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!

 

TellSpec: IoT device that can be a life-saver — and the killer app!

Posted on 10th December 2013 in design, environmental, health, Internet of Things, M2M

Whenever someone tries to dismiss the Internet of Things as a nice future vision, I love to rebut them with an example — such as the bassinettes in the Toronto Hospital for  Sick Children that allow doctors to diagnose a life-threatening infection a day before there are visible symptoms — that shows the IoT’s not only a reality, but is also saving lives!   That usually stops them in their tracks.   .

Now there’s a great new example on the horizon: the TellSpec food inspector.

In fact, because of the service’s three components, I’d say it’s a near-perfect example if you want to introduce the IoT to someone! Once in widespread use, it might well be the “killer app” that finally makes the IoT a household phrase — extremely useful (and easy to use), affordable, and allowing you to do something that couldn’t be done before.

For a variety of reasons, the rate of food allergies is increasing alarmingly, and adults with gluten allergies or parents whose kids are allergic to peanuts can’t always depend on package labels or appearances to warn them of when a given food may trigger a deadly attack of anaphylaxis. Then there’s the rest of us, who are increasingly dubious about whether our foods include pesticides, transfats or other unwanted substances. Or, we may just want to track our calorie consumption. TaDa! The TellSpec!

The crowd-sourced (yea! The people know best) system is a a classic IoT service, because it combines:

  • a device: the TellSpec scanner, which is small enough to go on a key chain — and would have been impossible without the revolution in sensors and nanotechnology (specifically, nanophotonics): its guts are a low-power laser and a spectrometer on a chip that measures the reflected light, analyzing any food’s chemical composition in less than 20 seconds. This kind of analysis used to require a bulky, stationary spectrometer.
  • analysis in the cloud: the data is transmitted to the cloud, where an algorithm analyzes the spectrum information. As you can imagine, doing this kind of analysis on a large scale and in real time was impossible until the cloud.
  • the app: within seconds, you get an easy-to-understand message that details the food’s components, such as transfats, caloric content, allergens, etc.

How cool is that?

The system is in prototype right now. They’re taking pre-orders now, for delivery in August. The scanner plus a year of the analysis support will be $320, and after that, it will cost $7.99 per month or $69.99 yearly. My normally acceptable range of cost for an app is $.00 or less, LOL, but even a cheapskate like me realizes that this is well worth the price.

What a marvelous invention, and what a proof of concept!

As always, I’m indebted to Postscapes for the tip on this one.

Best quick intro to the IoT that I’ve seen!

Following up on my last post, I’ve found what I think is the best quick intro to the Internet of Things!

Internet of Things,” released today by the Center for Data Innovation (hadn’t heard of them! BTW, they also get points in my book for covering XBRL, the magic potion for data…) is a quick read: it has short intros to most of the major consumer-oriented areas affected by the IoT, from healthcare to home automation, combined with two examples for each of those topics. I hadn’t heard of some of the examples (thanks, authors Daniel Castro and Jordan Misra!), although most are frequently cited ones ranging from the Nest thermostat to the Vitality GlowCap.  All in all, they’ll show almost any skeptic that the IoT is already a reality and that it will change their life!

The report concludes with brief policy recommendations for government and business alike:

  • (for government agencies) lead by example, i.e., include funding for sensors in bridge projects, etc. Yea (you listening, Obama Administration?).
  • reduce barriers to data sharing (this harkens back to my Data Dynamite book: data gains value by being shared!).
  • give consumers access to their data (again, something I wrote about in Data Dynamite).
  • avoid inundating consumers with notices (a fine line, since they need to be informed, in plain English, about how their data will be used).
  • regulate the use of data, not the collection (in line with Mercatus Center’s advice)

All in all, a nice intro to the IoT!

BTW: Thanx to ol’ friend Pete O’Dell for turning me on to this report!

$100 billion potential savings in medical costs: more evidence for GlowCap!

Posted on 2nd July 2013 in government, health, Internet of Things

In the draft of the article on the Internet of Things that Cisco’s Dave Evans and I hope to sell to the Harvard Business Review, the lede (BTW, I love old newsie terms, like “pieing the type”…) is about reducing the waste in medical spending by improving patients’ compliance rate with drug compliance through use of the Vitality GlowCap, my favorite poster child for the IoT. glowcaps_loops

If you aren’t familiar with the GlowCap, it fits on a regular pill bottle, but has an important difference: each one has its own IP address, and includes a sensor, transmitter and battery.It’s preset for the time when you and your doctor agree you should take the pill.

When it’s time to take your pill, the cap begins to glow and  makes a gentle sound. As soon as you take the cap off and replace it, a signal is sent to the company’s server where it is recorded: you and your doctor both get reports of your rate of compliance (for the first time, the doctor actually knows if you’ve taken your pill: no guesswork!). But if you don’t take it, the sound and light become more insistant, and continue for two hours. Then, if you still haven’t taken it, you and/or a caregiver or relative get an email, text or recorded alert. How cool is that? By pressing on the bottom of the cap you can even place an automated request to your pharmacy to refill the prescription! Bottom line? With the GlowCap, studies show that patient compliance increases from an average of 50% to 85%.

According to these new numbers from the IMS Institute for Healthcare, that’s HUGE: they estimate that failure to take pills on time results in $100 billion in wasted health care spending annually

I’m still dubious about the nirvana of IoT refrigerators that will prepare my shopping list for me (I’m more the kind of chef who, about 2 hours before dinner, starts to wander the online recipe sources for something I’ve never made before: until my refrigerator becomes psychic, I’m not holding my breath…), but the GlowCap is just the kind of IoT device that can truly make our lives a little simpler, and save money — and lives — in the process!

P.S.: I’ve tried it myself. It really works.

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New IDC report says IoT has reached tipping point for government

As you may know, I’ve been critical of the Obama Administration in the past for ignoring the Internet of Things’ potential. Maybe this report will light a fire under them!

IDC has just released a major report, The Coming of Age of the Internet of Things in Government. Research Director Massimiliano Claps concludes that:

“The Internet of Things is reaching a tipping point that will make it a sustainable paradigm for practical applications. The public sector’s use of the IoT is still limited but emerging strongly in the transport, public security, and environmental sustainability domains …. IoT applications in the public sector can span a variety of domains: public security, defense, environmental protection, transport, and health. In each of these domains, connected objects can provide situational awareness that can help citizens and government personnel act and react at the operational level, monitor the status or behavior of people and assets to make management decisions, and support very fine-grained, sensor-driven analytics that help with planning decisions.”

Couldn’t agree more!

The report says that despite the IoT’s promise to revolutionize a wide range of governmental services, most of the applications to date have focused on environmental monitoring, transportation and security. “The limitations have to do as much with the early stages of the technology as with the management approach to using it.”

It cites some of the emerging m-medicine services that promise to both improve patient care and reduce costs such as around-the-clock mobile vital signs monitoring.

The Coming of Age of the Internet of Things in Government urges agencies to:

“…consider multiple management factors that will influence the ability to harness the benefits of IoT, including the volume, variety, velocity and value of data that are going to be generated, the massive scale of the infrastructure, the complexity of governance, the financial sustainability and the legal aspects.”

I hope this report will prove the impetus for a major new emphasis on governmental applications for the IoT!

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