Apple & IBM partnership in Japan to serve seniors a major step toward “Smart Aging”

As Bob Seger and I prepare to turn 70 (alas, no typo) on Wednesday (as long as he’s still singing “Against the Wind” I know I’m still rockin’) my thoughts turn to my “Smart Aging” paradigm, which combines Quantified Self devices that can change our relationships with doctors into a partnership and give us encouragement to do more fitness activities and smart home devices that make it easier for seniors to run their homes and avoid institutionalization.

That’s why I was delighted to read this week about Apple (obligatory disclaimer: I work part-time at The Apple Store, especially with “those of a certain age,” but am not privy to any of their strategy, and my opinions are solely my own) and IBM teaming with Japan Post (hmm: that’s one postal service that seems to think creatively. Suspect that if one B. Franklin still ran ours, as he did in colonial days, we’d be more creative as well…) to provide iPads to Japan’s seniors as part of Japan Post’s “integrated lifestyle support group” (the agency will actually go public later this year, and the health services will be a key part of its services).

Apple and IBM announced, as part of their “enterprise mobility” partnership that will also increase iPads’ adoption by businesses, that they will provide 5 million iPads with senior-friendly apps to Japanese seniors by 2020.  IBM’s role will be to develop app analytics and cloud services and “apps that IBM built specifically for elderly people .. for medication adherence … exercise and diet, and … that provide users with access to community activities and supporting services, including grocery shopping and job matching.”

The overall goal is to use the iPads and apps to connect seniors with healthcare services and their families.  I can imagine that FaceTime and the iPads’ accessibility options will play a critical role, and that current apps such as Lumosity that help us geezers stay mentally sharp will also be a model.

According to Mobile Health News, the partnership will offer some pretty robust services from the get-go:

“If seniors or their caregivers choose, they can take advantage of one of Japan Post Groups’ post office services, called Watch Over where, for a fee, the mail carriers will check in on elderly customers and then provide the elderly person’s family with an update. 

“In the second half of this year, customers can upgrade the service to include iPad monitoring as well.After Japan Post Group pilots the iPads and software with 1,000 seniors for six months, the company will expand the service in stages.”

Lest we forget, Japan is THE harbinger of what lies ahead for all nations as their populations age. 20% of the population was already over 65 in 2006,  38% will be in 2055.  As I’ve said before in speeches, the current status quo in aging is simply unsustainable: we must find ways for seniors to remain healthy and cut the governmental costs of caring for them as they grow as a percentage of the population.  As Japan Post CEO Taizo Nishimuro (who looks as if he’s a candidate for the new services — y0u go, guy!) said, the issue is “most acute in Japan — we need real solutions.”

IBM CEO Ginni Rometty said her company will take on a 3-part mission:

“First, they’ll be working on ‘quality of life apps,’ both by building some themselves and by integrating others, all of which will be aimed at accessibility first. The key target will be iOS, since it’s a mobile-first strategy in keeping with our changed computing habits. Second, they’re working on developing additional accessibility features not yet available, and third they’re helping Japan Post with the service layer required to deliver this to the elderly.”

Sweet! — and it reminds me of the other recently announced IBM/Apple announcement, in that case with J & J, to build a robust support structure for Apple’s new open-source ResearchKit and HealthKit platform to democratize medical research.  The IoT ain’t nothin’ without collaboration, after all.

Cook, according to TechCrunch, put the initiative in a global context (not unlike his environmental initiatives, where, IMHO, he’s become THE leading corporate change agent regarding global warming):

“Tim Cook called the initiative ‘groundbreaking,’ saying that it is ‘not only important for Japan, but [also] has global implications. Together, the three of us and all the teams that work so diligently behind us will dramatically improve the lives of millions of people.’

“…. The Apple CEO talked about how the company aims to ‘help people that are marginalized in some way, and empower them to do the things everyone else can do.” He cited a UC Irvine study which details how remote monitoring and connection with loved ones via iPad help instill a sense of confidence and independence in seniors. He added that he believes what the companies are doing in Japan is also scalable around the world.”

It will be interesting to see exactly how the partnership addresses the challenge of creating those senior-friendly “quality of life” apps: as someone who’s on the front-lines of explaining even Apple’s intuitive devices to older customers, I can tell you that many seniors begin are really frightened by these technologies, and it will take a combination of great apps and calm, patient hand-holding to put them at ease.

As I enter my 7th decade, I’m pumped!

Smart Aging: Kanega watch for seniors Kickstarter campaign ends today

“Independence with Dignity” is the motto for Jean Anne Booth’s Kanega Watch, which is in the last day of its Kickstarter campaign.

I’m not crazy about it, but in general I like what you see, and hope you get on board.  It addresses three major concerns for the elderly:

Kanega watchlike what I see, and hope you’ll get on board!  It’s designed to deal with three critical aging concerns:

  • falls
  • medication reminders
  • wandering.

I met the woman behind it at a conference in Boston last Summer, and even though the prototype at that point looked very unappealing, this looks more promising.

I’m in the process of creating a list of 10 objective criteria for evaluating devices and apps that fit with my “Smart Aging” paradigm shift, which combines Quantified Self devices to encourage healthy habits and change your relationship with your doctor into a partnership, and smart home devices, which make it easier to manage your home when elderly, so you can “age in place.”  Here’s how it stacks up against my criteria (which, BTW, are still in development — comments welcomed). Bear in mind that I haven’t seen current prototype, and the site doesn’t answer all of my questions. :

Is it easy to use?

  1. Does it give you a choice of ways to interact, such as voice, text or email?
  2. Does it give you reminders?
  3. Is it easy for you to program, or allow someone else to do it remotely?
  4. Does it have a large display and controls?
  5. Is it intuitive?
  6. Does it require professional installation?
  7. Is it flexible: can it be adjusted? Is it single purpose, or does it allow other devices to plug in and create synergies?

YES: voice-activated, rather than requiring buttons. No programming.


Does it protect privacy & security?

  1. Is storage local vs. cloud or company’s servers? Is data encrypted? Anomized?
  2. Do you feel creepy using it?
  3. Does it protect against exploitation by scam artists (such as identifying callers)?
  4. Is it password-protected?
  5. Is security “baked in” or an afterthought?

NO CLUE.


Does it complicate your life, or simplify it?

YES: doesn’t require a smartphone to function, and is voice-activated rather than using buttons.

Does it protect privacy and security?

NO CLUE.

 

Is it affordable?

  1. Are there monthly fees? If so, low or high?
  2. Is there major upfront cost?
  3. Does full functioning require accessories?

IFFY: You can get one by contributing $279 to the Kickstarter campaign. If that’s the retail price, it’s a little pricey, but lower than the Apple Watch base, $349, and probably a good price considering the value added services . Didn’t see anything about a monthly fee for the fall reporting & response service.

Does it stigmatize and/or condescend?

  1. Is it stylish, or does the design” shout” that it’s for seniors?
  2. Is the operation or design babyish?
  3. Would younger people use it?

NO: it doesn’t have a stigmatizing button, & uses a familiar form factor (watch).

Does it use open or proprietary standards?

NO CLUE.

 

Is the information shareable if you choose to do so?

NO CLUE.

 

Can you learn something from it to improve your life and empower yourself?

  1. For example, does health data encourage you to exercise more, or eat better?

NO: doesn’t give you feedback, measure your activity, etc.

Does it help you do something you couldn’t do before?

  1. Does it create a new range of services that were simply impossible with past technologies?

YES: The wandering alert (offers directions home) is new. Otherwise, just does some things such as medication alerts and calling for help that other devices have done.

Is it sturdy?

YES.

 

Does it have “loveability” (i.e., connect with the user emotionally)?

(This term was coined by David Rose in Enchanted Objects, and refers to products that are adorable or otherwise bond with the user)

YES: it has a Siri-like voice, which you can name, which gives reminders about taking meds and gives you directions home if you wander.
I’d give it about a 5 out of 10: I wouldn’t call this a must have — I’d like a little more of a multi-purpose tool that combines smart home and Quantified Self functions — like the Apple Watch (again, disclaimer that I work part time at Apple Store — but don’t have any proprietary info.) The watch is a little too clunky looking for me (prefer the Jony Ive-aesthetics of the Apple Watch), but it looks promising — and doesn’t require coupling to a smartphone, which is befuddling to a lot of seniors.

Kickstarter backers will begin receiving their Kanega watches in February 2016, with general market availability in summer 2016. The site doesn’t say anything about price.

Only a few hours left to join the Kickstarter campaign!


Yeah, I couldn’t figure out the names either. Turns out it’s from Cherokee: “Unalii” is “friend”, and “Kanega” is “speak.”  You learn something every day….

Apple ResearchKit will launch medical research paradigm shift to crowd-sourcing

Amidst the hoopla about the new MacBook and much-anticipated Apple Watch, Apple snuck something into Monday’s event that blew me away (obligatory disclaimer: I work part-time at The Apple Store, but the opinions expressed here are mine).

My Heart Counts app

Four years after I proselytized about the virtues of democratizing data in my Data Dynamite: how liberating data will transform our world book (BTW: pardon the hubris, but I still think it’s the best thing out there about the attitudinal shift needed to capitalize on sharing data), I was so excited to learn about the new ResearchKit.

Tag line? “Now everybody can do their part to advance medical research.”

The other new announcements might improve your quality of life. This one might save it!

As Senior VP of Operations Jeff Williams said in announcing the kit,  the process of medical research ” ..hasn’t changed in decades.” That’s not really true: as I wrote in my book, the Quantified Self movement has been sharing data for several years, as well as groups such as CureTogether and PatientsLikeMe. However, what is definitely true is that no one has harnessed the incredible power of the smartphone for this common goal until now, and that’s really incredible. It’s a great example of my IoT Essential Truth of asking “who else could use this data?

A range of factors cast a pall over traditional medical research.

Researchers have had to cast a broad net even to get 50-100 volunteers for a clinical trial (and may have to pay them, to boot, placing the results validity when applied to the general population in doubt).  The data has often been subjective (in the example Williams mentioned, Parkinson’s patients are classified by a doctor simply on the basis of walking a few feet). Also, communication about the project has been almost exclusively one way, from the researcher to the patient, and limited, at best.

What if, instead, you just had to turn on your phone and open a simple app to participate? As the website says, “Each one [smartphone] is equipped with powerful processors and advanced sensors that can track movement, take measurements, and record information — functions that are perfect for medical studies.” Suddenly research can be worldwide, and involve millions of diverse participants, increasing the data’s amount and validity (There’s a crowdsourcing research precedent: lot of us have been participating in scientific crowdsourcing for almost 20 years, by installing the SETI@Home software that runs in the background on our computers, analyzing data from deep space to see if ET is trying to check in)!

Polymath/medical data guru John Halamka, MD wrote me that:

“Enabling patients to donate data for clinical research will accelerate the ‘learning healthcare system’ envisioned by the Institute of Medicine.   I look forward to testing out Research Kit myself!”

The new apps developed using ResearchKit harvest information from the Health app that Apple introduced as part of iOS8. According to Apple:

“When granted permission by the user, apps can access data from the Health app such as weight, blood pressure, glucose levels and asthma inhaler use, which are measured by third-party devices and apps…. ResearchKit can also request from a user, access to the accelerometer, microphone, gyroscope and GPS sensors in iPhone to gain insight into a patient’s gait, motor impairment, fitness, speech and memory.

Apple announced that it has already collaborated with some of the world’s most prestigious medical institutions, including Mass General, Dana-Farber, Stanford Medical, Cornell and many others, to develop apps using ResearchKit. The first five apps target asthma, breast cancer, cardiovascular disease, diabetes and Parkinson’s disease.  My favorite, because it affects the largest number of people, is the My Heart Counts one. It uses the iPhone’s built-in motion sensors to track participants’ activity, collecting data during a 6-minute walk test from those who are able to walk that long. If participants also have a wearable activity device connecting with the Health app (aside: still don’t know why my Jawbone UP data doesn’t flow to the Health app, even though I made the link) , they are encouraged to use that as well. Participants will also enter data about their heart disease risk factors and their lab tests readings to get feedback on their chances of developing heart disease and their “heart age.” Imagine the treasure trove of cardiac data it will yield!

 A critical aspect of why I think ResearchKit will be have a significant impact is that Apple decided t0 make it open source, so that anyone can tinker with the code and improve it (aside: has Apple EVER made ANYTHING open source? Doubt it! That alone is noteworthy).  Also, it’s important to note, in light of the extreme sensitivity of any personal health data, that Apple guarantees that it will not have access to any of the personal data.

Because of my preoccupation with “Smart Aging,” I’m really interested in whether any researchers will specifically target seniors with ResearchKit apps. I’ll be watching carefully when the Apple Watch comes out April 24th to see if seniors buy them (not terribly optimistic, I must admit, because of both the cost and the large number of seniors I help at The Apple Store who are befuddled by even Apple’s user-friendly technology) because the watch is a familiar form factor for them (I haven’t worn a watch since I got my first cell phone, and most young people I know have never had one) and might be willing to use them to participate in these projects.

N0w, if you’ll excuse me, I just downloaded the My Heart Counts app, and must find out my “heart age!”


 

Doh!  Just after I posted this, I saw a really important post on Ars Technica pointing out that this brave new world of medical research won’t go anywhere unless the FDA approves:

“As much as Silicon Valley likes to think of itself as a force for good, disrupting this and pivoting that, it sometimes forgets that there’s a wider world out there. And when it comes to using devices in the practice of medicine, that world contains three very important letters: FDA. That’s right, the US Food and Drug Administration, which Congress has empowered to regulate the marketing and research uses of medical devices.

“Oddly, not once in any of the announcement of ResearchKit did we see mention of premarket approval, 510k submission, or even investigational device exemptions. Which is odd, because several of the uses touted in the announcement aren’t going to be possible without getting the FDA to say yes.”

I remember reading that Apple had reached out to the FDA during development of the Apple Watch, so I’m sure none of this comes as a surprise to them, and any medical researcher worth his or her salt is also aware of that factor. However, the FDA is definitely going to have a role in this issue going forward, and that’s as it should be — as I’ve said before, with any aspect of the IoT, privacy and security is Job One.

 

 

Apple Watch: killer app for IoT and lynchpin for “smart aging”

Wow: glad I put up with all of the tech problems during the Apple product launch today: the Apple Watch was worth it! It really seems as if it will be the killer device/app for the Internet of Things consumer market, and I think it may also be the lynchpin for my vision of “smart aging,” which would link both wearable health devices and smart home devices.

The elegant, versatile displays (it remains to be seen how easy it will be for klutzes like me to use the Digital Crown and some of the other navigation tools) plus the previously announced Health and Home Apps that are part of iOS 8 could really be the glue that brings together Quantified Self and smart home devices, making “smart aging” possible.

Activity AppIt will take some time to learn all about the watch and to see what apps the “Watch Kit” spawns, but here are some immediate reactions:

  • sorry, but I think it could kill the Lechal haptic shoes before they get off the ground: why have to pay extra for shoes that will vibrate to tell you where to go when your watch can do the same thing with its “Taptic Engine”?
  • I think I’ll also ditch my Jawbone UP, as much as I love it, for the Apple Watch: the video on how the Activity and Workout apps will work makes it look incredibly simple to view your fitness data instantly, vs. having to open an app on your phone.
  • (Just dreaming here): if they can pull off that neat “Milanese Loop” band on one of the versions that clamps to itself, what about not just a heart beat monitor, but a band that converts into a blood-pressure cuff? Guess that wouldn’t be accurate on the wrist, anyway, huh?

Wearables/fitness apps & devices market heats up with Google Fit pending launch

Google appears set to give Apple’s pending Health app a run for its money with the forthcoming launch of the Google Fit tools. The competition should really benefit consumers and health care (Google has already released the developer’s kit). In announcing the kit, Google said the new tools will provide:

“… a single set of APIs for apps and device manufacturers to store and access activity data from fitness apps and sensors on Android and other devices (like wearables, heart rate monitors or connected scales). This means that with the user’s permission, you can get access to the user’s fitness history — enabling you to provide more interesting features in your app like personalized coaching, better insights, fitness recommendations and more.”

The releases only cover local storage of data, with cloud storage to follow.  As Forbes notes, that’s where the competition with Apple will be fierce:

Google Fit will integrate with a number of solutions from Google. Your Android powered smartphone or tablet is the obvious first point of contact, but you should also consider Google Fit’s potential integration with Google Glass and the Android Wear smartwatch program. All of these devices can use their sensor suite to gather and relay health data.”

As with Apple Health, Google wants developers and device manufacturers to settle on its standard as the hub for collection and integration of health and fitness data, while it may not be in the individual company’s best interests to commit to a single proprietary standard. As Forbes‘ Ewan Spence predicted, it’s unlikely that any end users are going to change platforms for their devices just because of new health apps and devices.

I guess it would be inappropriate to refer to any potential “killer apps” that could sway anyone in this category, eh?

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Detailing my “Smart Aging” through the IoT vision

The best-laid plans get canceled due to Summer vacation…

I was supposed to speak to seniors (and those who love or care for them!) today in my dear little burg, Medfield, MA, about my “Smart Aging” through the IoT vision. However, the talk has been postponed til September due to the small number of sign-ups. Oh well, I guess most revolutions start with a whimper, not a bang.

Because I believe so strongly in the idea, I’ve posted the talk (including presenter’s notes) to SlideShare.

Basically, it fleshes out what I’ve written in a number of recent posts, that I believe we can and must meld two aspects of the IoT, Quantified Self wearable devices that measure and record personal health and wellness data 24/7 and smart home devices such as the Nest thermostat and Ivee voice-activated base station, to create a new approach to aging. I defined smart aging as:

using senior-friendly home and health technology to cut your health and living costs,
improve your health and quality of life, and keep you in your own home as long as possible.

I predicted that it can “bring unprecedented health and happiness to our senior years — while saving us  money!”

While there have been efforts for a while to specifically use technology to improve aging, I predicted that

“Smart Aging will instead result from tweaking efforts underway as part of the Internet of Things to improve life for everyone, of all ages. As Joe Coughlin, director of MIT’s AgeLab, says, ‘Counterintuitively, making home automation mainstream and cool means that it’s likely to end up in the hands of older adults sooner than if home automation technologies were only designed specifically for older people.’”

(that’s why I suspect that wearables such as the Nike Fuel or prototype MC10 for jocks will be more important for seniors than anything specifically designed for them — and will face fewer obstacles to adoption).

I stressed that there are still important obstacles, not only the security and privacy ones that are essential for ANY IoT product or service, but also some that are specific to seniors, such as preserving their dignity and letting them control who will share access to their data.

I concluded that this approach will pay multiple benefits:

  • Improve your health & fitness
  • Cut your medical bills
  • Build your self-esteem
  • Cut your living costs
  • Let you stay at home, safely.

I’d love to hear your thoughts on this subject.

Will sports-star wearables make them cool enough for general public?

OK, first an admission of guilt: I don’t synch my Jawbone UP every day (although now that my wife and I are sharing results and challenging each other, that’s subject to change).  Evidently, I’m not alone: I read stats somewhere (can’t remember the source) that about 40-50% of all Quantified Self device users stop using them within the first six months.

But that’s not the big problem: that’s the fact that only a very small percentage of the population ever uses the devices at all, despite their benefits for health and fitness.

Part of the answer, IMHO, is making them sooo simple to use that you’d automatically use them (for example, I like the fact that the Lose It! app nags me every day if I haven’t entered my diet, activity, or weight), but the other factor is creating a cool factor about wearables. I read recently about a VC in Silicon Valley who always wears her Jawbone to cocktail parties because it starts conversations, but Silicon Valley VCs aren’t generally regarded as celebrities in the heartland, so I’m thinking more about sports stars.

biostamp

Now there’s a Boston-area startup, MC10, that might just make that breakthrough.  According to The Boston Globe, the company has a number of 1st-rank sports luminaries as investors/advisors, including former NBA star Grant Hill, hoop coach John Thompson III,  Indianapolis Colts quarterbacks Andrew Luck and Matt Hasselbeck, soccer star Kristine Lilly, and four-time Olympic women’s ice hockey medalist Angela Ruggiero.

The company’s first product is the translucent, stick-on Biostamp, due to be released next year. “The device, a barely visible 2-square-inch patch, is designed to stick on any body part like a second skin and record biometric data from heart rate and hydration levels to muscle activity and sleep patterns.”  It’s likely to replace the current, bulky and obtrusive devices for serious athletes. 

According to The Globe, there is about a dozen companies developing similar devices for jocks.

I’ve got a big collection of ball caps (primarily those of The Team That Shall Not Be Mentioned This Year, the one that “plays” [as it were…] @ Fenway Park), and an equal number of T’s from the same guys. Obviously, fans love to bond with their fav jocks by wearing their apparel, so I’m wondering whether the advent of Biostamps and similar devices will lead to fan apparel with similar devices built in, as worn by their favorites (hmmm: somehow I can’t see comparing my caloric intake with Big Papi …).

I see a lot of guys and gals around Boston with gray hair wearing the same gear, so I suspect the same approach might be a more productive way to get seniors to wear such devices than to design ones specifically for them.

This niche bears watching!

 

The New IoT Math: 1 + 1 + 3 — Jawbone UP24 now controls Nest thermostat

A chance conversation about the IoT the other day turned me on to this elegant proof-of-concept that what I call “Smart Aging” to help seniors be healthier and avoid institutionalization is possible: my Jawbone UP bracelet could now control my Nest thermostat (if I had one: with three heating zones in my house, I’m gonna wait until the NEST price drops before I’ll buy them…).

That, ladies and gentlemen, is exactly what I’m talking about with my concept of “Smart Aging” for seniors, which would combine:

  • Quantified Self devices such as Jawbone UPs, Nike FuelBand, the congestive heart failure necklace,  or the Biostamp sensor (more about that one in a future post!) that will easily and unobtrusively monitor your bodily indicators and, if you choose, report them to your doctor, both to improve diagnoses, and to encourage you to adopt healthy practices such as a daily walk.
  • smart home devices such as the NEST or the voice-activated Ivee hub.

Even better, if device manufacturers get it about one of my Essential Truths about the IoT:  who else could use this data?, they will allow free access to their algorithms, and someone will realize that 1+1=3: the two devices are even more powerful when linked! In this case, the Jawbone UP is powerful, and so is the Nest, but something totally new is possible when they are linked:

“By connecting your UP24 with your Nest Thermostat, the temperature of your house will automatically adjust to a temperature you prefer – the moment you go to bed or wake up.

“Through UP Insights, we have shared the fact that an ideal sleeping environment is cooler, between 65 and 72 degrees. With the Nest integration, we no longer just tell you this fact. We make it a reality. Once your band enters Sleep Mode, your thermostat will kick down to your ideal temperature. And when you wake? You guessed it. Your thermostat will automatically adjust to a warmer temperature… all without leaving your bed.”

Nest-2_thermostatJawbone_UpHow cool (or hot, depending on the season…) is that?

I particularly like it for seniors because of one UP feature: instead of setting a precise wake-up alarm, you also have the option of creating a 30-minute window when it it should vibrate to wake you, with the exact time determined by what the UP determines is the ideal point in your natural sleep cycle.  Some working people on extremely tight morning schedules may not want to take advantage of that option, but for seniors, answering to no one but themselves, that would be an added benefit: get the best possible sleep, AND get up in a warm house (oh, and while you’re at it, why not link in some Phillips HUE lights and a coffee pot plugged in to a Belkin WeMo socket, so that you’ll also have fresh-brewed coffee and a bright kitchen?).  Sweet!

Do the math: one IoT-empowered device is nice, but link several more of them, and 1 + 1 = 3 — or more!

Apple iWatch: could they really make wearables acceptable to mass market?

The WSJ had a piece this week speculating on the rumored Apple iWatch (Disclaimer: I work part-time in an Apple Store. In that capacity I don’t know anything you don’t know — including whether the iWatch will actually ever happen! My sources for this blog are limited to publicly-available ones.).

The Journal notes that none of the smart watches released so far have had major penetration, and, as a further cautionary note, I’d point out that most people who start using a Jawb0ne UP, Nike FuelBand, etc. stop using them in several months (HELP: I recently read the data on that claim, but I can’t find the citation. Can you help me find it???).

HOWEVER, as I speculated recently in my posts on Apple’s soon-to-be-released HealthKit and HomeKit, the company has shown time-and-time-again over the past 15 years that it knows how to create disruptive devices (even though Clayton Christensen was skeptical, LOL!) and create huge new markets that make tech devices mainstream.

Given my new-found pre-occupation with “Smart Aging” through a combination of Quantified Self and smart home devices, I really like the idea of a smart watch for seniors. I haven’t worn a watch since I got my first Palm Pilot (wow: remember when they were cutting edge??), but seniors do, and I suspect that if they could get immediate feedback on their vital signs from something that was not only functional but fashionable and didn’t require any technical savvy, they wouldn’t feel stigmatized by wearing the watch, a critical factor in its widespread acceptance.

Let’s see what happens!

 

New #IoT Health Paradigm: Partnership Between Doctor and Patient

With all the Internet of Things emphasis on making “dumb” things “smart,” we shouldn’t ignore how it will make all of us smarter as well.

Nowhere will that be as important as in healthcare, where I believe it will produce a dramatic paradigm shift in which patients will become empowered and will be full partners in their care, improving health, and cutting costs. Today’s post follows up on one I wrote recently focusing on seniors’ health care, which I believe will dramatically improve due to the IoT.

I was provoked to write by the annual report from the Partners (appropriately enough….) Health Center for Connected Health (full disclosure: my wife directs the women’s physical therapy program @ Brigham & Women’s Hospital, part of Partners, although her particular service isn’t working with the Center), which reports on a wide range of initiatives to address key issues such as reducing re-admissions, improving access to care, and helping with the transition from hospital to home.

IMHO, there’s an inevitability to this shift, because the current health care system is unsustainable, at least in the US. Costs are too high, many physicians will retire in the next decade, and the number of seniors is increasing dramatically. Oh, yea: we ain’t getting what we’re paying for either: our health is lousy compared to other nations.

But something amazing happens when people start to track and report their own health indicators, either on their own or as part of the fast-growing Quantified Self movement. As Dr. Joe Kvedar, founder and director of the Center  for Connected Health, says, “People can and do take very good care of themselves when you give them the tools to do so.”

We’ve got the essential tool for this transition right in our hands: the Center for Connected Health has found that 70% of patients in one of Partners’ community health centers have smartphones.

The apps  — there are now more than 100,000 health care ones! — and related devices such as Fitbits, Nike Fuels or Jawbone UPs to monitor health via smartphones still aren’t fully accurate, but they’re still valuable because they do accurately demonstrate personal activity trends, so you can compare your activity from day to day.

And they do change behavior:

“Can trackers really change behavior in people? Last year, Dr. Rajani Larocca, a primary care physician at Massachusetts General Hospital, conducted a six-week lifestyle program for 10 patients with diabetes ages 50 to 70 that included weekly sessions to encourage exercise and healthful eating; each participant also was outfitted with a Fitbit Zip tracker.

“‘Every single person increased their activity,’ Dr. Larocca said. ‘People felt more knowledgeable.’ Eight months later, about half the patients from the group still wear a tracker.

“Researchers at the Center for Connected Health in Boston have been giving activity trackers to subjects for six to nine months, then studying changes in their behavior. Dr. Kamal Jethwani, head of research at the center, said he saw three distinct groups of people among study participants.

“About 10 percent are ‘quantified selfers’ with an affinity for this kind of feedback; just by looking at the numbers, they are motivated to be more active. An additional 20 percent to 30 percent need some encouragement in addition to tracker data to effectively change their behavior.

“But most of the subjects observed by Dr. Jethwani don’t understand the data and need help making sense of it. For them, he said, social motivation from a friend or joining a team or workplace challenge may be more effective.”

As I wrote in my post about seniors’ health care, as soon as we have effective mechanisms to feed the data to doctors the quality of care will improve. It’s like with so many inanimate things whose real-time status we’re able to really observe for the first time with the IoT: doctors will no longer have to rely on our self-reporting (“um, I think that about two months ago I felt out of breath a lot”) or the measurement of vital signs in the artificial setting of a doctor’s office. Instead, they’ll have access to longitudinal data about how you actually live (in fact, Partners introduced a system last year that allows people to electronically upload data to their medical records gathered from devices such as glucometers, blood pressure cuffs, bathroom scales, and pulse oximeters.

It’s a bright — and healthy — new day!

Gotta go now: my Jawbone UP tells me I’ve got to walk to CVS and the post office to meet my 10,000 steps per day target….

PS: If you’re ready to test the waters, check out the Center’s Wellocracy.com site to learn about self-monitoring devices and how to use them!