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Self tracking, Sensors, and mHealth: Trends and Opportunities

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Mobile health (mHealth) offers the perfect platform to merge self-tracking communities and sensor technologies. Toss in the power of social networking capabilities, and you've put the trifecta of instantaneous 'track, share, and compare' at people's fingertips.

Publicado en: Salud y medicina
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Self tracking, Sensors, and mHealth: Trends and Opportunities

  1. 1. Self-tracking, Sensors, and mHealth: Trends and Opportunities<br />Carol E. Torgan, PhD., FACSM<br />Kinetics Consulting :: From lab bench to park bench<br />www.caroltorgan.comTwitter @ctorgan<br />mHealth Networking Conference, March 2011<br />© Carol Torgan, Ph.D. 2011 <br />
  2. 2. What is self-tracking?<br />Who’s doing it?<br />Why are we doing it?<br />How do we do it?<br />What do we do with the info?<br />What’s next?<br />
  3. 3. “Finally: Self-Tracking is Cool Enough for Viral Advertising”<br />information aesthetics. Where form follows data. Feb 15, 2011<br /><br />© Carol Torgan, Ph.D. 2011 <br />
  4. 4. “We can’t look at health in isolation. <br />It’s not just in the doctor’s office.<br />It’s got to be where we live, we work, we play, we pray.”<br />– U.S. Surgeon General Regina Benjamin,<br /><ul><li>LA Times, March 13, 2011</li></ul>© Carol Torgan, Ph.D. 2011 <br />
  5. 5. Self-tracking<br />Tracking your life<br />weight, exercise, diet, sleep, <br />menstrual cycle, heart rate, mood, ….<br />physiological, behavioral<br />social, environmental<br />Life-logging<br />Data-driven lifestyle<br />Personal informatics<br />Personal analytics<br />Personal monitoring<br />Living by numbers<br />Quantified self<br /> Gary Wolf, Kevin Kelly <br />© Carol Torgan, Ph.D. 2011 <br />
  6. 6. Who is tracking<br />Patients<br />Professionals<br />Acute and chronic health conditions<br />Asthma<br />Cancer<br />Diabetes<br />Mental health …<br />Athletes<br />Astronauts<br />Soldiers<br />Firefighters<br />Scientists<br />© Carol Torgan, Ph.D. 2011 <br />
  7. 7. Technology moves from edges inward<br />Professionals<br />Patients<br />© Carol Torgan, Ph.D. 2011 <br />
  8. 8. Who is self-tracking?<br />Unpublished data courtesy of Susannah Fox, Pew Internet<br />Pew Internet Project & California HealthCare Foundation national survey:<br />15% of U.S. internet users have tracked their weight, diet, or exercise routine online<br />17% of U.S. internet users have tracked any other health indicators or symptoms online<br />Women internet users more likely than male users to do these activities <br />Internet users who experienced a significant recent health change more likely to track (gain/lost weight, quit smoking, pregnancy)<br /><br />© Carol Torgan, Ph.D. 2011 <br />
  9. 9. Patients<br />Professionals<br />Event-driven trackers<br />© Carol Torgan, Ph.D. 2011 <br />
  10. 10. Why track?<br />“For many self-trackers, the goal is unknown. <br />Although they may take up tracking with a specific question in mind, they continue because they believe their numbers hold secrets that they can’t afford to ignore, including answers to questions they have not yet thought to ask.”<br /> – Gary Wolf, The Data-Driven Life,<br />The New York Times, April 26, 2010<br />© Carol Torgan, Ph.D. 2011 <br />
  11. 11.<br />© Carol Torgan, Ph.D. 2011 <br />
  12. 12. iChemoDiary<br />Lose It!<br />Pregnancy Tracker<br />Mood Reporter<br />Pedometer<br />Menstrual Calendar<br />RunKeeper Pro<br />Mole Measure<br />Crohn’s Diary<br />Glucose Buddy<br />© Carol Torgan, Ph.D. 2011 <br />
  13. 13. What can be tracked vs. What should be tracked<br />Source: PricewaterhouseCooper HRI survey, 2010<br />PricewaterhouseCoopers, Healthcare unwired, Sept 2010<br />© Carol Torgan, Ph.D. 2011 <br />
  14. 14. Sensor technology<br />Issues:<br />Cost<br />Tissue compatibility, safety<br />Range, response time <br />Sensitivity, specificity<br />Reproducibility<br />Clinically relevant information<br />© Carol Torgan, Ph.D. 2011 <br />
  15. 15. Sensors that connect to the body<br />Polar<br />Zeo<br />BodyMedia<br />Fitbit<br />IDEAL LIFE<br />iHealth<br />Withings<br />Sleeptracker<br />…<br />© Carol Torgan, Ph.D. 2011 <br />
  16. 16. Wearable sensors<br />Attach to clothing or integrate into fabric<br /> e-fibers smart clothing interactive clothing <br /> e-textiles smart textiles interactive textiles<br /> e-fabrics smart fabrics <br />Unobtrusive, direct skin contact <br />Issues: friction, bending, stretching <br /> washable, light weight <br />© Carol Torgan, Ph.D. 2011 <br />
  17. 17. Under Armour® / Zephyr E39 biometric compression shirt<br />Removable electronic monitor (‘bug’)<br />Heart rate<br />Breathing rate<br />Skin surface temperature<br />Triaxial acceleration<br />Real time data<br />Monitor performance<br />Share and compare<br />Store on internal hard drive<br />> handheld or laptop<br />Debuted NFL combine Feb 2011<br />Available to public 2012<br /> (photo from Under Armour®) <br />© Carol Torgan, Ph.D. 2011 <br />
  18. 18. Screen-print sensor onto fabric: Smarty pants<br />Carbon sensor arrays on elastic band of underwear<br />Tight contact, direct skin exposure <br />Sensors survive large deformations<br />Electrochemical detection of sweat<br />(hydrogen peroxide, ethanol, lactate)<br /> Applications: <br />Healthcare<br />Sport<br />Military<br />Yang-Li Yang et al, Analyst, 135:1230-1234, 2010 (photo from Royal Society of Chemistry) <br />© Carol Torgan, Ph.D. 2011 <br />
  19. 19. Ingestible core body thermometer pill<br />Partnership<br />Johns Hopkins University Applied Physics Lab<br />NASA / Goddard Space Flight Center<br />Silicone coating, wireless telemetry <br />Microminiaturized circuitry, microbattery<br />Quartz crystal temperature sensor<br />Pill in system 18 to 30 hours<br />1988 Commercially available <br /> (research, university, military)<br />1998 John Glenn used for medical experiments <br /> on Space Shuttle Discovery <br />Applications: astronauts, athletes, firefighters<br />NASA<br />© Carol Torgan, Ph.D. 2011 <br />
  20. 20. Heart Failure: CardioMEMS<br />6 million heart failure patients in U.S.<br />> 1 million hospitalizations each year<br />$39 billion yearly direct cost of care<br />Heart functions poorly, fluid builds-up<br />Traditionally measure body weight<br />Miniature wireless sensor <br />MEMS = microelectromechanical system<br />Permanently implant in pulmonary artery<br />Transmits real-time pressure data<br />Patients take daily readings<br />Send to doctor (handheld or computer)<br />Doctor modify meds = prevent hospitalization<br />39% drop in hospitalizations in treated patients, shorter stays <br />WT Abraham, et al, The Lancet, 377:658-666, 2011;<br />© Carol Torgan, Ph.D. 2011 <br />
  21. 21. Data visualization<br />How do we:<br />Make the data tell a story?<br />Use the data to educate and empower?<br />Make the data actionable?<br />Have the data answer questions <br /> that haven’t been asked?<br />Data issues:<br />Cause and effect vs. correlational<br />False positives / false negatives<br />Signal vs. noise<br />Customize data vs. aggregate data<br />Photo courtesy of Chris.T. (Eng) on Flickr<br />© Carol Torgan, Ph.D. 2011 <br />
  22. 22. © Carol Torgan, Ph.D. 2011 <br />
  23. 23. Health Literacy<br />—the degree to which a person can obtain, process, and understand basic health information and services needed to make appropriate health decisions.<br />Nearly 9 out of 10 adults have difficulty using everyday health information that is available in health care facilities, retail outlets, media, and communities.<br />Innovations in Health Literacy - Workshop Summary<br />March 10, 2011 Institute of Medicine Report <br /><br />© Carol Torgan, Ph.D. 2011 <br />
  24. 24. © Carol Torgan, Ph.D. 2011 <br />
  25. 25. Salt-o-meter<br /><br />© Carol Torgan, Ph.D. 2011 <br />
  26. 26.<br />© Carol Torgan, Ph.D. 2011 <br />
  27. 27. ‘Weight loss’ on Flickr<br />Photos courtesy of Flickr, clockwise L to R: uneduex, 157/365; Christi Nielsen, Diet; <br />bark, 40+290 Notch; Vernon_White, Weight_Loss_Montage_2009-03-04_side<br />© Carol Torgan, Ph.D. 2011 <br />
  28. 28. What to do with our data: Track, share <br />Twitter: #Withings<br /><br /><br />© Carol Torgan, Ph.D. 2011 <br />
  29. 29. Track, share, compare<br />1in4internet users living with <br />chronic conditions has looked online <br />for someone with similar health concerns.<br /><br />Peer-to-peer Healthcare, Pew Internet, Feb 2011<br />© Carol Torgan, Ph.D. 2011 <br />
  30. 30. Track, share, compare*, care <br />Integrate data with health records & health care team<br />PHRs & EHRs<br />*N=1<br />Case Study<br />Personalized Medicine<br />Biological Passport<br />© Carol Torgan, Ph.D. 2011 <br />
  31. 31. Track, share, compare, publish: Data donorship<br />N=1,000<br /><br /><br /><br /><br />© Carol Torgan, Ph.D. 2011 <br />
  32. 32. Opportunities: Baby Boomers<br />~78 million baby boomers<br />~56% have high willingness to use in-home health monitoring devices <br />in tandem with care from their primary physician<br />“Boomers want to shape the technology they use, <br />unlike younger generations who allow their lives to be shaped by it.”<br />– Michael Rogers, Practical Futurist, in MIT Enterprise Forum Northwest Report<br />Key values & Key health issues<br />© Carol Torgan, Ph.D. 2011 <br />
  33. 33. Corporations<br />Workplace disease prevention & health promotion programs<br />Amt spent on programs: $1.00 <br />Medical costs fall $3.27<br />Absenteeism costs fall $2.73<br />Health risk assessments<br />Incentives<br />Key interventions<br />Baicker, K. et al, Health Affairs, 29(2):1-8, 2010<br />© Carol Torgan, Ph.D. 2011 <br />
  34. 34. Data coaches<br />Front line specialists:<br />Nutritionists<br />Diabetes educators<br />Personal trainers<br />School nurses<br />Physicians<br />Psychologists<br />Coaches<br />When asked about the last time they had a health issue, <br />70% of adults in the U.S. say they received information, care, <br />or support from a health professional. <br />–Peer-to-Peer Healthcare, Pew Internet, Feb 2011<br /><br />© Carol Torgan, Ph.D. 2011 <br />
  35. 35. Global: Noncommunicable diseases-NCDs(cardiovascular, respiratory, diabetes, some cancers)<br /> ~35 million deaths a year<br /> 60% of all deaths globally <br /> 80% in low- & middle-income countries<br /> Half of deaths are in people under 70<br />Twice (2x) the number of deaths as<br /> infectious diseases<br /> maternal and perinatal conditions<br /> nutritional deficiencies <br />combined<br />Up to 80% of heart disease, stroke,<br />type 2 diabetes, & over a third of cancers <br />are preventable!<br /><br />© Carol Torgan, Ph.D. 2011 <br />
  36. 36. The future of sensors<br />Measure compressive stresses in spine<br />Monitor CSF for biomarkers of Alzheimer’s disease<br />Monitor blood for medication concentrations<br />Knee implants, stents, …<br />Monitor our Microbiome <br />Microbial cells : human cells = 10:1<br />(10-100 trillion microbes in our intestine)<br />Conditions that may be influenced:<br />obesity, psoriasis, heart disease, asthma, IBS …<br />“What used to take up a building<br /> now fits in my pocket,<br /> and what fits in my pocket <br />will fit inside a blood cell in 25 years.” <br />– Ray Kurzweil, inventor and futurist<br />© Carol Torgan, Ph.D. 2011 <br />
  37. 37.<br />© Carol Torgan, Ph.D. 2011 <br />
  38. 38. Carol Torgan, PhD., FACSM<br />Kinetics Consulting<br /><br /><br />Twitter @ctorgan<br />List of talk resources are posted at: <br /><br />© Carol Torgan, Ph.D. 2011 <br />