Anna could not figure out what is wrong with her: in spite of being generally healthy, she has been sweating during sleep for days, she had lost some weight although she gave up her diet a while ago and she has been feeling mortifyingly tired for a while. It was not only her who noticed these symptoms but also her smart home: the sleep tracker mattress, the microchip in the toilet which detected some elevated lab markers in her urine, the smart scale measuring the weight loss and the digital mirror which noticed the darkening circles under her eyes. Then suddenly she received an invitation by email to see the doctor – based on the information Anna’s smart home sent to him. Although she thought it might just be the result of her stressful work, according to the data collected by the sensors, these series of symptoms might point to cancer which she and her doctor might catch in its earliest stage.
This story is not from a science fiction movie, but how the future of healthcare will look like. In spite of common belief this future does not lie in shiny, post-modern hospital buildings with huge, terrifyingly omniscient devices but rather in small devices with disruptive technologies which bring care home.
There are already signs which point into this direction: IBM Watson analyzes large amounts of unstructured data, sensors bring health information to smartphones, digital stethoscopes and video consultation let patients get help from a distance and drones deliver medical equipment to underdeveloped regions.
However, patients with a chronic condition, who meet medical professionals once in a while, but are left alone in the majority of their time, have not experienced the benefits of such medical development yet. The same applies to people who feel healthy and only visit the GP once a year or only go to specialists when they feel actual symptoms and realize health problems.
In the future, this will change completely due to increasingly powerful and affordable sensors and due to such devices and services which cut out the “middlemen” of GPs or clinicians (such as 23andme or Heal) from the healing process.
Why should healthcare come home and how will it happen?
Nowadays there is a revolution of wearable health devices, but their successful utilization requires technical skills. Users struggle with Bluetooth connections, the adequate usage of apps and sometimes it is difficult to analyze data without having a medical background. Thus, the installation of automated sensors which do not require the user’s constant attention makes perfect sense.
As all imaginable devices grow smarter, instead of placing sensors on purpose all over the house, the personal articles such as televisions, smartphones/tablets but also showers, sinks, toilets or fridges will automatically be installed with sensors which will be able to communicate with each other and to compare data to the already existing information stored in clouds. These devices will be able to notify their users when some measurements are off, moreover they will also be able to send suggestions how to change lifestyle routines, they will be able to alert medical professionals in case of emergency or to notify doctors if the patients do not get better even though they are adhering to the prescribed treatments.
SPHERE (Sensor Platform for Healthcare in a Residential Environment), an Interdisciplinary Research Collaboration (IRC) with the vision of establishing a common platform of nonmedical/environmental sensors to impact a variety of healthcare needs, believes that sensors can be categorized into three types – and two of them constitute archetypes of home sensors: (1) indirect ones, which are able to detect human behaviour through home energy use; (2) remote ones, specifically detecting human behaviour through video monitoring; or (3) on-body sensors for monitoring purposes as well as energy harvesting and management.
Certain elements of the “health internet of things” already exist. We can easily navigate through an ultramodern apartment and place sensors to almost every room. For example, you can place CubeSensors – small, very simply designed cubes all over your apartment, and they will analyse all the important aspects of your indoors. The smart cubicle measures air quality, temperature, humidity, noise, light, air pressure – and based on your personal information it adjusts the relevant factors for optimizing your well-being at home. It is your own fairy-godmother without the annoying condition that everything disappears after midnight.
Smart sensors will help you through the day
You wake up in your bedroom, and your smart sleep monitors tell you the quality of your sleep (and it could also wake you up at the best time to make sure you are energized in the morning). Afterwards, you go into the kitchen to have breakfast and your morning coffee. There could be smart forks and spoons that either teach you how to eat slowly; or let people with Parkinson’s disease eat properly again. Scanners could measure the ingredients, allergens and toxins in your food and let smartphone applications help control our diet. There could be 3D food printers using fresh ingredients and create pizza, cookies, or almost any kind of final products just like what Foodini does these days.
After breakfast, you go into the bathroom, you can brush your teeth with a Kolibree smart toothbrush analyzing whether you are hydrated or not; and giving rewards for cleaning your teeth long enough to count. When you go into the shower, your smart home could bring the temperature down by using a smart device like Google Nest. And it is only the beginning!
Imagine toilets with microchips similar to the MC10 biostamps, sensors logging movement patterns, bathroom sensors following patterns of water usage, digital mirrors measuring basic vital signs – and you already arrive at Anna’s story.
Obviously, there are hundreds of other ways as well how personalized prevention would be made possible in order to help people live longer and healthier.
Smart homes could mean the solution for the elderly and those living alone
In Japan, an estimated 6.24 million people aged 65 or older were living alone in 2015, exceeding the 6 million mark for the first time, according to a welfare ministry survey released in July 2016. In the island nation, there are already clean-up crews specializing in cleaning apartments where lonely people died unnoticed. Some experts believe that there are already 40,000 of these cases and they think that in 10 years, it is likely to go over 100,000 cases. Sometimes weeks go by until someone notices these “lonely deaths”.
Smart homes can be the answer to avoid such heartbreakingly sad, unnoticed deaths as well as to give back the independence for the elderly who are left for their own by their families or friends for some reasons. Violetta Roberts, who lives in the United States and whose home is full of sensors and trackers, which in case of irregularities send e-mail alerts to her nurse, said in a report that she decided to try the smart home project because she did not want to be in a coma for three days without somebody knowing about it.
Violetta’s home is connected with sensors by the Healthsense company in the frame of a pilot project. Healthsense already monitors 20,000 lives on a daily basis in assisted living communities, and last year they decided to expand into private homes. Although there might be false signals, the overall data from the pilot project looks promising. A cohort of 34 older adults who used the Healthsense monitoring system had around 50 percent fewer emergency room visits and hospital admissions than those with similar health issues who did not have the sensors.
And it is not purely the result of the data-collecting devices per se, it is also the psychological effect that you can feel safer, someone, your homey “Dr. Big Brother” is watching over you.
The Italian city of Bolzano runs a similar project called Secure Living —created by the IBM Human Centric Solution Centers Europe, IBM Human Ability and Accessibility Center, IBM Hursley Emerging Technologies Lab, TIS Innovation Park, the technological park of Bolzano, and Dr. Hein GmbH—to help seniors safely ‘age in place’ at home. It concentrates rather on both security and health issues of the elderly, and try to help through sensors installed at their homes. These monitor the environment in real time, checking for changes in temperature or potential dangers such as water leaks or high levels of carbon monoxide. Data is transmitted and displayed on a dashboard in an off-site central control room, and on an assigned operator’s Android mobile device via e-mail, SMS or Twitter. When problems arise and immediate action is required, alerts are sent to family members, volunteer ‘angels,’ members of the Bolzano Social Services Department or local emergency staff, based on the individual’s specific need.
In a way, such sensors not only enable the elderly to feel safer at home, but also makes for them possible to stay in their own, familiar environment and does not force them to go into some care facility and leave their whole life behind.
What are the challenges of an all-knowing home?
Considering the rapid technological development in medicine, it is not surprising that the challenges standing in the way of smart homes and sensor-based health services are rather ethical and psychological then technological.
The notion that “Dr. Big Brother” is supervising every aspect of life might be terrifying and annoying at the same time. In the case of the Healthsense pilot project, some elderly decided to participate in the program, after the alerts coming from the sensors caused them anxiety.
Also, some would not want sensors and data telling them what lifestyle choices they should make – even when the added benefits might be saving their lives.
As another aspect, there might be a difference between the short-term and long-term effects and advice of smart homes on people. Some might be happy to stay disease-free by using sensors at home, but might not be willing to change their behaviour on the long run. Psychological studies show that it is difficult for humans to carry out long-lasting and profoundly life-altering changes such as giving up smoking or losing weight. So it will be necessary to find new ways of gamifying health to promote active health management and make the most of sensors and smart algorithms.
While the transition might not be free from troubles, and as with most of the things in life, it has some advantages and disadvantages, I believe it is a fact that everyone has to accept – healthcare is coming home sensor by sensor.