Robots as companions: Are we ready?

Nao

Nao

Some people on Earth seem to think so. In fact, they believe in the concept so much, they are actually building the world's first personal robot that can read & respond to human emotions. A collaboration between French robotics firm, Aldebaran, and Softbank mobile from Japan. You may already know one of Aldebaran's existing robots, Nao. The new robot is called Pepper, is due to launch in Japan in February 2015, and is priced at 198,000 Yen. Using today's exchange rates, that's approximately $1,681 and £1,074, although only the Japanese launch has been confirmed for now. Pepper may be sold in the USA through Sprint stores at some point. The notion of a robot in your home that can interact with you, and even tell you a joke if you're feeling sad, attracted my curiosity. So much so, that in September 2014, I hopped on a train from London to Paris. 

Me & Pepper in Paris

Me & Pepper in Paris

Why Paris? Well, the world's first home robot store opened in Paris this summer, called Aldebaran Atelier, and they had Pepper in the store. You can't buy any of the robots in the store just yet, it's more a place to come and learn about these robots. 

So what's Pepper like? You have to bear in mind that the version I interacted with in Paris is not the final version, so the features I saw are not fully developed, especially the aspects of recognising who you are, and getting to know you and your needs. The 3 minute video below shows some of the interaction I had. For now, Pepper understands English, French and Japanese. 

A bit more about how Pepper works. In the final version, Pepper will be able to understand 5 basic emotional expressions of the face: smiling, frowning, surprise, anger & sadness. Pepper will also read the tone of your voice, the verbage used, as well as non verbal communication such a tilting your head. So for example, if you're feeling sad, Pepper may suggest you go out. If you're feeling happy, Pepper may sing a song and do a dance for you (more on that later). According to a Mashable article, "Pepper has an 'emotional engine' and cloud based artificial intelligence". The article also states, "The cloud AI will allow Pepper to share learnings with cloud-based algorithms and pull down additional learning, so that its emotional intuition and response can continually improve. It's either a technological breakthrough or the most terrifying robot advancement I've ever heard of."

Some facts and figures for you; 

  • 4 feet tall, and weighs 61 lbs/28kg

  • 12 hour battery life - and automatically returns to charging station when battery is low

  • 3D camera which senses humans and their movements up to 3 metres away

In the press kit I was given at the store, it's stated that "Pepper's number one intention is about being kind and friendly. He has been engineered to meet not functional but emotional needs." 

It's not just speech and movement that Pepper responds to, it's also touch. There are sensors on the upper part of his head, upper part of his hands and on the tablet attached to his chest. Pepper may be talking to you, and if you place your hand on his head, the way that you would with a child, Pepper will go quiet. Although, when I tried it, Pepper responded by saying something about sensing someone was scratching his head! 

The creators anticipate Pepper being used to care for the elderly and for baby sitting. What are your thoughts? Do YOU envisage leaving your elderly parent or young child with Pepper for company whilst you do some chores or dash to the supermarket? I told Shirley Ayres, Co-Founder of the Connected Care Network, about Pepper. Her response was; "I'd prefer a robot companion to 15 minutes of care by a worker on minimum wage struggling to provide quality care on a zero hour contract."

Given aging populations, and the desire for many to grow old in their own home, rather than an institution, are household companion robots the answer to this challenge? As technology such as Pepper evolves, will a robot at home be the solution to increasingly lonely societies? Will we really prefer the company of a household robot versus another human being? Will we end up treating the purchase of Pepper the same way we treat the purchase of an Ipad? Will your children buy you a Pepper so they don't have to visit you as often as you'd like? The CEO of Aldebaran, Bruno Maisonnier, believes they will sell millions of these robots. Apparently, they'll be able to make a profit from the sales of robot related software and content. Apps for robots?

Pepper does have all sorts of sensors so it can understand humans as well as understand the environment it's operating within. I understand it will collect data, but it's not clear to me, at this stage, exactly what would be collected or shared. Just because Pepper seems kind and friendly, doesn't mean we should not consider the risks and benefits associated with any data it collects on us, our behaviours and intentions. There could be immense benefits from a robot that can 24 hours a day remind an older person when to take their medications, and potentially collect data on when doses are being skipped and why.

An Institute of Medicine panel has just recommended that "Physicians should collect more information about patients' behaviour and social environment in their electronic health records." Some of the information the panel recommends collecting include "whether they are experiencing depression; their social connections and sense of social isolation." Is technology such as Pepper the most effective route to collecting that data? Do we want a world where our household robot sends data to our doctor on how often we feel sad and lonely? Perhaps for those of us too afraid to reach out for help and support, that's a good thing?

My brief interaction in Paris with Pepper was fun and enjoyable, a glimpse into a possible future. With it's childlike gestures and ability to monitor and respond to our emotions, could we as humans one day form emotional attachments to household robots? Here is the video of Pepper wanting to play some music for me in the Paris store. 

One does wonder how the introduction of these new robots might impact jobs? What does technology such as Pepper mean for human carers? A recent report from Deloitte forecasts that 30% of jobs in London are at high risk from automation over the next 20 years. It's low paid, low skill jobs that are most at risk. Microsoft is trying out a different robot called K5 from Knightscope as security guards in their Silicon Valley campus. In Japan, Pepper has been used by Softbank to conduct market research with customers in a Tokyo store. Nestle is planning to use Pepper to sell coffee machines in 1,000 of it's stores across Japan by the end of 2015. Here is the video showing how Pepper might work in selling to consumers in Nestle's stores. 

Now, some of us may dismiss this robot technology as crude and clumsy, with little or no potential to make a significant impact. I personally think it's amazing that we've reached this point, and like any technology, it won't stand still. Over time, it will improve and become cheaper. We are at a turning point, whether we like it or not. Does Pepper signify the dawn of a new industry, or will these household robots be rejected by consumers? How are household robots treated by the law? Do we need to examine how our societies function rather than build technology such as Pepper? Are we becoming increasingly disconnected from ourselves that we need Pepper in our homes to connect with ourselves as humans? Does the prospect of having a robot like Pepper in your own home with your family, excite you or frighten you?

Given the intense pressure to reduce costs in health & social care, it would be foolish to dismiss Pepper completely. So in the future, will we also see companion robots like Pepper stationed in hospitals and doctor's offices too? Can personal robots that connect with our emotions change how we 'deliver' and 'receive' care?

[Disclosure: I have no commercial ties to any of the individuals or organisations mentioned in the post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

Sensors: What value do they add?

That was the underlying question throughout the Body Computing conference (BCC) last Friday in Los Angeles. The conversation in Digital Health is maturing, and the question facing all parties is, what's in it for me? Investors want to know if there are significant returns to be made, entrepreneurs want to know if they will be rewarded for taking risks, physicians want to know if clinical decision support will be helped or hindered, and consumers want to know if they can prevent disease or better manage an existing disease. That's just a few of the interested parties. Many more are curious about the potential value of sensors that could collect data about each of us in real-time. 

I really enjoyed listening to the talk by Dr David Beiser during the session on virtual visits. When we think about sensors and the type of data we might be able to collect on people and how frequently, he really made me stop and think with this one question.

Do we need to be collecting more data on people? Even though we have lots of data already, it's sometimes not enough to answer questions that arise in pharmaceutical research. For example, I regularly use a database with the health insurance claims for 100+ million Americans. It sounds like a huge database, right? Well, if I have to answer a question which involves a rare disease and/or a rare event, even this seemingly giant database sometimes doesn't have enough patients available to analyse. Could we one day have a database which captures health data in real-time on the health of not just an entire country, but multiple countries? Is that going to be the made possible by existing organisations? Or will be it be done by new organisations that bypass traditional infrastructures and develop new methods of both collecting, sharing and making sense of these data? New organisations such as British startup, uMotif, whose founder & CEO, Bruce Hellman spoke at BCC and announced their plans to create the world's largest health self-management dataset. 

As mentioned in my last blog post, my slot to speak at the conference was on Consumer Wants & Needs, and I shared the results of my survey. Over the course of 4 days, 886 people had opened the survey, but only 86 had responded, giving me a response rate of 9.7%. Not bad for an impromptu survey over a couple of days. The slides below reflect responses one week after the conference, now with 94 responses. Looking at the geodemographics of responders.

  • 62% were outside the USA

  • 60% were men

  • 92% were between 25-55

I acknowledge the results are not representative of the population as a whole, given that I didn't get anyone aged 65 or older responding (and that group is likely to contain the heaviest users of health & social care). 

I asked 7 questions about sensors, and the answers to these 4 questions in particular were of most interest to me.

  • Would you wear a smartwatch if it could improve your health? 81% said Yes

  • Would you considering implanting a sensor under your skin if it could improve your health? 49% said Yes

  • Would you want a smartphone to diagnose illness without having to visit a doctor? 74% said Yes 

  • Would you share data from your body if you got paid to share the data? 57% said Yes

I deliberately allowed only an answer of Yes or No to my questions when designing the survey. As it turns out, I received feedback from people who told me they didn't respond to the survey, as there wasn't an option to answer 'Maybe' or 'It depends'. Especially regarding the question on sharing data from your body if you were paid for that data. For example, their answer might change depending upon whether it's Google vs their hospital wanting to buy their data. Including a 'Maybe' option in future surveys is something I will definitely do, I wonder how many of the people who answered 'No' in my survey were actually 'Maybe'. Some people even emailed me to request that there be a option to answer each question with free text, as they had many questions and concerns that they wanted to share. This experience only serves to remind me that understanding the wants & needs of consumers is not cut & dried. 

I was surprised at how many people said Yes for the smartwatch question, given that the smartwatches already in the market are not particularly good, and it's such a new market too. I know of organisations developing sensors that would be implanted underneath our skin, and I'm also surprised to see almost half of people would consider the implanted sensor. When it comes to the idea of a smartphone diagnosing illness without having to visit a doctor, I'm not surprised at all. Using the healthcare system can often be 'disruptive' to your life. Making an appointment, waiting a week or more for the appointment, taking time off work for the appointment, and so on. When it comes to being paid to share data from your body, I wonder if I had made that a two part question, with the second part of the question asking which organisation you would be most willing to share your data with for payment. 

As I said before. this survey was an experiment, and the combination of user feedback and the initial results compel me to undertake more surveys in the future. It appears to me that consumers may be more open to sensors than we think. I'd also like to drill down deeper over time to ask how people feel about sensors in particular settings or scenarios. Interestingly, the questions I asked relate to future of medicine as envisioned by Dr Eric Topol, whose recent talk at AHIMA centred around the 'rebooting' of medicine, in which he sees access and ownership of medical data shifting from physicians to consumers through the proliferation of smartphones and health apps. I love this powerful statement from Topol's talk, "You are your data but more importantly each individual needs to own their data. That’s where we need to be."

What do you think of the results of my survey? What question(s) do YOU think I should be asking next time?

Big Pharma & Sensors

The pharmaceutical industry is often one of the most risk averse groups in healthcare. However, I found a talk (video is below) given in April 2014 by Professor Patrick Vallance, President of R&D at GSK to be very illuminating. The talk was about looking ahead to 2025. Now, when Vallance talks about monitoring of patients in clinical trials, he believes the future will be "Invisible, wearable devices with real-time data collection."  At BCC, Stuart Karten's session was on "Design: The Future is Not Wearable…It’s Invisible" with a great recap of Karten's session here. 

When Vallance speaks about patients, he remarks that "patient influence will become much more evident". Mentioning sensors in the context of drug safety, Vallance also talks about a future which involves, "Instant feedback in terms of surveillance of medicines post-launch, with various sensing devices/monitors, and listening to patients in real-time, much more than we are able to do at the moment". Why would the President of R&D at the world's 4th largest pharmaceutical company be talking this way publicly if sensors have limited value both now and in the future? Perhaps it's the work that GSK has been doing with McLaren Applied Technologies that is behind these perspectives on the future?

Moving forwards

This coming week, there are two events which are relevant to this conversation. Kaiser Permanente, is hosting an event in Washington, DC where they discussing a future where we could receive care anywhere. The event looks at both current & emerging technologies. 

The second event is Cisco's Internet of Things World Forum in Chicago. I attended last year, and found it useful to understand what Cisco and their partners are doing in this space. 

It really is incredible to see how sensor technology is evolving, and to see organisations working towards a future where billions of devices might be connected together. These converging forces could potentially impact health & social care. However, there are barriers to unlocking this value, and one of the biggest is standards (or lack of them). Today, within health & social care, we already suffer from systems that don't talk to one another, even in the same building. It's extremely frustrating for everyone involved. Then we hear about these new sensors, new devices and new software interfaces and we wonder, where are the standards? How will all these different devices talk to one another? Will I be forced to be buy all my products from one vendor in order for everything to work seamlessly? Actually, there are multiple standards emerging. A great article from Joe McKendrick highlights these different standards being proposed for the Internet of Things. It's early days and it's not clear which will become the preferred standard. 

With the consumerisation of health & social care, who will be the organisations that will serve our needs over the next decade and beyond? Will it be the existing players in health & social care, or will it be the 'interlopers' as Don Jones (who helped conceive the Qualcomm Tricorder XPRIZE) mentioned in his talk at BCC on 'The bleeding edge of mobile'? Or will it be a combination of these different types of organisations working together? Will this shift happen primarily in the USA or will it take place in other countries too? Which country will lead the world with research and development of sensor technology? Will it be a different nation that leads the world in the deployment of these sensors in real-life settings?

We are all hopeful of what sensors might do for us, but ultimately, like so many new technologies in health & social care, we're going to need to see evidence of it's value, as well as finding someone willing to pay for this innovation. This is likely to be easier in some markets than others, given the impact of austerity measures on budgets across Europe. Your appetite for risk as well as how much trust you have built with consumers could determine whether you're part of the future or left behind in the past. The choice is yours. 

[Disclosure: I have no commercial ties to any of the individuals or organisations mentioned in the post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

Sensors: What do consumers want & need?

[Link to the survey is here]

We keep hearing more about developments in the world of sensors which hope to be able to monitor our health in between visits to the doctor. Some of the most prevalent sensors in 2014 are those in wearable technologies such as wrist based trackers which monitor how far you've walked or how much you've slept. In 2015, Apple's watch is due to launch, offering more of that but in a sleeker design. Will they add further sensors to the watch over time? There is much excitement about these technologies, but what problems do they actually solve? Are we building the right technology for the right people at the right price? Is this a sustainable market or merely a bubble? Is all of this technology socially desirable? What do consumers around the world actually need?

Many of us forget to take our medications, especially as we get older. This causes problems not just for us as patients, but for the people that are caring for us. What if we could have a smart pill that could tell notify others automatically that we have taken our medication? It's already been invented by Proteus Digital Health. I still find myself in awe when thinking about how far we have come, and wondering where we might go next?

Socks that measure how much pressure we place on different parts of the foot, cars that can monitor our health, even our homes. The dream of the Internet of Things is that we will move to a world where tens of billions of devices are connected powered by machine to machine communication. At the moment, it is a dream but companies are entering this space, and exploring how to build the ecosystem that allows this dream to become a reality.

Now, our bodies generate data 24 hours a day, 7 days a week. Imagine a world where sensors on our bodies, in our environment or even inside of our bodies could harness this data stream and use it to improve not just our individual health but the health of the world. 

That's the vision behind the Center for Body Computing at USC. It's the home of the Body Computing conference (BCC), set up by Dr Leslie Saxon in 2007. That's the same year that the first iPhone was launched. We need visionaries like Dr Saxon to challenge our thinking, and to create environments which enable us push the boundaries of what we believe is possible, even if that does upset some of the traditional thinking in health & social care. I first attended the conference in 2012, and it's one of my favourite events to attend. I wrote about my 2013 experience.

This Friday, Dr Saxon once again hosts BCC, only this year, I'm not just attending, I'm speaking there! A privilege and an honour. 

I'm on a panel titled "The State of Venture Investment in Digital Health and the State of Consumer Wants and Needs". I'm speaking on consumer wants and needs. I believe the patient/consumer voice is still not heard as frequently as it could be, which is what drives me in my research to refine my understanding of what people around the world really want from all this new technology.

Do people feel comfortable with a world where machines know more about their health than their doctor? Do people feel comfortable with sensors that are implanted under the skin or even swallowed? What aspect of their health do people want to monitor the most? Do people want a world where sensors embedded in their cars, homes and offices monitor the state of their body? Do people worry about how these new sources of data may be used against them?

I want to be able to capture the pulse of the world and share those opinions at BCC. This is where I would like your help. From San Diego to Sydney, from New York to New Delhi, from Accra to Abuja, I want to understand your needs, desires and concerns. I want your voice to count!

I want to harness the insights of the crowd through an online survey I'm launching today. 

The link to the survey is here.

Please could you share the link to the survey via your networks. I've never done this before, so it's an experiment. I hope to get responses from as many different countries as possible. 

I'll be sharing the results of the survey at BCC, and I'll be publishing the results in a blog post next week. My hope is that I can repeat this survey at regular intervals to see how consumer wants & needs evolve.  

[Disclosure: I have no commercial ties to any of the individuals or organisations mentioned in the post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

Finding a signal within the noise

Apple's new iPhones and their new watch. That's what dominated the technology headlines last week. More firms are planning to enter the smartwatch space. In health & social care, what value do these smart watches actually add? The Apple watch claims to be able to track our activity levels, with new fitness and workout apps. Sounds great for those who want to monitor their activity or monitor their workouts in the gym or whilst jogging. I wasn't blown away by the keynote and I began to wonder how useful are these health & fitness features for someone whose job involves sitting for the entire working day? Bus drivers, taxi drivers, truck drivers? How useful is the Apple watch for someone confined to a wheelchair? Add a price of $349 for the watch and that you need your iPhone nearby the watch to use all the functions, and I wouldn't blame you for concluding that the reality of the Apple watch doesn't match the hype. Has it been designed by the 'worried well' for the 'worried well'? Are the primary beneficiaries those of us with above average income/education, who are digital savvy and already engaged with our own health? What value Apple's watch will add to health & social care? Only time will tell. 

Technology for Parkinson's disease

For me, what's remarkable, is that last week, there were three advancements in the development of technology for Parkinson's disease (PD) that didn't grab the headlines the way the Apple watch did. The main symptoms of PD are tremor, rigidity and slowness of movement, and it's estimated that between 7-10 million people around the world are living with PD. There are no lab tests to diagnose PD, no cure, and we don't know what causes PD. 

The first advancement was at the British Science Festival, where Dr Max Little gave an update on his work for the Parkinsons Voice Initiative. He'd already developed the technology to test for symptoms using voice recordings alone, more in his TED talk. He's gone one step further now, by using smartphones to track how the disease progresses in those that have PD, collecting data on voice, location & movement every 20 microseconds. He is now conducting larger trials to evaluate the technology, and he has said, "This new kind of remote data analysis will help patients monitor their conditions on a minute-by-minute basis from the comfort of their own homes".

We often hear talk about bringing the hospital into the home, and it's encouraging to see someone actively working on that. What I find particularly fascinating is Dr Little is interested in developing a tool "that could potentially provide specific feedback to people on symptoms that matter to them". The research has been going on for 8 years, and it reminds me that every problem in health & social care can't be solved with a weekend hackathon.

The second advancement is an activity tracker from Australia called the Parkinson's KinetiGraph Data Logger that allows automated reporting of a PD patient's movements. It's just been approved by the FDA in the USA. The device is prescribed to a patient, who wears it on their wrist, and it can collect data for 10 days, after which it's downloaded by the physician. This wearable technology offers physicians the ability to know much more about changes in a PD patient's movements outside of the doctor's office. The device even vibrates and reminds patients to take their Levodopa medication, and records data on when the patient took the medication. Remember that in my testing of the new Android Wear smart watches, an app already exists that allows me to get medication reminders on the watch, and to record when I have taken or skipped my dose. For many in the world of health, wearable technology is just a buzzword with little or no value, and I can understand their perspective. It's easy to dismiss this emerging area of computing, but dismissing it entirely might be foolish.

The third advancement was that Google X bought Lift Labs, joining the Life Science division. What do Lift Labs make? Their product, Liftware, is a spoon that vibrates to stablise tremors, which makes it much easier for people with PD to eat. The founder of Lift Labs, Anupam Pathak, "sees the technology being extended to other everyday objects, as well as extending the diagnostic capabilities to be able to monitor tremors over time." Google X is the part of Google that runs their most ambitious projects. Many of the people I meet who are experimenting with new technology in health & social care, are driven because of personal experience or a family member's experience. The mother of Sergey Brin (one of Google's co-founders) has PD, so I find this acquisition of Lift Labs most fascinating. Once again, time will tell what they bring out in the future. You can see more in the video below.

Finding the signal

Finding the signal within the noise of Digital Health is increasingly a challenge. The three advancements I listed above could both improve the quality of life for PD patients as well as enable a deeper understanding of this disease. They are not just cool technologies, but designed to solve real problems associated with different aspects of PD. 

Now, Apple's watch might offer extra features once it's launched, but for now, it's health features leave people wondering, "Is that it?". What problems does it solve that existing technology does not? 

How do we evaluate and test emerging technologies in Digital Health? This fledgling industry is evolving so rapidly that many organisations I speak to are struggling to keep up with the pace of change. How do we determine what offers sustainable value? One of the steps that seems to be missed is about understanding needs. Do we truly understand what doctors, nurses and other frontline staff want? Do we truly understand what patients want? Do we truly understand what the ordinary consumer wants?

Is the Digital Health industry at times trapped in the dogmatic perspective that the system is always wrong, and startups are always right? 

On top of that, do we actually have a genuine understanding of the underlying problems facing us in health & social care? I meet so many organisations that believe by making services 'Digital', everything will be transformed. I challenge that mindset. Have you stopped to examine whether the underlying process or service is flawed? Merely 'digitising' an existing process or service isn't going to help in the long term. It makes your process looks shiny and modern, but it's fundamentally still a flawed process. 

This week, it was announced that two US hospitals are working with Apple to trial the use of the new HealthKit platform with patients that have diabetes and other chronic diseases. Apple have built up amazing levels of trust with consumers around the globe by delivering a simple but great user experience. Could they do the same with health & social care? Many of us are excited by the possibility that companies with no track record in health, such as Apple, could transform aspects of healthcare delivery, but it's too early to tell. As Dan Diamond points out, an unsustainable hype cycle built up for the Apple watch, and another is building up in advance of the iPhone 6 release this Friday with regard to what the new iPhone can do for our health. 

In a thought provoking article by Darius Tahrir, which questioned the benefits of Digital Health, Julia Adler-Milstein, a professor in the School of Information at the University of Michigan said “There’s a risk of backlash against the technology: we were promised all these benefits, and we’re not seeing them”.

Evidence based medicine is the bedrock of modern healthcare systems, so how can we practice evidence based Digital Health? What evidence do we need to help us find the signal within the noise? Is the health of the Digital Health industry at risk if we don't take steps to generate, evaluate and share the evidence?

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

Will the home of the future improve our health?

According to BK Yoon, that would be one of the benefits in their vision of the 'home of the future'. Who is BK Yoon? He's President and CEO of Samsung Electronics. Last Friday, I listened as he delivered the opening keynote of IFA 2014, which is the largest consumer electronics and home appliance show in Europe.

Whilst many talk of bringing healthcare out of the hospital/doctor's office into the home, Samsung, in theory, have the resources and vision to make this a reality at a global level. Samsung Group, of which Samsung Electronics is the biggest subsidiary, have just invested $2 billion in setting up a biopharmaceuticals unit. Christopher Hansung Ko, CEO at the Samsung Bioepis unit. said in an earlier interview, “We are a Samsung company. Our mandate is to become No. 1 in everything we enter into, so our long-term goal is to become a leading pharmaceutical company in the world.” 

Is South Korea innovative?

My views on Samsung (and South Korea overall), changed when I visited Seoul, the capital of South Korea during my round the world trip in 2010. I had only scheduled a 3 day stopover, but ended up staying over 3 weeks. I was impressed by their ambitions, their attitude towards new technology and their commitment to education. Their journey over the last half century is truly amazing. "Fifty years ago, the country was poorer than Bolivia and Mozambique; today, it is richer than New Zealand and Spain." Bloomberg released their Global Innovation Index at the start of this year. Guess which country was top of the list? Yup, South Korea. The UK was ranked a lowly 16th.

After my visit, I left South Korea with a different perspective, and have been paying close attention to developments there ever since. I believe many people in the West underestimate the long term ambitions of a company like Samsung. Those wishing to understand the future, would be wise to monitor not just what's happening in Silicon Valley, but also in South Korea. 

Aging populations worry policy makers in many advanced economies. Interestingly, recent data shows that South Korea's population is aging the fastest out of all OECD countries. Maybe that's one of the drivers behind Samsung's strategy of developing technology that could one day help older people live independently. 

We've been hearing about smart and connected homes for many years, and one wonders how this technology would be integrate with our lives. How easy would it be to set up and use? How reliable would it be? Would I have to figure out what to do with all these data streams from the different devices? I used to believe that Apple was unique in really understanding the needs and wants of the consumer, but it seems Samsung have been taking notes. They have conducted lifestyle research with 30,000 people around the world. The results of that research were shared after they keynote. Whilst reading the reports, one feels like Samsung Electronics is now trying to position itself as a lifestyle company, not a technology company. Whether it's one of the opening statements, "The home of the future is about more than technology and gadgets. It's about people." It's about responsive homes that adapt to our needs, homes that protect us, homes that are empathetic. How much is all of this going to cost us, right? Is it only going to be for the rich? Is it only going to work with new homes, or can we retrofit the technology?

Data driven homes - is that what we truly want?

Their research also says, "Technology will promote eating and living right. Devices around the home will inspire us to make decisions that are right for our bodies, taking an active role in helping us achieve better health by turning goals into habits." So in Samsung's vision, the fridge of the future will inform you that some of the food inside has expired and needs to be thrown away. Where do we draw the line? What if you come home from work hoping to grab a beer from the fridge, but the fridge door is locked, because the home of the future knows you've already consumed more than your daily allowance of calories?

Do we actually want to live in data driven homes? Our homes are often an analogue refuge in an increasing digital & connected world. We have the choice to disconnect and switch off our devices and just 'be'. What if part of our contract with our energy provider or home insurer is having smart home technology installed?

In a recent survey of Americans aged 18+ for Lowe's, 70% of smartphone/tablet owners want to control something inside their home from their bed via their mobile. Obesity is already a public health issue not just in the USA, but in many nations. Will being able to switch on the coffee pot, adjust the thermostat and switch on the lights by speaking into your smartphone whilst lying in bed lead to humans leading even more sedentary lives in the future? 

However, there is a flip side. Rather than just dismiss this emerging technology as silly or promoting inactivity, these advancements may be of immense benefit to certain groups of people. For example, would the home of the future enable someone who is blind, disabled or with learning difficulties a greater chance to live independently? Would the technology be useful when you're discharged from hospital after surgery?

Is it just about the data?

One of the byproducts of these new technologies for our homes, are data. Sensors and devices which track everything we do in the home are going to be collecting and processing data about us, our behaviour and our habits. Samsung to mention in their research "Our home will develop digital boundaries that keep networks separate & secure, protecting us from data breaches, and ensuring that family members cannot intrude on each other's data." It all sounds great in a grand vision, but turning that into reality is much harder than it appears.

We expect to hear about Apple's HealthKit later today. Who will you trust with the data from your home in the future? Apple, an American corporation or Samsung, a South Korean corporation? Or neither of them? Is the strategy of connecting our homes to the internet simply a ploy to grab even more data about us? Who will own and control the data from our homes? Where will it be stored? 

Despite the optimism and hope in BK Yoon's keynote, I can't help wonder about the risks of your home's data feed getting hacked, and what it means for criminals such as burglars, or even terrorists. Do we want machines storing data on the movements of each family member within our own home? Or will tracking of family members who are very young or very old, in and around the home, give families peace of mind and reassurance?

Ultimately, who is going to pay for all of this innovation? Even today, when I talk to ordinary hard working families about new technologies, such as sleep tracking, I'm conscious it's out of the reach of many. For example, the recently launched Withings Aura system allows you to track and improve your sleep. It's priced at $299.95/£249.95. If given the choice, how many ordinary families would invest in the Withings Aura to improve their sleep vs buying a new bed from Ikea for the same price?

The video below was played during the keynote, and gave me a glimpse into Samsung's vision of the home of the future. BK Yoon claimed that the future is coming faster than we think. He seemed pretty confident. Only time will tell. 

How does this video make you feel? Does Samsung's vision make you excited and hopeful, or does it frighten you? Do you look forward to a home that aims  to protect you and cares for your family? How comfortable do you feel with your home potentially knowing more about your health than you or your doctor? How will the data about our health collected by our home integrate with the health & social care system? Will the company that is most successful in smart homes be the one that consumers trust the most?

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

How do we measure health?

I saw a tweet which made me really think about our existing approaches to measuring our health. 

Morgan Gleason is a 15 year old girl who lives in the USA. She was diagnosed with a rare disease, Juvenile Dermatomyositis (JDM) at the age of 11. From her website, "The main symptoms of JDM are weak or painful muscles, skin rash, fatigue and fever." I wonder how many other Morgans are out there? How many feel that their voice as a patient needs to be heard?

I speak to patients regularly as part of my research in Digital Health, and many of them tell me when they visit their doctor, what they want is health. Not Health IT, Digital Health, Health Outcomes, but plain and simple Health. There is too often a tendency for those in health & social care, in whatever function, to prioritise on what makes their lives easier, what makes the system more efficient or even what allows them to increase profitability.  

We're hearing more and more talk about data driven health. For the last decade, I've worked with epidemiologists and health economists in the pharmaceutical industry to use patient data the USA, UK, France & Germany to help decision makers understand how drugs are used in the real world. My work has contributed to speeding up drug development and helping to make drugs safer. So, what kind of data on patients? Typically, data from 'real world settings', i.e. the doctor's office or the hospital. One of the most common types of research projects I've worked on, has been to use these databases to help researchers understand the natural history of a particular disease.  For example, when I look at the data, I can answer questions such as;

  • When were patients diagnosed?

  • What the patients were diagnosed with?

  • Were the patients treated after diagnosis?

  • If so, what kind of drug?

  • Were lab tests ordered?

  • If so, what were the results?

  • When patients were hospitalised?

  • How long the patients were hospitalised for?

What's frustrating for me and others is that the existing data collected from doctor's offices and hospitals doesn't show the full picture of a patient's health. If I have to look at medication adherence, and if the database shows that some patients don't have a repeat prescription for their medication when they're supposed to, why is that? 

The transactional data currently available from healthcare systems doesn't tell me WHY. With 'Big Data' being frequently part of  conversations about innovation in health & social care, collecting even more of the same type of data doesn't seem logical. There are major gaps in existing 'Big Data', and for me, that's patient generated health data (PGHD). It's the marriage of 'hard' data from the system and 'soft' data from the patients that could be the key to meeting the challenges ahead of us.

How do individuals measure their health?

What value might be unlocked if we understood how different people measure their health? The system might currently measure someone's health based upon clinically validated instruments, i.e. blood pressure, blood glucose, cholesterol, and so forth, but how do people measure their own health? More importantly, how can the system accommodate data such as whether Morgan is able to ride her horse or not? 

mindbodysoul.jpg

More and more people have been using activity trackers such as Fitbit to track how active they are, and even using the social elements of the app to compete with their friends and family. Some are even sharing the data & insights gained from their Fitbits with their doctors. For many medical professionals, the data from consumer devices such as Fitbit has limited or no clinical value, even if they had systems which could incorporate such data into the patient's record. The array of hardware and software increasingly becoming available to consumers to monitor aspects of their health is largely unproven. So what to do? 

It's fascinating to read about Dr Josh Umbehr, a doctor in the USA who not only welcomes patient generated data from devices such as Fitbits, but has built his own computer system in his practice which can accept data from a patient's Fitbit. “We don’t know what all this data means, yet,” Umbehr said, “but I can discuss it with the patients and we can both follow it.” 

I have much sympathy for over worked doctors who are apprehensive about dealing with these new streams of data. Whilst patients collecting all sorts of (unvalidated) data about themselves sounds great in theory, it could be dangerous if used and interpreted in isolation. I even ran a Health 2.0 London event in 2013 entitled, "Information Obesity: A possible side effect of Digital Health?" Having to deal with patient generated health data could even put physicians at risk, as Sue Montgomery points out, "providers could be held liable if they don’t review all information in the patient’s record—if this lack of review leads to misdiagnosis or other patient harm."

However, do patients wishing to share data from their Fitbit signify the emergence of a new era where patients can themselves choose to capture (and share) data that is important to them? Thinking back to the patient databases I work with, if I observe that a patient doesn't visit the doctor for 6 months, does that mean during those 6 months they were healthy, they were well? 

What new discoveries might happen if patients were able to bring data into the system that measured health based upon their own experience? Would that future involve having to reboot Health IT infrastructure as we know it? There is already the pioneering personal health record system called Patients Know Best developed in the UK, which in March 2014 had the ability to integrate data from 100 devices and apps.

However, should we limit patient generated data to structured data like number of steps or number of hours slept? In a thought provoking post about patient generated health data, Dr Scott Nelson says, "Unstructured data gathering tools like Apple’s Siri could be used to capture and store patient verbal input and feedback on regular basis. This unstructured data could be parsed into structured formats that could then be automatically organized, analyzed, and visualized for doctor’s use at the time of care." 

If patients like Morgan were able to use Siri to measure their health simply by speaking into the phone, why aren't we offering that to patients today? Would you feel comfortable sharing how healthy you are feeling by speaking into your phone? Who is thinking about the patient data in the form of digital diaries, video, audio, pictures? Are we heading towards a world where the data on your smartphone will reveal more about your health than the data collected during your visits to the doctor?

Understanding human health

If medicine revolves around disease, what if we could measure and maximise wellness? Dr Lee Hood in the USA aims to see if we could with his 100K Wellness Project. It's an ambitious study that aims to enroll 100,000 people over the next 20 years (subject to funding). What I find fascinating is that Dr Hood wants to quantify "wellness". 

Do we have to reboot the entire system of medicine to truly understand human health? New research suggests people with friendly neighbours and strong community ties are less likely to suffer heart attacks. When was the last time your doctor asked you how friendly your neighbours are? When was the last time your doctor asked you if you feel like you belong to a community? Even if they did ask you these questions, where on the paper form do they record such information?

Where have you lived? In Bill Davenhall's TEDMED talk in 2009, he shows how where have lived can impact our health. Yet, our place history is not in our medical records. Now, an electronic health record (EHR) is defined as a systematic collection of electronic health information about an individual patient or population. Ironically, when EHRs are being developed, how many stop to ask patients how THEY measure their health? 

It's encouraging to read of a system that is building technology today which allows us to understand what's important to a patient. For example, the Hudson Center for Health Equity & Quality have developed a "system that captures patient data on who the patient actually is, what is important to the them and what’s preventing the patient from getting the necessary care." We need more institutions to take these bold leaps forward. 

The future

Whilst it's clear that health & social care systems are being stretched beyond their limits, what's not clear is how we prepare our people, policies & processes to be able to cope with an increasingly complex and uncertain future. Just because we've measured our health in a certain way up till now, do we keep doing the same in future years? Can we really accommodate the needs of all stakeholders? Who will be the winners and losers in this new era? Technology is merely the tool here, and probably the simplest factor in the equation. Ultimately, it's the combination of people, policies and processes moving in tandem that will trigger the change many of us are hoping will occur. 

Moving forward won't be simple or easy. Yes, change is typically tough to navigate and often downright terrifying. However, the inspiring Sir Ken Robinson reminds us that "imagination is the source of all human achievement". Yet, the most dangerous words I keep hearing from decision makers in health & social care are "We've always done it this way". Is your organisation tapping into the imagination of your employees?

I'm curious to know what health means to YOU, and how YOU measure your own health? Feel free to leave a comment below, reply to me via Twitter or email. 

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

The paradox of privacy

in , , ,

When you're driving the car, would you let an employee from a corporation sit in the passenger seat and record details on what route you're taking, which music you listen to and the text messages you send and receive? 

When you're sitting at home watching TV with your family, would you let an employee from a corporation sit on the sofa next to you and record details on what types of TV shows you watch? 

When you're in the gym working out, when you're going for your daily walk, would you let an employee from a corporation stand alongside you and record details on how long you walked, where you walked, and how your body responded to the physical activity? 

I suspect many of you would answer 'No' to all 3 questions. However, that's exactly the future that is being painted after the recent Google I/O event. Aimed at software developers, it revealed a glimpse of what Google have got planned for the year ahead. New services such as Android Wear, Android Auto, Android TV and Google Fit promise to change our lives. 

In this article titled 'Google's master plan: Turn everything into data!", David Auerbach appreciates how more sensors in our homes, cities and on our bodies is a hugely lucrative opportunity for a company like Google. "That information is also useful to companies that want to sell you things. And if Google stands between your data and the sellers and controls the pipe, then life is sweet for Google."

In a brilliant article by Parmy Olsen, she writes about the announcement at I/O about Google Fit, a new platform. "There’s a major advertising opportunity for Google to aggregate our health data in a realm outside of traditional search". Now during the event, Google did state that users would control what health and fitness data they share with the platform. Let's see whether corporate statements translate to actual terms & conditions in the years ahead. 

Do we even realise how much personal data are stored on our phones?

Do we even realise how much personal data are stored on our phones?

Why are companies like Google so interested in the data from your body in between doctor visits? As I've stated before, our bodies generate data 24/7, yet it's only currently captured when we visit the doctor. So, the organisation that captures, stores & aggregates that data at a global level is likely to be very profitable, as well as wielding significant power in health & social care. 

Indeed, it could also prove transformative for those providing & delivering health & social care. In the utopian vision of health systems powered by data, this constant stream of data about our health might allow the system to predict when we're likely to have a heart attack, or fall? 

Privacy and your baby

When people have a baby, some things change. It's human nature to want to protect and provide for our children when they are helpless and vulnerable. For example, someone may decide to upgrade to a safer car once they have a baby. We generally do everything we can to give our children the best possible start in life.

If you have a newborn baby, would you allow an employee from a corporation to enter your home and sit next to your baby and record data on it's sleeping patterns? In the emerging world of wearable technology, some parents are considering using products and services where their baby's data would be owned by someone else. 

Sproutling is a smart baby monitor, shipping in March 2015, but taking pre-orders now. It attaches to your baby's ankle, and measures heart rate and movement and interprets mood. It promises to learn and predict your baby's sleep habits. You've got an activity and sleep tracker for yourself, why not one for your baby, right? According to their website today, 31% of their monitors have been sold. The privacy policy on their website is commendably short, but not explicit enough in my opinion. So I went on Twitter to quiz Sproutling about who exactly owns the data collected from the baby using the device. As you can see, they referred me back to their privacy policy, and didn't really answer my question. 

The paradox

What's fascinating is how we say one thing and do another. A survey of 4,000 consumers in the UK, US and Australia found that 62% are worried about their personal data being used for marketing. Yet, 65% of respondents rarely or never read the privacy policy on a website before making a purchase. 

In a survey by Accenture Interactive, they found that 80% of people have privacy concerns with wearable Internet of Things connected technologies. Only 9% of those in the survey said they would share their data with brands for free. Yet, that figure rose to 28% would share their wearable data if they were given a coupon or discount based upon their lifestyle. 

Ideally, there would be a way in which we as consumers could own and control our personal data in the cloud and even profit from it. In fact, it already exists. The Respect Network promises just that, and was launched globally at the end of June 2014. From their website, "Respect Network enables secure, authentic and trusted relationships in the digital world". Surely, that's what we want in the 21st century? Or maybe not. I haven't met a single person who has heard of Respect Network since they launched. Not one person. What does that tell you about the world we live in?

Deep down, are we increasingly becoming apathetic about privacy? Is convenience a higher priority than knowing that our personal data are safe? Is being safe and secure in the digital world just a big hassle?

A survey of 15,000 consumers in 15 countries for the EMC Privacy Index found a number of behavioural paradoxes, one of which they termed "Take no action", "although privacy risks directly impact many consumers, most take virtually no action to protect their privacy – instead placing the onus on government and businesses". It reminds me of an interaction I had on Twitter recently with Dr Gulati, an investor in Digital Health. 

What needs to change?

Our children are growing up in a world where their personal data are going to be increasingly useful (or harmful), depending upon the context. What are our children taught at school about their personal data rights? It's been recently suggested that schools in England should offer lessons about sex and relationships from age 7, part of a "curriculum for life". Shouldn't the curriculum for life include being educated about the intersection of your personal data and your privacy?

We are moving towards a more connected world, whether we like it or not. Personally, I'm not averse to corporations and governments collecting data about us and our behaviour, as long as we are able to make informed choices. I like how in this article about the Internet of Things and privacy, Marc Loewenthal writes "discussions about the data created are far more likely to focus on how to use the data rather than how to protect it". Loewenthal also goes on to mention how the traditional forms of delivering privacy guidelines to consumers aren't fit for purpose in an increasingly connected world, "They typically ignore the privacy notices or terms of use, and the mechanisms for delivering the notices are often awkward, inconvenient, and unclear".

When was the last time you read through (and fully understood) the terms and conditions and privacy policy of a health app or piece of wearable technology? So many more connected devices, each with their own privacy policy and terms and conditions. Not something I look forward to as a consumer. The existing approach isn't effective, we need to think differently about how we can truly enable people to be able make informed choices in the 21st century.

Now, what if each of us  had our OWN terms and conditions and privacy policy and then we could see if the health app meets OUR criteria? We, as consumers, decide in advance what we want to share, with whom, and what we expect in return. How would that even work? Surely, we'd need to cluster similar needs together to perhaps form 5 standard privacy profiles? Imagine comparing three different health apps which do they same thing, but you can see instantly that only one of them has the privacy profile that meets your needs? Or even when browsing through the app store, you choose to only be shown those apps that match your privacy profile? That would definitely make it easier for each of us to be able to make an informed choice. 

Things are changing as it was revealed last night that Apple have tightened privacy rules in their new operating system for people developing apps using their new HealthKit API. An article cites text pulled from the licence, developers may "not sell an end-user's health information collected through the HealthKit API to advertising platforms, data brokers or information resellers," and are barred from using gathered data "for any purpose other than providing health and/or fitness services."

Apps using the HealthKit API must also provide privacy policies.

This news is definitely a big step forward for anyone who cares about the privacy of their health data. Although the guaranteed link to a privacy policy doesn't necessarily mean it will be easy to understand for consumers. I also wonder how companies that develop health apps using the HealthKit API will make money, given current business models are based around the collection and use of data. 

Will the news from Apple make you more likely as a consumer to download a health app for your iPhone vs your Android device? Will it cause you trust Apple more than Google or Samsung? Have Apple gone far enough with their recent announcement or could they do more? Will Apple's stance lead to them becoming THE trusted hub for our health data, above and beyond the current healthcare system?

How can we as individuals do more to become aware of our rights? As well as the campaigns to teach people to learn how to code, should we have campaigns to teach people how to protect their privacy? When commentators write that privacy is dead, do you believe them?

We're heading towards a future where over the next decade it will become far easier to use sensors to monitor the state of our bodies. Would you prefer a future where my body=my data or my body=their data? The choice is yours.

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

Will Android Wear impact health & social care?

Android Wear was shown on stage at Google I/O in June 2014. What is it? It's a version of Google's Android operating system but for smartwatches and other wearables. At the moment, you need to connect the smartwatches to your Android phone via Bluetooth in order for them to work, and you'll need a phone that's running Android 4.3 or above. 

The first two Android Wear devices were launched early in July. The Samsung Gear Live and the LG G watch. I ordered both, and have been using them for the last month. I'm particularly interested to understand what the potential of these devices in health & social care might be. 

In the demo at Google I/O, a some of the demos made me think of how they might impact health & social care. One demo was was ordering pizza by speaking into your phone (1 hour and 30 seconds in the video below) and the other was ordering a taxi by speaking into your phone (1 hour, 3 mins and 30 seconds in the video below).

Interestingly, the two apps which demonstrated these features are currently only available if you're in the USA. 

So, which patients would benefit from this service? How might these features be repurposed? Instead of calling a taxi, in the future, could a patient use an Android Wear watch to call for a nurse from their hospital bed? Could a older person in a care home use an Android Wear watch to order their favourite meal?

To use Android Wear with an app, you download an app from the Play Store onto your phone and the 'wearable' portion of that app is sent to your watch. There are a limited number of Android Wear compatible apps available so far.

An example of the screens that appear with the Medisafe app 

An example of the screens that appear with the Medisafe app 

At launch, the one that interested me the most was Medisafe, a medication management solution. You use the app on the phone to enter which medications you're supposed to take, the dose, and the times. Once you do that, the reminders pop up on the watch. The photo shows you the flow of the reminders on the watch. We already know that patients don't adhere to their prescribed medications or they skip doses, and that's it's a big problem. From a data perspective, the first sign that a patient is not adhering to their treatment regime, might be because they they haven't come back for a repeat prescription after a set period, for example, 30 days.

When I tested the Medisafe app, and noticed you can tap on the 'Skip' icon on the watch, I had a thought. Given the watch is connected to Google, what if when tapping on 'Skip', the watch would ask you why you are skipping a dose? What if you as a patient are able to speak in your own words WHY you've skipped the dose? Imagine if that data as free text could make it back to the patient's electronic medical record in real-time? What insights could these data provide? Could these patient generated data enhance 'active surveillance' of the safety of drugs?

Naturally, Android Wear is in it's infancy, and there are many challenges, but I wonder which organisation will be the first to experiment and to take the risk in exploring these new frontiers? I applaud MediSafe for being the first Digital Health app for Android Wear. 

What is Android Wear like in every day use? 

I like getting notifications on my wrist. For example, when a new email arrives, the watch vibrates gently, and I swipe the screen to read the email, and can even reply by speaking into the watch. It's also possible to get turn by turn directions on your watch. I spend a lot of time in Central London attending meetings, so I've found it useful to say to the watch 'OK Google Navigate to <destination>', and get turn by turn directions on the watch, with the phone in my pocket or bag. 

The attachment for each watch, which are needed in order to charge them.&nbsp;

The attachment for each watch, which are needed in order to charge them. 

There is a reason I ordered two Android Wear watches. I knew in advance the battery life was likely to be very limited. I was right, I find that whether I wear the Samsung or the LG watch, they don't last the day. So, I wear both watches, one is switched on during the working day, and then I switch to the second watch from the evening onwards. Until they can release a watch which actually lasts a few days or a week, this is still very much only for early adopters. 

On top of that, current engineering dictates the need for an attachment which attaches to the back of each watch, in order to connect to the charger. Lose that piece of plastic, and you're stuck with a dead watch. The charging experience needs to improve drastically, if these devices are to become consumer friendly.

Living in a big city like London, where I often travel late at night by public transport, I find it much safer using Android Wear watches. Why? Well, if I'm on the train or walking down the street, and I get an email or even a call, I can read and respond without even taking my phone out of my pocket. However, using Android Wear in public places is not without problems. Background noise is an issue. I was on a train last week showing friends how it worked, and the noise of my friends talking meant that speaking into the watch took several attempts before it actually understood what I was saying. As I brought the watch closer to my face, and was speaking to it, I noticed an older lady a few seats ahead of me, who looked at me like I was insane. Can you imagine an era where many people in trains are speaking into their watches? 

I was in an office showing the capabilities to a friend, when I attempted to show him I could send him a text simply by speaking to the watch. I tried to send a text which said, "You're in hot water", and the watch seemed to translate that as "urine water". Luckily, you have a chance to cancel the text or email by tapping the watch, whilst it's in the process of being sent. 

You can see from my video below, that even in a quiet environment, that asking the watch to send a text to 'Doctor' [pre-programmed contact in my phone] doesn't work the first time I try it.

For those that like to monitor your steps, you can see your steps by saying 'Ok Google show me my steps'. It almost feels like a step backward in user experience. That's a time when I want a button! In fact, the LG does not have an on/off button, as it's designed to be 'always-on'. I prefer the Samsung which does have an on/off button. 

The Samsung Gear Live has a heart rate sensor, whilst the LG does not. I was at the gym yesterday, clearly out of breath having just did a sprint on the treadmill. Upon finishing the sprint, I said 'OK Google measure my heart rate' to my watch, it returned back a reading of 61bpm, which is even lower than my resting heart rate. If Android Wear devices add more sensors to monitor our health, how can anyone be confident that the data are accurate?

How can Android Wear make an impact? 

Right now, these smartwatches are crude, clumsy and seriously flawed. During a month of testing, they are often more dumb than smart. Many of you will simply see Android Wear as a gimmick, and regard the devices as having no value in health and social care. Today, no value but what about tomorrow, next week or next year?

Remember the app that was launched called Yo, which raised a $1 million in funding. At first glance, the app appeared to offer little value or utility. However, it has been used by Israeli programmers to allow people in Israel to get notifications of incoming rocket attacks. A husband in California recently used wrist based wearable technology to monitor the health of his wife who is comatose. 

You may remember a post I wrote in May 2014 exploring the concept of using technology such as the Samsung Gear Fit to allow patients to have wireless electronic wristbands for hospital stays. I remember some hospital doctors dismissing my idea as absurd. Recently, Apple were granted 58 patents, one of which relates to a wireless hospital wristband which could transmit data to a smartphone. 

It's already possible to control lights at home with Android Wear, as can be seen in this video. When see that, I wonder how Android Wear could help those with limited or no mobility? As this technology evolves (and it will evolve rapidly), how might Android Wear help not just patients, but healthcare professionals and carers? Will we ever see apps for Android Wear developed and launched by hospitals?

In the 21st century, organisations that appear innovative don't always manage to respond as quickly as they'd like to new ideas. Take British Airways, who have pioneered the use of wearable technology on flights by trialling 'happiness blankets' that allow you to monitor how you're feeling when you're flying. Yet, they're letting Delta and American airlines be the pioneers, when it comes to allowing passengers to download their boarding pass to the Android Wear watch [Although, using Android Wear as your boarding pass isn't as easy as it sounds]

Some of us are waiting for the Moto 360 smartwatch to launch, which promises to be a bit more sophisticated than the current Samsung/LG watches. Others await the anticipated smartwatch from Apple. One barrier to Android Wear watches becoming successful, is that they need to be paired with a rather expensive smartphone with a data plan. 

Surely, the ideal smartwatch would be one that could connect to the internet on it's own? Now that sounds like science fiction. Not according to AT&T's Head of Emerging Devices, Glenn Lurie, who predicts that by the end of this year, wearables will have their own cellular connections, and be independent of smartphones.

In fact, just last week, Timex have introduced a smartwatch that has it's own 3G connection and doesn't need a smartphone to work. It's aimed at runners, and doesn't have the notifications or voice input of Android Wear devices, but imagine if the 2015 Android Wear watches also have their own 3G connection? Can you envisage a future scenario where this technology could benefit health and social care? Are there risks associated with embracing Android Wear that we are not considering? Which will be the next Digital Health app on Android Wear?

What new possibilities might be created by these developments? What will this space look like in 12 months time? Could these devices be a new source of real-time patient generated data? Or will Google's Android Wear ultimately fail due to privacy concerns? Would you feel comfortable with a watch attached to your skin that in the future may be streaming data from your body back to Google?

areyouready.jpg

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner

Robots in health & social care: Terrifying or marvellous?

I appreciate it's a tough time for doctors, facing increased pressure and scrutiny, from both payers and patients. They work so hard and make so many sacrifices along the way in order to practice medicine. Add to the mix that outsiders are developing technologies which may impact the delivery of care. Rock Health estimates that people with doctoral or medical degrees make up fewer than 20 percent of all CEOs of funded digital health companies. How will the established healthcare system react to outsiders who are 'disrupting' existing processes and procedures? Will they protest on the streets in the same manner as the taxi drivers across Europe last week, who are upset about the impact of consumers using the Uber app on their industry?

The perceived threat

The relentless progress of technology can be frightening. When I have spoken before about the possibility that one day doctors could become unemployed due to advancing technology, I've observed a whole range of reactions. When I even discuss the possibility of doctors being replaced by robots powered by artificial intelligence, many take the view that this is a preposterous idea. How dare we imagine a world where human doctors are replaced by machines & algorithms?

Now, if this was such a preposterous idea, with zero chance of every occurring in the future, the system would just ignore it, right?

In the USA, National Nurses United launched a campaign to alert the public to the dangers of hospitals using algorithms and unproven medical technologies. The video [below] they have put together is actually very thought provoking. The fact that they've invested time, effort and money into this campaign suggests to me that do indeed feel threatened by the potential impact of advancing technology. 

Depending upon how you view the future, robot nurses & doctors could be just a few decades away or unlikely to ever happen. Can we state with any certainty which path the development and adoption of robots will take in healthcare? I don't believe so. As AstraZeneca state on their website, "Predicting the future of healthcare is virtually impossible". It's sensible to consider all the possible future scenarios, not just the scenarios we feel comfortable with. 

One of the drivers behind exploring robots in healthcare is to understand if it could reduce medical errors. A hospital in the UK has brought in a robot to combat "serious" human errors in handing out prescriptions. 

Who is pushing the boundaries?

If you want to get a glimpse into the future of robots in healthcare, take a look at Japan. A country with the highest proportion of citizens aged over 65 on the planet. They are also leaders in robotic technology. For the Japanese government, their focus will be on the use of robots in nursing care. In 2020, Japan will host the Olympics, and is possibly going to host 'Robot Olympics' at the same time. Given that Dementia is increasingly challenging for healthcare systems globally, are robots the future of eldercare? Bristol Robotic Laboratory in the UK believe their robot, Molly could be part of that future. The video is truly eye opening. 

Softbank in Japan plan to sell a robot called Pepper, which is claimed to be the first robot that can recognise human emotions and respond to them. 

What does all of this mean?

The recent documentary, Power to the patient, opens with these sentences, "The relationship between doctors and patients is about to change dramatically. Modern technology enables patients to become their own personal healers, with the doctor as advisor".

Now, it may be the case that human doctors & nurses never become unemployed. However, if technology continues to advance at the same pace, what patients want from doctors & nurses may change. Even though the the United States’ National Robotics Initiative (NRI) seeks to integrate robotics to assist rather than replace nurses and physicians, the NRI’s language doesn’t specifically forbid healthcare organizations in the U.S. from seeking to completely replace nurses and doctors. 

What will systems under extreme cost pressure do if one day robots can do much of what doctors & nurses do today? Will the doctors who refuse to work with new technology have fewer opportunities? Will the successful doctors & nurses of the future be the ones that can work with robots & algorithms to deliver the care which serves patients' needs? What would training at medical school look like? How might the relationship between patients, doctors and nurses change? How will the power dynamics change? If there is conflict in decision making, whose verdict will reign supreme? Human or Robot? What if patients get emotionally attached to a robot caring for them at home 24/7? Can robots truly care for us?

Whilst people happily buy modern cars which are assembled by robots, would those same people feel comfortable if some aspects of health & social care were delivered by robots? Do you agree with Peter Diamandis, who envisions a future where patients prefer a robot rather than a human surgeon to perform cardiac surgery? NASA are developing a robot which could one day perform life saving surgeries on astronauts in space. 

Fact from fiction

I attended an event at Nesta in London last week, "Humanising the robot society", which I really enjoyed. In a few weeks, I'm attending an event at Policy Exchange in London, "Rise of the Robots: What skills will we need in the future economy and how do we get them?". What's fascinating is that the second event has David Willetts MP, Minister for Universities and Science as the first speaker. If robots truly aren't going to impact our lives, why would these two high profile organisations waste their time even discussing these possible scenarios? 

We must be mindful that it's easy for scientists to make grand claims about the future of Artificial Intelligence and robots. It's hard for members of the public to distinguish facts from hype. How do we have informed discussion? Perhaps the events in London are the way forward?

Technology, as always, can serve to both improve and undermine the quality of our lives. I believe the development and adoption of robots could have serious ramifications for everyone in society over the next few decades, not just those in health & social care. For some the rise of the robots seems terrifying, for others it seems marvellous. What's your view? 

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]

Enter your email address to get notified by email every time I publish a new post:

Delivered by FeedBurner