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 THE STAT 26Percentage of wireless customers who use their cell phones to take picturesMore Vitals
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JULY 7, 2004
The Dawning Age of "Silver Tech" [Page 2 of 2] MEET LAURA. In the future, all devices within the home will also adjust to their users' special medical needs. Already, Intel has developed a phone for Alzheimer's sufferers that displays a photograph of the caller, shows an explanation of the caller's relationship to the patient, and offers a brief summary of a prior conversation with that person. For these patients, who are often embarrassed to pick up the phone because of their memory problems, "it's the difference between going into deep isolation and social interaction," Dishman says. Some at-home medical devices will actually simulate interaction. In early July, 15 elderly adults in South Boston will begin a trial of a virtual exercise adviser. The animated adviser's name is Laura, and she looks a bit like Cameron Diaz but has dark hair, eyes, and skin. Developed by Tim Bickmore, assistant professor at Boston University School of Medicine, Laura resides on a computer. In synthesized voice or text, she asks questions, like how much the patient walked today. The user responds via a touch screen. Eventually, Laura will learn to recognize speech, and she might also consult users on, say, which food to pick at a restaurant. What's special about Laura is that her responses are based on an empathy software program. The animated figure shifts her eyebrows and smiles appropriately. So if you keep beating yourself up for not walking yesterday, she'll murmur an encouraging word. In the South Boston trial, Bickmore is trying to find out if Laura can improve the elderly's sense of happiness and reduce their loneliness. FROM SCALE TO NURSE. The smart home also could help prevent medical crises. Nowadays, many people don't go to the doctor when they aren't feeling well, and then they become seriously ill and wind up in the emergency room -- with a big bill. Today, 3% of patients with serious health conditions account for some 40% of total health-care costs. One way to reduce hospital visits is by monitoring patients at home who are at risk. For instance, health-care powerhouse Abbott Laboratories (ABT ) is developing a special monitor for the parents of children with diabetes. The monitor, likely to become available within a year or two, will amplify a warning set off by another device that's on the patient's arm, monitoring glucose levels. That way, if a parent is in a different room, they can still be alerted to any problem. Another approach is telemedicine, which involves providing health-care services over the telecom network. Some hospitals are starting to implement special scales, which measure a heart patient's weight and report it to a nurse daily because when heart patients get worse, their bodies begin retaining huge amounts of water. In case of a weight spike, the nurse would call up the patient and recommend, say, an adjustment to the dosage of a drug to avert a heart attack. PICTURES SPEAK LOUDLY. Besides benefiting the patients, this approach can drastically reduce demands on a doctor's time. Here's an example: Patients who carry implantable defibrillators, which normalize the heart rate, have to visit their cardiologist four times a year. But a reader from medical-device giant Medtronic (MDT ) allows the patient to run the test in his home and then e-mail the results to his doctor. By avoiding unnecessary chit-chat, the doctor can handle three times as many patients, says Dave Scheffler, director of Medtronic's remote-sensing device management business. It's not just data that doctors can view remotely, but images too. Brigham & Women's Hospital in Boston runs a special videoconferencing program for post-operation breast cancer patients. The hospital now releases the patients a day or two earlier than before and gives them a PC with a video camera. While at home, they can show their wound to their nurse and consult with the nurse online, live -- reducing health-care costs in the process, says Joseph Kvedar, vice-chairman of dermatology at Harvard Medical School and president of the American Telemedicine Assn. The key here is to keep the communication with the doctor two-way. Brighton (Mass.)-based PatientKeeper has developed special software allowing patients to use their cell phones and PDAs to access their medical records at the doctor's office. Problem is, today the vast majority of medical records are available only on paper. But that's expected to change as soon as various agencies agree on a definition of what constitutes an electronic record and figure out how to ensure its security. PERSONAL TOUCH? For all this medical technology on the market and in the labs, the health-conscious home is still a work in progress. At-home devices need to become smaller and easier to use, says Ben Schneiderman, an interfaces expert at the University of Maryland in College Park. Already, biotechnology giant Roche is developing a next-generation CoaguChek device -- which tracks the thickness of a patient's blood -- that's half the size of the existing gadget and contains only one button instead of several. And the smart home has yet to become clever enough to differentiate between the movements of a patient and, say, a pet. However, the biggest roadblock may be that patients will prefer the personal touch and feel they can't do without talking to their doc face-to-face. As health-care costs keep mounting, though, patients may be forced to change, turning instead to the helping hand of silver tech. "Things are definitely moving in that direction," says Robin Cisneros, director of technology and products for Kaiser Permanente. Indeed, high-tech at-home care could soon become a fact of life.
 By Olga Kharif in Portland, Ore.
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