Technology | Medical Futures Lab

Apr 20 2014

Communication, Culture, Design, Education, Health, Technology

Too Much of a Good Thing

A recent article published in the Argus Leader from Sioux Falls, SD highlights the difficulty that parents face in controlling their children’s internet usage. The article cites research by a distinguished pediatrician that determined social media can have a very negative impact on children. Heavy media use can be a detriment to a child’s health and social life. Therefore it is imperative that parents find a way to limit their child’s exposure to media on the internet and social media. Unfortunately many parents are not as savvy as their children when it comes to the internet so they do not understand the risks involved and potential consequences of excessive use. Nor do they know how to limit use or how much limitation is sufficient. Clearly children need to utilize the internet as a source of information and mental stimulation so it is crucial parents know where and when to cut down on internet use.

Some side effects associated with excessive exposure to the internet are lack of sleep and poor nutrition. Children need eight to ten hours of sleep a night and a balanced diet in order to develop properly and avoid health complications in the future. The internet acts as an escape and a distraction from normal life so kids these days spend more time indoors than ever before. They are also affected socially as interaction with others online hampers their face to face communication skills and ability to empathize. Substituting electronic for real life personal interaction leads to a poor understanding of facial expressions, tone and nuance in everyday conversation.

Due to these mal-effects of the internet on a child’s life it is imperative that parents limit online usage. As the author of the article points out, unfortunately parents do not understand the internet and mobile applications very well, often less than their children. Therefore, parents need to establish communication with the children in order to further their understanding and protect their children. This necessary role reversal makes for an interesting modern family dynamic.

As we move through this class trying to increase the use of mobile technologies and the internet to better patient care it is important to remember that there are physical and mental side effects associated with it. Every solution no matter how beneficial contains inherent negative side effects. We also need to understand that the baby boomer generation is not as well versed in technology as our generation. Therefore when designing solutions to issues in healthcare that involve the internet and media we must teach rather than simply provide. Overall tech literacy must be increased or else our solutions will remedy little and confound many.

Argus Leader Article: http://www.argusleader.com/story/news/2014/04/08/children-face-health-risks-social-media-overload/7452213/

Apr 18 2014

Culture, Design, e-patient, Health, Humanities, Humanity, Story, Technology

Guided Medicine or Big Brother: A Thought Experiment

Self-tracking devices have been lauded as the potential solution to filling in the gaps in traditional clinical data collection. Oftentimes, measurements in the doctor’s office are not truly indicative of the patient’s everyday behavior and lifestyle; patients may experience white coat syndrome, or increased anxiety in the presence of the doctor. Automatic self-tracking in everyday living may provide more accurate data because the data is collected in more natural settings.

One of the goals of self-tracking is to model and predict human behavior. This sounds quite promising; however, how does this automated self-tracking actually come about? Would we want our personal handheld devices to predict our next moves? And what a fascinating thought experiment it would be to have our phones, these inanimate devices, give us life suggestions. But oh wait, they do.

Google Now carefully watches its users’ every interaction to improve its efficacy. It can predict where you will go judging by your past behavior. It can detect that on Wednesdays, you like to get a Grande green tea frappe at Starbucks before your Russian literature class, and sometimes, when you’re having a particularly packed week, you treat yourself and venture into the bold Venti end of the spectrum. While Google Now has the potential to notify you if there is a promotion on green tea frappes, it may suggest another drink perhaps, and as a subtle suggestion, a drink with fewer calories and a lower fat content.

Photo Credit: clipandfollow.com

Popular Science awarded Google Now as the 2012 “Innovation of the Year” for its potential to serve as an “intelligent personal assistant.” It can infer your age bracket from your recent searches and tailor advertisements to your curated predilections. For your mother, it can suggest her favorite hair dyes or jewelry boutiques, but what if one day following her sixtieth birthday, it begins suggesting cholesterol medicine and life insurance? While this teeters on the edge of being mildly insensitive, it may regrettably be a sensible recommendation.

But it doesn’t stop there. Google Now has a minute-by-minute map of your life. Not only can it suggest nearby attractions and events, but it can also summarize your daily physical activity. Given your latest late-night food adventures, it could now suggest restaurants with healthier vegetarian options. It could also suggest a route that requires more physical exertion (to make up for that discreet donut run that you thought went undetected), and in your hurry, you wouldn’t notice that it was slightly more strenuous, with a steeper incline of about two degrees.

Photo Credit: geofffox.com

Physicians have the potential to produce mobile health applications that use the same tracking devices as Google Now. While they have the promise of displaying customized content and advertisements, they can also subtly suggest healthier eats and longer walking routes. With smartphones constantly linking accounts and contacts, mobile health applications will soon be connected to the information collected by Google Now. And suddenly, without your conscious awareness, you will be forced to be utterly and irrevocably healthy.

Apr 16 2014

Culture, e-patient, Technology

Quantified Self vs quantified self

I’ve mentioned a couple of his videos before, but last week, my favorite YouTube channel—PBS Idea Channel (and the host, Mike)—released an episode titled “How Much Can Data Improve Your Health?”

In the video, Mike talks about the Quantified Self: “that data about or from your body, usually gathered by gadgets, will lay bare and inspire you to improve your body-temple-wonderland.” He mentions that as time passes, gadgets not only get smaller, but also closer to—and possibly inside—the body. With the data we get, we can crunch the data and learn interesting things about ourselves. According to Mike, this is what Whitney Erin Boesel uses to differentiate the ideas of “quantified self” in lower case—having and knowing the data–and “Quantified Self” with title case—knowing and using the data. “Practitioners of the latter don’t just self track. They interrogate the experiences, methods, and meaning of their self tracking practices…”

One interesting thing to think about: what IS the population doing with their data? First, I can talk about this from a personal standpoint. I have two main devices that put me within the Quantified Self spectrum: I have a Nike+ fuel band that tracks motion and a sleep cycle app on my phone that tracks my sleep (side note, I’m experimenting a bit with different apps in the latter to see what kind of information I can get). If we wanted to put me on a continuum for quantified self, I would be unequivocally within the movement (knowledge the movement itself assumed to be a non-issue), but nearer to the “quantified self” end than to the “Quantified Self” pole.

That’s because, while I have this information, I’m not actually using it to do anything. I’m actually content with just the knowledge. Maybe I’d realize that I need to walk a little more tomorrow, or sleep earlier, but I’m still not doing much with all this data I have. Now, I realize that my team’s project has moved away from self tracking per se, but I still feel that this is interesting to talk about for patients and for what we know about patients tracking their data. Being part of the Quantified Self movement takes a LOT of energy (and the motivation accompanying it). I—and Mike as well—have a sense that people who track healthcare information tend to be part of the quantified self movement because of the effort required to be in the other camp. This isn’t a new idea; I’ve talked about it before. Having people put in effort is hard, it is a barrier to access and for patients, and it is a steep hill on the way to becoming more engaged in healthcare. It should be interesting to do a bit more research and learn if self-tracking itself leads to better outcomes, or if the engagement of the self-tracking has that effect.

Another related issue Mike mentioned was about data, “The objectivity of the information upon which they crunch is only just a shade of such….the transition from data to information is not a net 0 process.” He goes on to mention that the data doesn’t necessarily represent reality: “…the existence of a datum has been independent of consideration of any corresponding ontological truth.” This is more of an issue for our group, but it is one we have already considered and are working on a solution. Essentially, patients can give information, but we have no way of verifying its veracity until they are seen by an actual person (and even then, subjective, qualitative experiences like pain still elude external scrutiny), nor can we be sure that correct data represents that which we want to represent. For example, if a patient used our app that we proposed and with it mentioned that they are feeling pain and there is some discoloration of the knee, the patient’s relevant healthcare professionals—a doctor and/or nurses—would be told that there is some potentially severe problem like an infection. Yet the data could show the same symbols if the patient, say, got a tan and bumped it a few minutes prior.

He concludes by noting that the mass produced consumer products that we buy to track health data are often not to emphasize effectiveness in using the consumer’s own data, but rather to compare and compete with other people or with some “fitness ideal” that holds a standard towards which one should be working, because body competition is the focus of a lot of things in our world. Yet, they both allow us to learn more about ourselves, and thus act more effectively in the world.

Apr 10 2014

Culture, Health, Medicine, Technology

A Vital Change

Google recently announced a project in which they plan to develop contact lenses that measure a person’s blood glucose level. The project is very much in the early stages of development but it indicates the potential for furthering involvement of technology in healthcare. It is imperative that the healthcare industry supports technological innovations such as this that will improve patient care. Technology must be viewed in the same way as medication in how beneficial it can be to global health.

Google describes the project as a potential game changer for diabetes treatment. The function of the contact lens is to measure glucose levels in tears, thereby making it easier for diabetes patients to determine their blood glucose level. At the moment, a patient must draw his or her blood which can be a difficult and painful process. What ends up happening is that patients fail to regularly check their blood as often as they should and develop further complications as a result. How the data from the lens is made known to the patient is not currently established. Some have suggested a series of blinking lights in the lens that notify the wearer when it is time to take insulin. Another approach is to somehow transmit the data to the user’s smartphone where it is displayed in an application and stored on a secure Google server. In the latter solution it would also be possible to send this stored information to the patient’s physician, providing them with updates on the patient’s progress and insulin usage. A cutting-edge solution to treat diabetes more effectively is vital considering it is one of the fastest growing diseases in the world.

In this modern age of technology and rapid development of new and exciting products that better quality of life the healthcare industry must be more open and supportive of innovation in patient care. Not to say that it is currently averse to the prospect but there exists a lot of red tape and inefficiencies that slow progress. The industry must be willing to adapt as quickly as the rest of the economy in order to realize vital improvements that will help patients today. The laggard mentality and outdated ideals prevalent in the healthcare system must adapt to the current culture of innovation and ubiquitous use of high-tech devices. This will ensure projects such as the Google contact lenses become tangible products.

Apr 06 2014

Communication, e-patient, Health, Technology

Mindful mHealth

In the past several years, there has been increased discussion about bringing medicine into the technological era, and out of the darkness of paper methods and inefficiency. Words and phrases like “media,” “digital,” and “mobile technologies”are becoming more and more linked to healthcare. Because we do live in the age of technology, a time when nearly every person in America owns a cell phone (91%) and uses the internet, such a movement seems not only favorable, but necessary. As we push medicine into the digital age, we applaud new, innovative uses of advanced technology for testing, treating, and tracking—for features that allow the new age of “ePatients” to take control of their health.

One of the most “fashionable” new technologies is the mobile app. Apps allow patients to use their mobile phones to track their diet, exercise, blood pressure, etc. With so many emerging uses, smartphones provide a promising avenue to increased ePatient activity. As a result, when people think of patient-centered health media, the first thing that comes to mind is generally mobile apps—or is it?

When I say “people,” this is a very biased demographic. I am a Rice University student in a Medical Media Arts class. While my peers come from very diverse backgrounds, our current lifestyle places us in a specific demographic—that of educated young people who are exposed to mobile technology, specifically smartphones, on a daily basis. Those developing mobile health technologies generally come from similar backgrounds, in that they are most likely very familiar with smartphone usage, and quite possibly own smartphones themselves. For a significant portion of the population, this is not the case.

According to Pew Research, only 58% of Americans own a smartphone. While this is more than half of the population, this still means that roughly 131.8 million Americans (42%) do not own a smartphone or have access to mobile applications.

One of the many advantages of mobile technology is its ubiquitous nature and its potential to bridge health disparities by reaching large, diverse populations. However, if all of our focus is placed in a sector of mHealth that such a significant portion of people do not have access to, we are only compounding health disparities with a technological one.

While I believe that mobile applications are a very promising avenue of healthcare, I think that other mobile phone capabilities should continue to be utilized. For example, while only 50% of cell phone owners download mobile apps, 81% send and receive text messages. Text messaging is a simple, low-cost technology, which can be utilized with or without a smartphone, and has consistently been in greater use than mobile apps.

While text message-use is beginning to level-out, mobile app usage is still increasing. However, until the transferral to mobile apps is complete, the “non-app” population should not be ignored. Text message-based mHealth campaigns have already been developed, such as Txt4health, SmokefreeTXT, and text4baby. All of these services promote positive health behaviors by sending text message reminders to patients in the program. We should use these programs as models while we consider avenues that promote patient-centered healthcare and patient engagement, and be mindful of who we are trying to reach and how to best reach them. While mobile applications are a promising platform, which should definitely be utilized, we also have to ensure that we make mobile technologies the solution and not the problem in addressing health disparities.

Medical Futures Lab

Category Archives: Technology

Too Much of a Good Thing

Guided Medicine or Big Brother: A Thought Experiment

Quantified Self vs quantified self

A Vital Change

Mindful mHealth

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