This PDA's To-Do Lists Can Be a Lifeline


By Suzanne Robatille As assistive-technology products go, precious few work for people with cognitive impairments -- a difficulty processing and retaining information because of a brain injury, developmental disability, or disease such as Alzheimer's. That's why Randy Dayle, president of Cogent Systems in Orlando, invented ISAAC, a battery-powered device that allows people to take vital information with them wherever they go.

Dayle, who began developing the product seven years ago using his own money, believes that the total potential U.S. market for the ISAAC system is 1.5 million to 2.5 million users. Indeed, he says such estimates may be conservative, as many cases of developmental disabilities go unreported each year. BusinessWeek Online's Suzanne Robitaille recently talked with Dayle to find out more about his invention. Following are edited excerpts of their conversation:

Q: To me, ISAAC looks like a very bulky personal digital assistant (PDA).

A: It's about the size of a Walkman, and it can be carried in a bag or worn around the waist. It weighs just under 1.5 pounds (including batteries, case, and carrier). The screen needs to be big enough so that it's useful for people with the most severe cognitive disabilities. In many cases, the ability to comprehend information is easier if the navigation is simple, and the text is fairly large. Some users can't read, so they require pictures rather than words, which need to be clearly presented on the interface.

We're working on a smaller version, but it will have fewer features and will be targeted to a more specific segment of the cognitively impaired population.

Q: How does ISAAC work?

A: ISAAC is similar to a PDA in that it helps users to remember to perform and complete routine activities. The difference is that it's not an end-user product. Authorized practitioners program the system for each user. Information can be delivered as text, checklists, pictures, or audio, and is accessed through a simple interface.

Q: So the user doesn't need to do any programming work?

A: Correct. The user just needs to wear the system during the day. The key to ISAAC is its system-initiated prompts, which are set up and tailored for users.

Q: What other kinds of information can be programmed?

A: It's highly individualized. You could program medical history in there, which would be useful in an emergency. You could put in doctors' orders, or instructions for performing tasks at work or chores at home. You can tell ISAAC to read aloud a grocery-shopping list.

It can be used to remind people about such mundane tasks as bathing and dressing. These are normal activities to you and me, but for someone with a cognitive disability, they can be difficult to remember. The content can be changed as the user adapts to his or her tasks.

Q: How much does ISAAC cost?

A: The system's cost is around $2,600. Then a rehabilitation [expert] provides services, such as programming and content updates, at the rate the expert charges for the service. These services are often handled as a package, where the practitioner is paid a fee to implement treatment, and since ISAAC is part of an individual's treatment or rehabilitation plan, usually there are no additional costs for the patient.

Q: Will it work for everyone?

A: No -- it depends on the individual's capabilities, needs, and situation, as well the adaptive strategies used by their rehabilitation professional. That's why ISAAC is not a consumer-electronics product. For brain-injury survivors, for instance, the greatest effectiveness can usually be achieved when the system is introduced during the last stage of a rehabilitation training program.

Q: Is it possible that someone could have such a severe impairment that they wouldn't remember or know how to use ISAAC?

A: It's possible. More often, a given individual might not be a good candidate due to his or her degree of sensory impairment, such as their sight or hearing or motor skills.

Q: When will ISAAC be commercially available?

A: About 25 people have the system in the U.S. The parties who paid for the ISAAC for these users (some with developmental disability and some with acquired brain injury) include state vocational-rehabilitation departments, state brain-injury programs, worker's compensation insurance, and in one case, a private individual.

For it to become widely available and well-supported, we have to demonstrate that state-of-the-art cognitive assistive technology can be a viable business, especially as the population ages and illnesses like [Alzheimer's] become more prevalent. We have trained service providers who promote ISAAC around the country to practitioners, rehabilitation facilities, and paying organizations, as well as at conferences.

We have to work to convince three different sets of consumers: The end user and his or her family, the third-party payer, and the rehabilitation practitioner. We think ISAAC meets the needs of all three consumers. This system is designed as a prosthetic device -- [and] thus has the potential to be covered by insurance -- for those who rely on a family member or rehabilitation professional to help them complete their daily living activities.

Q: How does someone get ISAAC?

A: The user is first evaluated by a rehabilitation practitioner to see if he or she would make a good candidate. The device is then purchased for the client by a doctor or other rehabilitation professional through Cogent Systems. The device isn't covered yet by health insurers, so Cogent works with practitioners to obtain funding through private and public venues, such as government agencies and insurance companies. For more information, e-mail info@cosys.com Robitaille writes Assistive Technology, only for BusinessWeek Online


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