With the development of new self-care technology, tiny wearable health monitors may one day continuously collect signals from the body and transmit data to a base station in the home. Predictive software may identify trends and make specific health predictions, so users can prevent crises and better manage daily routines and health interventions.
The Center for Future Health at the University of Rochester has received an $800,000 grant to lead a project in proactive self-care care technology. The Pioneer Portfolio of the Robert Wood Johnson Foundation (RWJF) awarded the funds in the second part of a two-phase project. RWJF also supported the exploratory phase with an earlier grant of $372,000, for a combined total of nearly $1.2 million.
Albert Shar, RWJF vice president, said, "The Center for Future Health is forging a dynamic new field with this work, and we welcome the opportunity to play a role." He said the foundation "is very excited about the project" as it applies "key expertise from other fields to develop information patients can use to lead healthier lives and manage their care."
Researchers at the University, in collaboration with six private companies, dedicated the first phase to understanding the need for personal health monitoring technology. The current research phase is expected to take 12 months and supports the engineering of a system for cardiac monitoring.Mark Bocko, technical director of the center and chair of the Department of Electrical and Computer Engineering, said many measurable features in a health state can be detected before a person feels symptoms. Fluid can collect in lungs, for example, days before a person experiences shortness of breath.
Traditionally, he said, people see a doctor once or twice a year for intermittent snapshots of their health; they get sick, go to the hospital, get fixed, and go home. The project represents a new view of health care away from that of crisis-management mode. He said the team sought to find out how to put technology in the hands of people to let them monitor their health signs on an ongoing basis, and signal them about trends and warning signs when things may be changing.
Cecelia Horwitz, executive director and chief operating officer of the center, said, "Using our approach, people will be better able to make their own health management decisions. They will have control of their information, and can choose to send it to their health care providers. There will be a lot more health status information shared between them." The existing acute care system developed over centuries, she said, with the last century seeing the home play a very small part, and the individual an even smaller part. People have not possessed personal health information early enough to prevent acute episodes, and the new self-care technology will empower consumers.
Alice Pentland, chair of dermatology at the University of Rochester Medical Center, co-founder of the Center for Future Health, and winner of the 2002 MD Future of Health Technology award, said the idea is to develop an integrated health care system based on consumer-health technology. To help design features, the researchers led focus groups made up of patients, family caregivers, and medical doctors from the University of Rochester Medical Center. The researchers learned the technology should be noninvasive; users don't want to fiddle with PDAs, gadgets, and sensors, and want to avoid drawing attention with beeps or other noticeable reminders. And, users want the technology to let them preserve information privacy.
The system incorporates ambient technology; technology that goes with the person everywhere and, according to Horwitz, can look at motion, activity, the sounds of voice and breathing, and how they all intersect.
Pentland said signals, previously unquantified, will become meaningful information. "Ambient technology is about things that happen just because you're alive. You walk, talk, breathe, have people come to visit. If you're well, there is a pattern, if you're sick, the pattern is different. When you interact with people, if you look bad, they can tell. They don't need to take your blood pressure. Visible and audible changes in behavior are real data. If you're laughing, if you're drawn, if the color of your skin changes or you look sweaty; all of that can be assessed ambiently."Trends and Data
In designing health-monitoring devices, turning large amounts of raw data into usable, meaningful information becomes a challenge. Recognizing trends in a big body of data, according to Bocko, is a big field in itself. The researchers brought in companies for this and other areas of niche expertise such as product design, user-friendly interfacing, automation, and human factor design.
"It's very stimulating and very exciting to work with this talented group of people," said Horwitz.
Corporate collaborators from the Rochester area include Impact Technologies, LLC; Xelic; KEK Associates, Inc; and STI Technologies, Inc. Other collaborators include Foster-Miller of Waltham, Mass.; and RLW, Inc., of State College, Pa.
The team hopes to apply what they learn with the cardiac care project to the monitoring of other disease and of normal health. The project fits in with the center's focus on health monitoring and ongoing research in motion understanding, conversational computerized personal health assessment, and "middleware"; the interface between network protocols. The center also continues research on its Smart Bandage, which monitors pathogens, allergens, and general health status.
The Pioneer Portfolio of the Robert Wood Johnson Foundation provides the major portion of funding for this research with the participating companies each contributing additional funds.About the Robert Wood Johnson Foundation and the Pioneer Portfolio
The Robert Wood Johnson Foundation www.rwjf.org focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful, and timely change. Projects in the Pioneer Portfolio are typically future-oriented and look beyond conventional thinking to explore solutions at the cutting edge of health and health care.