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Winter 1999-2000
Vol. 62, No. 2

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Memory Glasses, Wristwatch Monitors, and Smart Socks . . .

Here's to Your Future Health

"Medicine is about treating disease. We are about maintaining health," says one of the founders of the Center for Future Health. In this bold new venture, engineers and physicians are together creating an arsenal of gee-whiz devices designed to put you in charge of keeping up on your own well-being--routinely, cheaply, and conveniently at home.

By Tom Rickey

In today's health care system, "high tech" and "high cost" often go together--usually in a hospital, and often in the waning years of life.

The latest technology--CT and MRI scanners, pacemakers, and the like--generally doesn't reach the patient's bedside until after he or she is already ill or injured.

A team of Rochester engineers, physicians, and scientists is out to change that.

Reasoning that it makes a lot more sense to help people avoid disease than to try (expensively) to fix things after it strikes, the University this spring launched the Center for Future Health. Its mission: to create affordable, user-friendly technology that people can use in their own homes to catch small problems before they escalate, and ultimately, to help them live longer independently.

Also see: Coming to a Drugstore Near You: Smart Tools in Your Future
A monitor in the bathroom shower that scans for signs of melanoma; computerized eyeglasses that jog a failing memory with whispered cues; a "smart bandage" that senses a developing infection and identifies, on the spot, the antibiotic needed to fight it: These are the kinds of gee-whiz devices that the center's engineers are engaged in developing in collaboration with its physicians.

Their goal is to make technology affordable and easy to use, so that the home, not the hospital or doctor's office, becomes the place where patients maintain their health. University officials know of no other effort where the focus is on developing new technologies for the prevention of disease through everyday use by large numbers of people.

"There are groups out there left and right developing devices for individual applications. But we're talking about something more sweeping--a fundamental change that will give people greater ownership over their own health," says Philippe Fauchet, center director. "Our new medical technology will be on a personal scale. It will be technology you can trust and use every day as a matter of simple routine.

"There is a good comparison between the way we treat our bodies in the present health care system and the way we treat our cars," he adds. "The best way to keep a car running as long as possible is to keep it maintained regularly --get the oil checked every 3,000 miles, do protective maintenance, do rust-proofing.

"But with our own health, we basically don't act until there's something wrong. It's the same as never changing the oil in your car and just running it until it dies on the highway."

The center is currently conducting about 20 research projects, including several in collaboration with the Media Lab at Massachusetts Institute of Technology. Most involve taking a new technology--pattern recognition, DNA computing, or artificial-intelligence software--and using it as the seed of a low-cost, portable device.

Software for recognizing patterns and motion might become the basis of a "gait monitor" that could give early warning of a stroke. Artificial-intelligence logarithms are being studied for use in an "anger alert," a device, perhaps packaged in a Dick Tracy wristwatch, that might be helpful in curbing emotions before destructive rage erupts. DNA could provide the miniaturized computing power required by a "smart bandage."

From the outset, engineers and scientists have been working closely with physicians, making sure the goals are realistic and appropriate. About two dozen core researchers are faculty members at the University, the center's lead institution. The MIT Media Lab, a long-term partner, contributes about half a dozen faculty participants. Also involved are researchers at the Georgia Institute of Technology and the University of Toronto, as well as dozens of graduate students.

The brainchild of Fauchet, chair of the Department of Electrical and Computer Engineering, and physician Alice Pentland, the James H. Sterner Professor and chair of the Department of Dermatology, the center is headed by Fauchet as director and Pentland as medical director. Sandy Pentland (Alice's brother), academic head of the MIT Media Lab and adjunct professor at Rochester, is external director.

The researchers hail from a broad spectrum of disciplines: computer science, neurology, electrical and computer engineering, chemistry, psychiatry, and community and preventive medicine, to name a few. Among others are political scientists, anthropologists, and ethicists who help analyze the social implications of the center's work.

A host of factors fostered creation of such a facility at Rochester, organizers note. Both the medical and engineering schools are highly ranked, and, with their campuses located just across the street from each other, collaboration is convenient. Rochester investigators also had already formed alliances with interested engineers at other research centers. And the University has expertise in licensing its technology, regularly ranking among the top 25 universities nationwide in patent royalties.

Several companies have expressed interest in the center, which is currently pursuing funding from large agencies like the National Institutes of Health and the National Science Foundation, as well as private foundations. Most of the projects build on research that is currently under way, funded through grants to individual investigators. As they progress, the devices will be tested and demonstrated in a prototype "medically smart home" before commercialization.

While it's tempting to think of the center as just another medical research facility, its focus will not be on "big medicine," Alice Pentland says.

"Medicine is about treating disease. We are about maintaining health," she emphasizes. "Currently medicine is centered on big machines in doctors' offices or hospitals, and it's not friendly for consumers to access.

"Your quality of life degrades before expensive technology is brought to bear on the illness. Information about your health is dispersed among many different providers. And the physician is in control. We have a new vision of medicine, where people can assess their health in their own homes, and where consumers have more control over their personal well-being."

It is estimated that last year individuals spent more than $25 billion on out-of-pocket costs not currently included as part of the "medical system," Pentland says--a sure sign that people want more say in their health care, she notes.

Adds Fauchet: "The current system is under tremendous stress. There are tools to keep you alive the last few years of your life--at tremendous cost. But what about maintaining your quality of life--at minimal cost?"

A question Pentland and Fauchet tend to get asked, with some frequency, is whether your average Joe or Jane is ready and willing to use the smart tools these researchers are envisioning.

They may get some clues on how people react to unfamiliar technology as a byproduct of another aspect of their work --the LINCOS project that is helping to extend do-it-yourself health care to areas where little if any care is currently available.

Designed, quite literally, to deliver technology by the boxful to isolated rural communities, LINCOS is a collaboration of the Rochester group with MIT and Costa Rican officials led by former president Jose Maria Figureres Olsen.

A LINCOS box can be described as a kind of "digital town center"--essentially a shipping container of off-the-shelf, easily maintainable technology that can be air-lifted into remote locations worldwide.

Equipped with a satellite link, wire-less telephone connections, mini-labs, a multipurpose information center, electronic banking services, and the like, the LINCOS container--which doubles as a prefab building--is envisioned as a community center supporting a wide range of applications in education, health, agriculture, and entertainment.

The Rochester group is developing the box's health component, ranging from educational materials to telemedicine technology for long-distance diagnosis to such basics as stethoscopes and thermometers. So equipped, local workers can connect to medical databases on the Internet, talk with people from other LINCOS communities, or help a doctor in a distant city diagnose a patient.

The first container was placed in a remote village in Costa Rica last summer. Several more are planned for that country, at least 20 in the United States, and dozens more throughout Latin America.

Timothy Dye, an associate professor in the Department of Community and Preventive Medicine, is making sure that all this modern technology meets the needs of those isolated communities. "You can develop the niftiest technological gadget in the world to improve health, but if it's not made in a way that people will use it--it doesn't help them at all," he says.

"LINCOS is a prototype for the integration of communities worldwide," adds Alice Pentland. "It's vital that we understand the needs of each individual community. Our work with this project will help us understand a culture's traditions, how it makes its decisions about health, how it perceives computers, and a variety of other issues.

"We don't want our inventions just sitting in a laboratory. We intend these technologies to be used, not only nationwide but worldwide as well."

As Fauchet puts it: "We want to give everybody the tools to be good to themselves."

Senior science editor for the Office of University Public Relations, Tom Rickey covers science and medicine for the Review.

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