMa scored the lowest at 28, falling below the junior doctors. Notably, these trials occurred in mid-2023. 

While these results have potential benefits, there are also quite a few risks and concerns. Researchers noted that the study offered a limited number of questions, especially in certain categories, meaning the actual results might be varied. LLMs also have a tendency to "hallucinate" or make things up. That's one thing if its an irrelevant fact but claiming there's a cataract or cancer is another story. As is the case in many instances of LLM use, the systems also lack nuance, creating further opportunities for inaccuracy.

This article originally appeared on Engadget at

The best ergonomic keyboards for 2024

It’s tough to give a blanket recommendation for ergonomics, as the term most accurately translates to “what works best for your body” — and all bodies are different. But if you’ve landed here, chances are you’re looking for a keyboard that’s easier on your shoulders, neck and wrists. Traditional keyboards keep your arms close together and force you to splay your hands outward. After a while, that can feel straining. By shifting the orientation of the keys, ergonomic keyboards can keep your upper body in a more neutral position, preventing you from twisting or over-extending your hands and arms. We’ve broken down the various features that make some boards more body-friendly than others and tested a handful to come up with the best ergonomic keyboards to suit different needs and preferences.

What to look for in an ergonomic keyboard

Alice vs split

Most ergonomic keyboard layouts fall into two categories: Alice and split. The former is a single board with the two halves of the keys rotated about 30 degrees apart at the bottom. The separation forms an A-shaped space between the keys — which has nothing to do with why it’s called an Alice layout, it’s just a happy coincidence. This subtle tweak pushes your elbows away from your ribs while keeping a straight line from your forearm to your middle knuckle. Using one, I pretty instantly felt more open along the front side of my body. This layout more closely resembles a traditional keyboard, so it should be easier for most folks to get used to than a fully split option.

Speaking of, split boards break the keys into two separate parts you can position individually. You can put them shoulder distance apart, bring them closer together or angle them as much as feels comfortable. You can also put your mouse between the halves, which may feel like an easier trip for your cursor hand. Personally, I like being able to put my current snack between the two parts.


You can find ergonomic keyboards with and without number pads. Not having those number keys on the right side lets you keep your mouse closer in, minimizing overall reach. But if you work with numbers a lot, you’ll likely want that pad included. Some programmable boards allow for the use of layers, which temporarily repurpose keys and can provide you with a ten-key option through clever remapping of letter keys.

Tenting and negative tilt

Tenting raises the middle of the keyboard up, so your hands move closer to a “handshake” position. Alice keyboards usually angle up towards the middle and always to a fixed degree, since the two sides are connected. Split boards often let you adjust the degree of tenting, going from flat to subtle to extreme lift.

You may have encountered keyboards with an optional lift at the back of the board, raising the top keys higher than the space bar. Every set of hands is different, but for most people, pulling the backs of the hands towards the forearms increases strain. Negative tilt has the opposite effect by sloping in the other direction, lowering the top number keys while raising the edge with the spacebar. Many Alice and some split keyboards offer an optional negative tilt. I found it was more comfortable to enable that feature when I’m standing, and I preferred to have the keys flat when sat at my desk.

Staggered vs columnar

This decision seems to be one of the more hotly-contested among ergo enthusiasts. A standard keyboard has staggered keys, with each row slightly offset to the rows above and below it — so the A key is about halfway between the Q and W above it. This is a holdover from vintage mechanical typewriters, in which each press activated a hammer that smashed ink onto paper in the shape of a letter. To fit the hammers as close together as possible, while still allowing for finger pads, the keys were staggered.

Columnar or ortholinear keyboards stack the keys in orderly columns, often with rows that are not linear. Proponents claim this makes the keys easier to reach. Whether that’s true will be up to your fingers to decide, but I can say for certain that if you learned to type on a staggered keyboard, switching to a columnar layout is tough. It will take days, possibly weeks before you instinctively hit the C key. The N, M and B keys don’t fare much better.

Programmable keys

With a few exceptions, most ergonomic keyboards will work with PCs or Macs as a standard typing input, but the use of function and hot keys may require some remapping. It can be as easy as an onboard switch to toggle between Mac and PC layouts, or as involved as downloading software to change up the keys. Some boards even include (or let you buy) extra keycaps to change, say, the Mac’s Command and Option keys to PC’s Start and Alt buttons.

For some boards, remapping or programming keys is a crucial feature. Gaming peripherals have extra keys that you can set to execute a series of keystrokes with the push of a single button. Keyboards that work with layers, in which a single button can perform several functions, typically allow you to change what those are. Some ergonomic keyboards have non-standard layouts, like thumb clusters with multiple keys near the space bar that you operate with your thumb. You’ll also be able to program those.

Other considerations

Ergonomic keyboards come in mechanical, membrane, and scissor switch versions. Which works best for you is, again, up to your preference. I won’t get too deep into the particulars here, but the short of it is that membrane and scissor switches are less customizable than mechanical and typically cheaper. Typing on them tends to be quieter and softer. Mechanical switches are more customizable, offer a more responsive typing experience and are usually pricier.

You’ll also have the option of wired or wireless ergonomic boards. All other things being equal, wired models are less expensive. Competitive gamers who rely on split-second responses may prefer the zero-lag of wired keyboards. Wired models also never run out of battery life and have fewer connectivity issues. But wireless keyboards keep your desk less cluttered.

Some ergonomic keyboards come with permanent or removable wrist or palm rests, which can be cushioned or hard. This is another area where opinions diverge: proponents claim they help you maintain a neutral hand position, while detractors say they put pressure on the tendons in your wrist. Ideally, your palms should be resting, not your wrists, and you might find you like having that support or you may find the pressure uncomfortable. 

Photo by Amy Skorheim / Engadget

How we tested

All our guides begin with extensive research to figure out what’s out there and what’s worth testing. We consider brands with good reputations that we’ve heard good things about from colleagues and other trusted publications. For this guide, I looked for keyboards with ergonomic features like tenting, split keys, palm support and so on. I also zeroed in on boards that didn’t require a deep amount of familiarity with the vast and exhaustive world of custom keyboards.

Once I settled on ten boards, I acquired them and used each one for anywhere from a few days to a few weeks. I tried out the remapping and macros software and considered the comfort, design, price and durability of each model before arriving at picks I think will work best for the most people out there.

This article originally appeared on Engadget at

England’s NHS will provide artificial pancreas to thousands of diabetes patients

England’s National Health Service (NHS) said on Tuesday that “tens of thousands of children and adults” with type 1 diabetes will receive an “artificial pancreas” to help manage their insulin levels. The hybrid closed loop system — a sensor under the skin that sends wireless readings to an externally worn pump, which delivers insulin as needed — can help patients avoid the risks of type 1 diabetes without worrying about finger sticks or injections.

This isn’t the first device of its kind. Tandem makes similar insulin pumps in the US after it received FDA authorization in 2019. Gizmodo notes that another company called iLet got FDA approval for a similar device last year. Although the NHS hasn’t said which specific device(s) its program will use, what’s different here is the nation’s publicly funded health care system providing them for free rather than as an exclusive privilege for the well-to-do. (Sigh.)

The hybrid closed loop system starts with a sensor implanted beneath the skin, which continually monitors glucose levels at regular intervals. The sensor sends that data wirelessly to a pump, worn externally, which delivers the proper insulin dosage. The “hybrid” part of its name comes from the fact that some user input, including entering carb intake, is still required in the otherwise self-regulating system.

The government agency gave an ultra-precise figure of 269,095 people in England living with type 1 diabetes, highlighting how many folks could potentially benefit from the rollout. The NHS says local branches will begin identifying patients for the program starting on Tuesday.

“Diabetes is a tough and relentless condition, but these systems make a significant, life-changing difference — improving both the overall health and quality of life for people with diabetes,” Colette Marshall, chief executive of Diabetes UK, wrote in the NHS’s press release announcing the rollout. “This really is a landmark moment and we’ll be working with the NHS and others to ensure a fair rollout that reaches people as quickly as possible.”

This article originally appeared on Engadget at

The 5 best meditation apps for 2024

Meditation is often touted as a mental cure-all, purported to help with stress, sleep, mood, focus and even certain medical conditions. I’ve been meditating most of my adult life. I’ve done silent retreats. I’ve been formally trained in various techniques. I’ve had someone in my contacts list who I referred to as a “guru.” So I feel I’m relatively qualified to give some bad news: Meditation won’t fix your life, despite what David Lynch says. However, there’s also some good news: Despite not actually being a cure-all for everything bad in the universe, meditation can certainly take the edge off.

This is where meditation apps can come into play. Of course, practicing mindfulness doesn’t require an app; people have been doing it for thousands of years, with nary a smartphone in sight. But mindfulness apps can be useful in a number of ways. They provide access to all kinds of guided meditations to suit different styles. Some even offer social connections, which can motivate you to keep up your practice via the magic of peer pressure. They are also particularly well-suited to beginners, with many of them offering a free trial. With all of this in mind, I downloaded some of the most popular meditation apps and set about sitting calmly on a comfortable chair to test them out. What follows is a comparison aimed at real people just looking to squeeze a bit more joy and relaxation out of daily life.

How we tested meditation apps

Every brain is different, so I did not rate these apps based on if they sync up with my preferred meditation style. First and foremost, I looked for apps that cater to various methods and those that offer guided meditations that go beyond what’s free on YouTube. All of the items on this list are available on both Android and iOS, so you won’t have to worry about something being only for iPhone owners.

Of course, there’s lots of free stuff out there, from podcasts and videos on YouTube to audio tracks on streaming services. You can even find guided breathing sessions on an Apple Watch or Fitbit, as well as meditations in Fitness+, Samsung Health or any number of workout video providers. For this guide, I focused on apps that stood out in some way. I liked apps with huge libraries of guided meditations and those that offer additional mindfulness activities, like yoga routines. I also looked for easy-to-use apps with well-designed layouts. You don’t want to start your meditation journey with a clunky app that actually increases anxiety.

The most important thing with meditation is to keep doing it, so I awarded points for clever gamification elements, simple social network integration and anything else that encourages repeat visits. Finally, I considered extra features that set an app apart from the glut of competitors out there. For example, some meditation apps offer novel ways to track your progress, access to yoga routines and a whole lot more.

At the end of the day, each of these apps has its strengths. But if installing an app or using a device is not how you prefer to meditate, you can always turn off your phone and find a quiet room or environment. For those of us who need a little help from a digital guru, though, here are our favorite apps for meditation.

Other meditation gear we tested

Brain-tracking wearables have been around for years, but there are some newer devices that have been tailor-made for meditators. These gadgets track the brain during meditations and offer real-time feedback. It’s a real boon for the data-obsessed, but also a real bank account drainer, with some gadgets costing thousands of dollars. I took two of the more-popular options for a spin to see what they’d make of my brain. Neurofeedback System is a weird contraption that not only claims to track brainwaves, but gives real-time feedback to “teach” people how to meditate and enter a flow state. The device involves a giant headset that’s stuffed with brainwave sensors that detect beta, alpha, theta and gamma waves, in addition to heart-rate sensors. It also comes with a truly bizarre companion gadget that uses light stimulation (transcranial photobiomodulation) to keep an eye on focus and attention levels. The whole thing is combined with an app that keeps track of dozens of data metrics and allows access to various guided meditations.

I’m as surprised as you to say that this thing appears to work, with some caveats. It’s uncanny how well it monitors the brain during meditations. If I got lost in a thought spiral about lasagna at six minutes in, sure enough, there would be a dip in analytics at the six-minute mark. It’s also fairly easy to use, despite a process that involves wetting a number of electrodes. As magical as the accurate brain-tracking seems to be, however, I wasn’t as keen on the actual training portion, which often involves staring at a screen throughout the entirety of the practice. It’s also not for the financial faint of heart, as the device costs $1,500.

NeoRhythm Omnipemf

NeoRhythm’s Omnipemf is another wearable to help people get into that ever-elusive flow state. It doesn’t track your brain, but rather floods it with electromagnetic fields at specific frequencies to make it more susceptible to meditation and focus. This is supposed to prime your brain for the meditative state and, in theory, make it easier to capture that zen. However, I didn’t get much from it, other than a placebo-esque buzzing in my head.

To use it, you simply pop on the wearable and go about your day. You aren’t tied to an app, so you can meditate in whatever way you like. There are multiple modes that go beyond meditation, as this thing is supposed to help with focus, pain relief and sleep. I’d wait for some peer-reviewed studies, however, before buying this.

This article originally appeared on Engadget at

FDA approves the first over-the-counter continuous glucose monitor

The US Food and Drug Administration has approved the first continuous glucose monitor (CGM) people can buy without a prescription. Dexcom's Stelo Glucose Biosensor System has a sensor users are meant to insert into their upper arm, similar to the company's other CGMs that need a doctor's prescription for purchase. It pairs with a smartphone application that can show the user's blood glucose measurements and trends every 15 minutes. 

The company designed the device specifically for adults 18 and up who are not using insulin, such as those managing their diabetes with oral medications and non-diabetics making a conscious effort to control their sugar intake. It could be a great tool for people with insulin resistance, including individuals with PCOS and other metabolic issues that heighten their probability of developing diabetes in the future. In general, it could give users the insight to be able to better understand how the food they eat and the movements they make impact their overall health. 

While CGMs aren't anything new, they've become a wellness trend on social media last year, and even non-diabetics started using them. By clearing Stelo, the FDA is making the monitors more accessible than before. "CGMs can be a powerful tool to help monitor blood glucose," said Jeff Shuren, MD, director of the FDA's Center for Devices and Radiological Health. "Today's clearance expands access to these devices by allowing individuals to purchase a CGM without the involvement of a health care provide. Giving more individuals valuable information about their health, regardless of their access to a doctor or health insurance, is an important step forward in advancing health equity for U.S. patients."

Stelo will be available starting this summer. Each patch is meant to last for 15 days before users will need to replace it. Dexcom has yet to reveal how much it would cost, but it said Stelo will "provide an option for those who do not have insurance coverage for CGM."


This article originally appeared on Engadget at

Dr. Garmin will see you now

There’s a reason smartwatches haven’t replaced clinically-validated gear when you visit the hospital — accuracy and reliability are paramount when the data informs medical procedures. Even so, researchers are looking for ways in which these devices can be meaningfully used in a clinical setting. One project in the UK has explored if a Garmin Venu 2 and dedicated companion app could be used to free up doctors and nurses, six minutes at a time.

The Six Minute Walk Test (6MWT) is used to diagnose and monitor a number of cardiovascular maladies. This includes conditions like Pulmonary Hypertension that, if left untreated, are eventually fatal. “[The test has been] a cornerstone of hospital practice and clinical trials for decades all around the world as [...] a marker of how well the heart and lungs are working,” explained project leader Dr. Joseph Newman. While a change in a blood test marker might be clinically relevant, Newman said “it’s probably more important to someone that they can walk to the shop and back.” The test requires a patient walk on a flat, hard surface for six minutes straight, which stresses the heart enough to measure its capacity. A professional tests the patient’s heart rate and blood oxygen levels at the start and end, and while it’s simple and reliable, "it’s not perfect,” according to Newman. “This is why we’ve looked to change it in two important ways," he said, "can we make it shorter [...] and digitize it for remote use?"

After all, six minutes is a lifetime in a clinical setting, and patients dislike having to schlep all the way to their hospital just to walk up and down a corridor. It’s why Newman and Lucy Robertson — both researchers at the Royal Papworth Hospital in Cambridge — began looking for ways to revolutionize the test. They wanted to see if the test could be shortened to a single minute, and also if it could be carried out by a patient at home using a Venu 2. The watch was connected to a secure and dedicated clinical trial platform built by Aparito – a Wrexham-based developer – for testing. This was then sent out to patients who were instructed to wear the watch and walk outdoors to complete their own tests. “They’re asked to walk on flat, even, dry, relatively straight roads rather than in laps or circuits,” said Dr. Newman, with patients walking at their own natural pace.

“We carried out a product appraisal early on in the research process and were open-minded as to the brand or model,” said Newman. “Garmin came out on top for a few reasons; we can access raw data as well as Garmin’s algorithmically-derived variables,” he said. Because the research was being funded by a charity, the British Heart Foundation, the watch had to offer good value for money. It helped that Garmin, because of its existing health research division, gave the team “confidence in the accuracy of the sensors,” not to mention the fact that Aparito feels that “the Garmin SDK is relatively easy to work with,” he said. But while Garmin is in use right now, there’s no reason this setup couldn’t eventually work with a number of other brands. “As long as the technology works, it’s accurate, reliable and patients accept it, then we’re not tied to any brand.”

There are several benefits in giving patients the ability to run the tests at home: it’s more representative of the demands of their actual life, and patients can retake the test at regular intervals, making it easier to track that person’s health over time. “We can see real value in providing patients with pulmonary hypertension with an app and smartwatch to monitor their progress,”said Dr. Newman. “It’s unlikely to ever fully replace the need for in-person hospital reviews, but it will likely reduce their frequency.”

The results of the study right now suggest cutting the test to one minute has no detrimental effect on its outcome or accuracy,and that patients are far more likely to run the test regularly if they’re able to do so at home. “It’s likely that the upfront costs of wearables [to a hospital] may be offset by the longer term reduction in hospital visits,” said Newman. If that turns out to be right, then it means clinicians can better focus their time and efforts where their expertise is more valuable.

This article originally appeared on Engadget at

New York City is suing social media firms for allegedly harming the mental health of children

After designating social media as a "public health hazard" in late January, New York City is now suing Meta, Google, Snap and TikTok for "fueling nationwide youth mental health crisis." Specifically, these companies face three counts in the lawsuit: public nuisance, negligence and gross negligence. The Mayor Eric Adams administration accuses TikTok, Instagram, Facebook, Snapchat and YouTube of "endangering our children's mental health, promoting addiction, and encouraging unsafe behavior."

These are allegedly achieved by way of harmful algorithms, gambling-like mechanisms and manipulation through reciprocity — making the user "feel compelled to respond to one positive action with another positive action." The city believes that there is a correlation between the increase in social media usage and the decline in local youth mental health over "more than a decade."

In response, Google and Meta told CNBC that they have always worked with youth safety experts and provided parental control tools. ByteDance's TikTok also highlighted some of its specific tools to Axios, namely age-restricted features, parental controls and an automatic 60-minute time limit for users under 18. However, none of the tech companies acknowledged the problematic features listed by the Adams administration.

This lawsuit follows a recent Senate hearing on online child safety, in which the CEOs of all the aforementioned tech companies (except Google) were present. In his opening remarks, Senator Lindsey Graham told the tech execs that "you have blood on your hands" — a reference to online child exploitations and cyberbullying that unfortunately led to deaths. 

Through this case, the Adams administration wants these tech companies to pay up for the city's youth mental health services, which apparently cost more than $100 million each year. But ultimately, it's about forcing these tech giants to stop manipulating young users into addictive behavior, as well as getting policymakers to place new federal laws that safeguard youth mental health on social platforms.

Before this New York City lawsuit, Meta already faces a similar case from 41 states back in October 2023, in which it was accused of misleading the public about the safety of its platform's "addictive" features. Meta, Snap, TikTok and Google were also sued in a multi-district litigation in 2022 for their addictive features that allegedly cause "emotional and physical harms, including death" to adolescents.

This article originally appeared on Engadget at

HIPAA protects health data privacy, but not in the ways most people think

The “P” in HIPAA doesn’t stand for privacy. It’s one of the first things a lot of experts will say when asked to clear up any misconceptions about the health data law. Instead, it stands for portability — it’s called the Health Insurance Portability and Accountability Act —and describes how information can be transferred between providers. With misinterpretations of HIPAA starting with just its name, misunderstandings of what the law actually does greatly impact our ability to recognize how the kinds of data do and don't fall under its scope. That’s especially true as a growing number of consumer tech devices and services gather troves of information related to our health.

We often consider HIPAA a piece of consumer data privacy legislation because it did direct the Department of Health and Human Services to come up with certain security provisions, like breach notification regulations and a health privacy rule for protecting individually identifiable information. But when HIPAA went into effect in the 1990s, its primary aim was improving how providers worked with insurance companies. Put simply, “people think HIPAA covers more than it actually does,” said Daniel Solove, professor at George Washington University and CEO of privacy training firm TeachPrivacy.

HIPAA has two big restrictions in scope: a limited set of covered entities, and limited set of covered data, according to Cobun Zweifel-Keegan, DC managing director of the International Association of Privacy Professionals. Covered entities include healthcare providers like doctors and health plans like health insurance companies. The covered data refers to medical records and other individually identifiable health information used by those covered entities. Under HIPAA, your general practitioner can't sell data related to your vaccination status to an ad firm, but a fitness app (which wouldn't be a covered entity) that tracks your steps and heart rate (which aren't considered covered data) absolutely can.

“What HIPAA covers, is information that relates to health care or payment for health care, and sort of any piece of identifiable information that’s in that file,” Solove said. It doesn’t cover any health information shared with your employer or school, like if you turn in a sick note, but it does protect your doctor from sharing more details about your diagnosis if they call to verify.

A lot has changed in the nearly 30 years since HIPAA went into effect, though. The legislators behind HIPAA didn’t anticipate how much data we would be sharing about ourselves today, much of which can be considered personally identifiable. So, that information doesn’t fall under its scope. “When HIPAA was designed, nobody really anticipated what the world was going to look like,” Lee Tien, senior staff attorney at the Electronic Frontier Foundation said. It’s not badly designed, HIPAA just can’t keep up with the state we’re in today. “You're sharing data all the time with other people who are not doctors or who are not the insurance company,” said Tien.

Think of all the data collected about us on the daily that could provide insight into our health. Noom tracks your diet. Peloton knows your activity levels. Calm sees you when you’re sleeping. Medisafe knows your pill schedule. Betterhelp knows what mental health conditions you might have, and less than a year ago was banned by the FTC from disclosing that information to advertisers. The list goes on, and much of it can be used to sell dietary supplements or sleep aids or whatever else. “Health data could be almost limitless,” so if HIPAA didn’t have a limited scope of covered entities, the law would be limitless, too, Solove said.

Not to mention the amount of inferences that firms can make about our health based on other data. An infamous 2012 New York Times investigation detailed how just by someone’s online searches and purchases, Target can figure out that they’re pregnant. HIPAA may not protect your medical information from being viewed by law enforcement officers. Even without a warrant, cops can get your records just by saying that you’re a suspect (or victim) of a crime. Police have used pharmacies to gather medical data about suspects, but other types of data like location information can provide sensitive details, too. For example, it can show that you went to a specific clinic to receive care. Because of these inferences, laws like HIPAA won’t necessarily stop law enforcement from prosecuting someone based on their healthcare decision.

Today, state-specific laws crop up across the US to help target some of the health data privacy gaps that HIPAA doesn’t cover. This means going beyond just medical files and healthcare providers to encompass more of people’s health data footprint. It varies between states, like in California which provides options to charge anyone who negligently discloses medical information or some additional breach protections for consumers based in Pennsylvania, but Washington state recently passed a law specifically targeting HIPAA’s gaps.

Washington State’s My Health My Data Act, passed last year, aims to “protect personal health data that falls outside the ambit of the Health Insurance Portability and Accountability Act,” according to a press release from Washington’s Office of the Attorney General. Any entity that conducts business in the state of Washington and deals with personal information that identifies a consumer’s past, present or future physical or mental health status must comply with the act’s privacy protections. Those provisions include the right not to have your health data sold without your permission and having health data deleted via written request. Under this law, unlike HIPAA, an app tracking someone’s drug dosage and schedule or the inferences made by Target about pregnancy would be covered.

My Health My Data is still rolling out, so we’ll have to wait and see how the law impacts national health data privacy protections. Still, it’s already sparking copycat laws in states like Vermont.

This article originally appeared on Engadget at