Geared Up For Health

  • Eric Dishman is wound up about incontinence. That's not a typical concern around Intel's Portland, Ore., campus, where most of the 14,500 employees are preoccupied with building smaller and faster computer chips. But Dishman, 35, a vibrant sociologist with tight tufts of light brown hair, heads Intel's Proactive Health Lab. His mission is to use technology to assist people with the "activities of daily living"--getting dressed, making meals and so forth — so that we can all age with dignity and stay home with loved ones as long as possible.

    Why not? Computers help us do just about everything else. Shouldn't they also make our lives easier in our golden years? The concept has far-reaching implications. "Did you know that almost two-thirds of all people enter nursing homes because of falls and incontinence?" asks Dishman, his mind whirling, "and about 80% of incontinence cases could be solved with timed voiding [that is, encouraging someone to use the toilet before a problem occurs]. The big question"--the question Dishman is hoping to answer--"is, How do you design intelligent reminders that don't embarrass people and that help them live better lives?"

    Dishman is also racing to come up with sophisticated technologies to help keep us from overtaxing the medical system. With the number of people over age 65 set to double in the next 25 years, our already overburdened health-care system is at risk of toppling entirely. Potential products range from vibrating shoes that aid with balance to talking pillboxes that remind you when it's time for your next dose. "You get these horrifying statistics, like the cost of health care will go up five times in the next seven years unless you can keep people out of those emergency rooms and out of doctors' offices," says Sandy Pentland, co-founder of the Center for Future Health and former academic head of M.I.T.'s Media Lab. The solution among the cognoscenti is simple home-based technologies — that is, wiring your world for health.

    Already, futuristic health-care devices are leaping off the drafting boards. Among the new inventions currently in circulation that could improve your well-being: the LifeShirt, a vest that monitors cardiac, pulmonary and respiratory activity as well as posture; the M2A capsule, a pill that when ingested reports on the functioning of your intestines; a nurse bot named Pearl that will take your vital signs and retrieve basic items; and the Health Dashboard, inspired by the dashboard in your car, which displays everything from environmental metrics like the pollen index and flu trends to personal data like blood pressure, cholesterol levels, exercise patterns and drug compliance.

    As is often the case, the technology is getting a jump start through the military. At M.I.T., Pentland, for one, has been building devices for the Army as part of the Warfighter Physiological Status Monitoring program, including, according to Pentland, gear to be worn by every soldier that would report back to officers "who's on the ragged edge, who's not." Sensors track hydration, heart function, sleep status, psychological status, tremors and blood flow because the Army, like a family, wants to account for the health of its members and prevent bad situations by catching problems early.

    For civilians, basic tabletop systems are already available. Sheila Teylor, 43, of Mirando City, Texas, has been using a device called the Health Buddy from the Health Hero Network. Every day the Health Buddy asks Teylor, a diabetic, a series of simple questions — such as, Have you been following a low-salt diet?--and then relays her responses, along with her body stats like blood pressure and weight (taken separately), to her doctor. The system automatically tells the doctor which patients are having problems and creates a Web page that Teylor and her family can use to monitor her health. As a result, Teylor and her support system are better informed, and she's less apt to eat foods like salt that are harmful to her.

    The data on telehealth, as this technology is called, are impressive. According to Craig Lehmann, dean of the School of Health Technology and Management at Stony Brook University and an adviser to Viterion, maker of a device similar to the Health Buddy, "One hundred percent of the literature supports that compliance of individuals with chronic ailments goes from 30% to 35% when they check in with a nurse or doctor over the phone to about 95% to 98% when those numbers are transported automatically." Not everyone is a saint, of course, and some people do try to cheat the system by, say, putting a hand on a table to take five or 10 pounds off their weight when they step on the electronic scale. But even so, telehealth promises to help individuals stay better connected to the medical system, their health and their families, with greater convenience and less expense.

    There are still many issues to work out: how to protect privacy, how to deal with the Health Insurance Portability and Accountability Act (which stipulates that transferring health information electronically confers liability), how to structure reimbursement, how to lower prices and, most important, how to deal with the changing demands of the health-care system and what that means for all involved. "You might think that many patients would be reluctant to trade a doctor-patient interaction for a small electronic device," says Joseph Coughlin, founding director of the M.I.T. Age Lab, "but just the opposite appears to be the case. We've done a number of studies with Harvard and here at M.I.T., and people don't want to give the devices back."

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