When technology turns to help people

For those who follow my twitter feed (@dewsbury) I mentioned how the Xbox’s always aware functionality caused Xboxes to switch on when Aaron Paul says in the advert says ‘Xbox on’ people report their Xboxes switching on (see http://www.bbc.co.uk/news/technology-27827545). This annoying functionality does have its upside as well as the downside.  

With the recent Google IO (https://www.google.com/events/io) it was mentioned that the new Android operating system will have a always aware functionality, so even in the closed state it will still listen for the command ‘OK Google’. This for some might be a little worrying, especially in the light of Facebook’s attempt to be constantly aware and record the sounds in your environment whilst you use its app (http://guardianlv.com/2014/05/facebook-has-new-microphone-application/).

 

Therefore, the benefits of always-aware applications might not appear to outweigh the security and privacy issues.  This was certainly my belief, until I was alerted, by my bother to an article in the ABC news (http://kstp.com/news/stories/S3484579.shtml?cat=127) in which a two year old uses Siri (the voice aware IOS platform) to call for emergency services as her mother suffered from “an autonomic nervous system disorder that causes her to faint”. The child was taught to press the button and say call emergency services, if her mother fell over, which was the case at the time.

As telecare and telehealth devices evolve the standard pendant, based technologies will be surpassed by smarter more common/mundane technologies such as the standard mobile phone.  Many smart phones have the ability to dial numbers through speech input and this will only increase over time as operating systems become smarter. The advent of smart watches will also add to this if they have accelerometers built into them and can determine if a person has fallen.

The rise in health apps (see http://phonesngagdets.blogspot.co.uk/2014/06/my-favourite-fitness-app-virtuagym-www.html) can only be a good thing as the poor ones will eventually be weeded out and the best ones will remain. Adding the ability to determine health characteristics is essential to make the move from a mobile phone being a standard communication tool to being a fully interactive useful piece of hardware. 

It is good news that technology is finally being used appropriately to help people in a number of ways. One such way that caught my eye was the Brianwriter (http://www.techrepublic.com/article/the-brainwriter-the-200-open-source-wearable-for-the-paralyzed-that-can-read-and-write-thoughts/#ftag=RSS56d97e7) which turns your thoughts into drawings and communications.  This was originally designed for people who were paralysed and in many ways is better or more promising than Oculus Rift (http://www.oculusvr.com/) or Google Glass (http://www.google.co.uk/glass/start/).

We are at the dawn of an incredible change in the way in which technology can be used to make people’s live better and facilitate their safety. I just hope that my idealistic dreams is not proved wrong. Technology developed for one thing can reused and re-purposed for something else. My fingers are crossed.

The Future of Health and Technology

I was recently asked to speak at the University of Edinburgh on the 26th May 2014 for Health Informatics Scotland and the British Computer Society. The talk was entitled the Future of Health and Technology. The talk attempted to consider the links between people and technology and health whilst focussing on telecare. It presents a person-centred perspective and introduces the Dependability Telecare Assessment tool (DTA) which is currently being redesigned and updated to a version 2. 

The talk description is available at http://www.bcs.org/content/conEvent/8720
 and http://www.knowledge.scot.nhs.uk/his/events/webinars/the-talk-the-future-of-technology-and-health.aspx

The talk is available as a Webinar for all at http://www.video3uk.com/ospcast.aspx?eid=ECYe56Kdi8XD 

The slides for the presentation are available at Slideshare http://www.slideshare.net/GuyDewsbury/the-future-of-ttechnology-and-health-edinburgh-university-may-26th-2014


 DTA version 2 will be available from www.gdewsbury.com

If you have any comments on this presentation guy would enjoy hearing them

some thoughts on the Internet of Things and telecare

The latest in a line of buzzwords is the Internet of Things (IoT). It refers to the use of sensor technologies embedded in object (similar to ubiquitous computing) and making objects recognisable. An example of this is QR codes which are imply representation of URLs and when scanned can direct a mobile device to a web page. Near Field Codes (NFC) are also becoming popular, and are entering the shopping arena. You can now pay for things without ever pressing a butting just by holding your credit card over or close to the NFC scanner.

The excitement around IoT is not what exists currently but what the potential for this technology is.

Ubiquitous and ambient technologies have been around for a while now, but using IoT in conjunction with Ubicomp or Ambient sensors adds a new dimension.  For telecare the possibilities are interesting.  It should be possible to embed sensors into the fabric of the home to monitor people at home. Sensors could be embedded in clothing, and provide GPS coordinates to friends and family when someone can no longer recall the right direction to travel.

Sensors in clothing could also provide biosensor data on heart rate, blood pressure, and other critical data which could be fed wirelessly to a localised hub in the home.  This means the home occupier owns their own data, but the data could be sent to specific people, such as doctors, in the event of an issue arising.

Sensors that detect when someone falls could be embedded in clothing and bedding. 

Most importantly and most excitingly, these sensors can be integrated together so the data is amalgamated to provide a clear picture of a person’s life style and habits. They could provide traceability when accidents and other things occur.  

The advances in sensors mean that sensors can be developed for specific issues such as Parkinson's or Epilepsy. Every condition will require different settings on sensors to measure bespoke things.  Most importantly, the necessity for call centres will disappear as the technologies should be able to contact the correct people depending on the event.

IoT has the potential to make sensors and data SMART.  The task of the programmer is to work with the range of data that could be available and build realistic algorithms to harness the potential of this technology.  I suspect this is where things might have to wait for humans to catch up. But as with mobile technologies, there is no reason for this technology to be harnessed for the benefit of everyone.  

As we see with the various fitness bracelets that gather data on exercise, this technology could be employed to work as a support for everyone.  Working away in the background, forgotten about until it is needed.  What we have to ensure is that we do not build a need which is unsustainable or itself a problem. So I would recommend liberal use of the off button when required.

(Google) ‘Now’ there is something new for people with dementia

For many younger people, after a long drinking session on a Friday or Saturday, if they find that they are lost or unsure how to get home what do they do?  Most will turn to their Smartphone to call for help or to find out where they are.

For people with reduced capacity there has always been a push to develop reminder and location aware devices to reorientate them. These have included some great telecare devices such as Buddi (http://goo.gl/vXZ3E) and services such as Telecare Technology (http://goo.gl/XtK25) who provide a range of reminder services.  The services and devices if use correctly could help a person remember their medication or important dates/times or assist a lost or confused person.

Google Now on my Nexus 4

What is exciting is the development of a completely new free system from an old system. Google Now (http://goo.gl/Uxz4c) is just such a system. Google Now is the new Google search feature designed for Android mobile Smartphones but also available for iPhone and iPad.

Google Now is more than just an entree to the world’s number one search engine, it uses the data already collected by your Smartphone to determine your location and can synch with your Google calendar and other Google apps to assist you through your day.  

One feature that stands out is the constant monitoring of the phone’s location.  For a burglar this might not be ideal for Google to monitor your location 24/7 and for people paranoid about privacy this might also seem a little zealous, but the advantage is that when you go somewhere, Google Now will tell you how long it takes to get how and how far it is.  It can also link in with your recent searches and suggest places locally you might have searched for or it considers you might want to know about.  To illustrate this, I was shopping last weekend in an area I rarely visit, and had previously been searching for a DIY store as I needed something from it. Whilst shopping I looked at my phone and it told me that I has thirty miles from home and that a branch of the DIY store I had previously searched for, before I left the house, was only a minute away.  Thus I killed two birds with one stone and went to the DIY store after I finished shopping.

Google Now integrates with other Google apps and services

This got me thinking about the other applications of Google Now and the most obvious one was for people with dementia. Google Now maps your routines and places you go and integrates with other Google apps such as email, maps, calendar, tasks etc.  This therefore presents an opportunity to build in simple reminders to a dairy to take medication which can be done in the calendar.  Google Maps, for those that use it for directions and navigation will already know that this has the ability to be programmed to where you live and take you home.  If Google know where you live then it can reorientate people who get lost.  It provides turn by turn navigation for walkers which I have used in many large cities when I have been for a meeting.

For a person with dementia Google Now provides a non patronising way or providing location based services and reminders both of a daily routine and medication. It would not be difficult to add in alerts to call friends and family to the system so that if a person was “out of zone” or potentially lost the family could be notified by SMS or even Google Hangout and open up an online face to face conversation with the person.

Google Now purportedly learns from you.  It logs where you go and what you do on your phone and links in with other apps to find your likes and dislikes.  In time and with use, it should be a very good source of help. It is not too difficult to see that even though Google Now is relatively new, and I would suggest in its infancy, there is a real opportunity to develop this service for people who in the future who will get dementia or some other health issue. Most importantly it has the potential to put the person in control of what is monitored and the correct response.

Telecare - the interoperability issue revisited

 
At a recent Athene meeting I discussed the idea of interoperability and in so doing thought it might be wise to share these thoughts more formally.

When telecare was conceived, it appears to have been considered as a reactive, rather than proactive technology that generates alerts after something bad has happened. It does not stop falls, or stop anything, but can generate rather vague alerts which can go through to a call centre or a family member. That said it can also produce false positives which can and often are very annoying for family members.

It, therefore, seemed appropriate that one of the key concerns of telecare is that it should be interoperable, by which I mean I can take any piece of telecare and it will connect to any other piece of telecare irrelevant of who made it, in a sort of plug and play way.  This is also a legacy of the smart home/home automation KNX association which provided the world’s only open standard an interoperability standard for smart buildings which are compliant to EN 50090, EN 13321-1, and ISO/IEC 14543. Interconnectivity would do away with the need for connecting boxes, extra wire and potentially making less dependable systems.

Continua Health Alliance  and many other organisations and groups (see http://projecthydra.info/wp-content/uploads/2012/07/Standards_Project_Hydra.pdf) have been set up to explore the relative merits or interoperability, but as companies might say how much they are in agreement with this idea, it is not is their business interest to allow their own devices to connect to someone else’s. If they did allow this then certain monopolies would potentially come crashing down. Instead, we are left with a faint nod to interoperability whilst ensuring that the top players in telecare and telehealth retain their throne through not allowing other devices to connect easily.

If we look to the emerging mobile market, there are currently three main players, Apple, Google and Microsoft, with their iOS, Android and Windows mobile operating systems. These systems allow companies to make apps for these devices, and apps which are written in C++ and HTML5 are often easier to cross platform. What is interesting about this is that one app, can be cross-platformed to a range of mobile devices and even have standard computer based versions as well. A good example of this is the game ‘Angry Birds’ which can be played in the browser (Chrome) as well as through Facebook, as well as on most mobile devices.

If we consider what we actually want from telecare in the future, it might not be the reactive containment model that currently exists, instead we might want a more flexible proactive technology that can predict and prevent falls, or unexpected difficulties etc. This, I am sure will come through the mobile platforms, in the near future, with people having mobile devices which have sensors monitoring actions and activities in the home as well as outside the home. We will hopefully dispense with anything we need to wear, such as the pendant, and have unobtrusive sensors built into everyday artefacts and clothing. We will hopefully develop systems in which the data is more usable to the person with health conditions so they can sensibly make their own rationale decision on their health state, as well as alert the correct people if someone is in crisis without direct intervention.

I also see the rise in robots as interesting, but wonder if this is the actual way we want things or whether the building of robots is actually a step in making technologies more intelligent and more honed to our future needs and wishes. 

There are always utopia's and dystopia's, and the reality will possibly somewhere in the middle, but I can see that mobile platforms provide a valuable reference to build and new telecare world in which the person is not a passive recipient of care. This change in the way of seeing telecare does require a large change in the way we see telecare and consider its merits, but I think that it is evident that we need to take things to a new level.

So what is the next step? 

I hope that someone from one of the big companies, be that Microsoft, Apple, Google, IBM, Philips, Bosch, Samsung, Nokia, HTC, Backberry etc read this and like some of the vision and start to run with it.  I, of course, would be happy to add some assistance fin this venture. 

So we need to move away from interoperability thinking and instead consider cross platform mobile devices which are proactive and reactive.  We need to have devices that are what people want and will use that produce real information that helps the person as well as the health professional.  We need a cultural shift in the thinking of telecare and telehealth to embrace this new thinking, and we need the big IT/mobile companies to take up the health and social care challenge today so we can start to experience it before it is too late.

What do you think?