We know more about our cars than our bodies

It’s a safe bet that you know how many cubic inches your car’s engine displaces, but don’t know your average systolic blood pressure. And you probably know the number of miles per year you drive, but have no idea how much more or less exercise you’re getting.

Which is more valuable to you: car or body? Which are you more dependent on? Which is more costly to fix? Which is more painful to fix?

Most of us need to know more about our bodies

A rapidly expanding body of research from people you should trust defines the need for improving our super-sizing eating habits and super sedate lifestyle.

Better diet and exercise could reduce cancer rates 30 to 40% or 300 million cases worldwide.- International Obesity Task Force, 2001
Modifiable lifestyle factors account for 50% of premature death in the U.S.- JAMA, 1993
Obesity affects over 70 million Americans and is the second leading cause of unnecessary deaths, causing at least 300,000 deaths annually and costing the U.S. more than $100 billion a year. – American Obesity Association
Patients who are actively counseled on weight loss, nutrition, and exercise have reduced their diabetes risk by 58%, vs. those who received only general information. – New England Journal of Medicine, 2001

Out of sight, out of mind?

There is an often-quoted business mantra: What gets measured, gets done. Meaning, the things that we set metrics for, are the things that we spend our energy paying attention to. Why is paying attention to metrics important in health? Because “out of sight, out of mind” can be deadly.

For chronic diseases, including hypertension, diabetes, and asthma this is an especially difficult problem: the way that body functions or dysfunctions is invisible and easy to forget. What characterizes diseases as chronic is that people live with them for many years and they often aren’t acute, meaning there is no need to be under a physician’s constant care. Day to day monitoring and medication for these diseases is done in the home by the individual with friends and family.

A new category of smart-home appliance

Given the extreme consequences of not monitoring our health, there is a real need for a solution. Use the car’s dashboard as a metaphor and apply it to new type of intelligent home appliance and you’ve got a digital health dashboard. Like a car dashboard, it would be easy to integrate the use of a health dashboard into our daily lives.

A health dashboard in the home

To be acceptable for the home a Health Dashboard needs to match the design style of a home. No one wants something that looks like a medical device sitting on the Chippendale desk. It should fit on a bedroom dresser, study bookshelf, or hung on a bathroom wall. The device is more effective when placed in a high traffic location where the owner will glance daily at the information.

Ambient’s Health Dashboard is a dedicated wireless device that records and displays health trends

Like a weather station, the Dashboard is modular, and comes in various sizes and configurations. Typically it has between 2 and 5 meters or 4″x4″ mini-screens. Each meter displays trends in information about four categories that are relevant to your health: 1) aspects of your environment that influence your health, 2) trends about your body, and 3) a log of health-related behaviors.

Category I: Environment trends

Pollen index (sent via Internet data feed)
Air quality index (sent via Internet data feed)
Pain Index: change in barometric pressure (sent via Internet data feed)
Flu trends (sent via Internet data feed)
Alternative: astrology, astronomy, biorhythms, alignment of planets?(sent via Internet data feed)

Category II: Trends in body metrics

Blood pressure (sensed locally via wireless BP cuff, or traditional cuff and input manually)
Weight/BMI (sensed locally via wireless scale, or traditional scale and input manually)
Peak flow (sensed locally via wireless spirometer, or traditional spirometer and input manually)
Blood Sugar (sensed locally via wireless glucometer, or traditional glucometer and input manually)
Cholesterol: LDL (low density lypos), HDL (high density lypos)
Resting heart rate, time to return to normal heart rate (sensed via cuff, and/or exercise wearable)
How you feel: pain, energy level, dizziness, and appetite (input manually)

Category III: Trends in behaviors that influence your health

Exercise (sensed with wireless pedometer or other wearable. Input wirelessly or manually)
Medication compliance (sensed with wireless pill dispenser or input manually)
Patterns of daily activity: Sleep patterns, cooking patterns, TV watching patterns, sociability patterns (sensed via a variety of home-security-type wireless sensors)

Trend tracking is the key

Doctors tell us that it’s the trends in data that matter. The change or the rate of change is much more important that any given value. Especially if you are trying to catch problems before they become emergencies. People rarely log and analyze enough measurements to see trends in their health, even though it is exactly these trends are the most meaningful early warning sign for emergencies.

The daily home monitoring that a Health dashboard supports will allow people to log, trend-spot, and in some cases identify problems before they become expensive, life-threatening emergency-room visits.

“Home monitoring is astonishingly effective at keeping at-risk members out of the hospital” –Harold Pickin, Chief Medical Officer, BlueCross BlueShield New England

Sharing is the most effective motivator

Knitting people together socially also keeps them healthier. Weight-watchers, AA, running clubs, group therapy, trainers, are all examples where people seek community and companionship to achieve a goal they could not alone achieve. They trade privacy for social motivation. Wireless technology offers this same trade. It can increase awareness between people with chronic diseases and their network of care providers.

The Health Dashboard device connects to the Internet via a wireless network, so you may also choose to send certain information to a family member, visiting nurse, physician, or trainer. Others can receive information, at a level of detail that you specify, via a device that you also specify, for example a web page, an email, or an Ambient device. Summarization of information preserves privacy while still providing the most important data point: large trends. The important point is that YOU control if information is shared with other family or care-providers and how detailed that information is.

Do clocks make us on-time? Do scales make us lose weight?

Does awareness of information really change behavior? As my co-workers will tell you, I’m late to plenty of meetings, even though I wear a watch. So you may ask: “will the health dashboard which displays data about my health really make me healthier?” It will take real clinical studies to quantify the affect of these displays on healthy behavior, but I know that home-based health dashboards are an important start in self-awareness.

Its hard to be on-time if you don’t know the time; and it’s hard to lose weight if you don’t know your weight; and it’s hard to stay healthy without a dashboard for your health.

Health Dashboard in Use

New technologies are moving sensing and display technologies out of the hospital and into people’s lives and homes. The following scenario illustrates how new home-based technologies enable and enlist family and friends in the process of caregiving in a new way, resulting in an extended social care network that does not only include professional care-givers, but also with remote loved ones. This non-professional community is an important source of support, encouragement, and early warning system especially in monitoring chronic diseases.

Judy, 76, is one of the 50 Million Americans that have high blood pressure, also called hypertension. Unmanaged, this could lead to a stroke, heart attack, or other complications. Her doctor has prescribed medicine that she often forgets to take because it doesn’t seem to do anything. Her doctor also says that diet and exercise are important to control her hypertension but she doesn’t understand this relationship.

Judy’s son, Andy, lives several hundred miles away and his job that keeps him on the road most days. He only sees his mom every few months. Judy’s son is worried about her, but Judy isn’t ready to talk of a retirement center or nursing home. In fact, with some precautions and careful monitoring of her condition, she is capable of remaining independent for years.

To monitor her condition, Andy buys Judy an Ambient Blood Pressure Cuff so she can take her own blood pressure every morning. This cuff has a wireless communications chip embedded in it that sends her readings to two other Ambient display devices: an Ambient Health Dashboard and an Ambient key chain.

Judy’s likes the Health Dashboard that stores and shows her the trends in her readings. Judy was never very confident in interpreting numbers, and this display shows glanceable information in a way that is easily to understand and non-threatening.

At any time Andy can glance at his keychain to see a summary of the Judy’s BP trends: These are represented as a color: Green means healthier, yellow is no change, and red means trending in an unhealthy direction. Andy feels better having a summary of his mom’s health and helps him feel more involved in her health and well-being.

Judy feels better able to track her condition and is more likely to take her meds, exercise and eat healthier. Especially since she knows Andy will congratulate her for keeping her BP down.

About the company

Ambient’s vision is to embed information representation in everyday objects: lights, pens, watches, walls and wearables. With Ambient, the physical environment becomes an interface to digital information rendered as subtle changes in form, movement, sound, color or light.

Ambient Devices provides the hardware, infrastructure and services that support embedded wireless devices. For more information contact Ambient at 617 758 4129.
About the author

David Rose, President of Ambient Devices believes that in 2005 most people will have a dozen wireless devices to monitor the status of their health, investments, weather, and loved ones. Ambient Devices makes a technology platform, to help companies embed wireless in everyday objects: Swatch watches, Cross Pens, Steelcase office furniture, Nike shoes, and Bayer Glucometers.

Before Ambient, David founded Viant’s Innovation Center, an advanced technology group that studies disruptive technologies’ impact on the Fortune100. In the early-web-days, David started a digital photo-sharing company that was sold to FlashPoint Technology. In the early-interactive-days, he led Interactive Factory, a design-technology consultancy specializing in broadband multimedia applications and smart toys, including the award-winning LEGO Mindstorms Robotic Invention System.

David teaches Information Visualization at Harvard University’s Graduate School of Design, and is a frequent speaker for corporate research departments and conferences. David studied interactive cinema at the MIT media-lab and earned his masters at Harvard.

David Rose drose@ambientdevices.com 857 222 4416