Is the Internet of Things the Real Thing?

The Internet of Things: an exciting new world with a digital nervous system or a nightmare where objects take decisions while we are unconscious?

15 years ago, when the term was first coined, it was about assigning everything around us a unique identity with RFID tags, to enable all material things to talk to each other and save us time for gathering and using information. As RFID tags dropped below 1 cent cost, and sensors, modems and devices are getting smaller, smarter and cheaper, this vision is moving closer to reality.

The latest Gartner's Hype Cycle (August 2014) places the Internet of Things at the peak of Inflated Expectations, while Big Data evolving in tandem with IoT has already started to fall into the through of disillusionment, getting ready to join mobile health and cloud computing right there on the bottom of the through.


Consumers are not ready to embrace the flood of smart wearables and appliances - as they don't really know what to do with them, don't perceive their value and are concerned about privacy and prices.

Clay Christensen's theory of "disruptive technology" emphasizes that technologies tend to get better at a faster rate than users' needs increase. Next Big Thing often starts as an expensive "toy". When the telephone was first introduced it could only be afforded by the rich and it could only carry a signal over a short distance. If Watson really had said in 1943 that "there is a world market for maybe five computers", as Gordon Bell pointed out much later, it would have held true for some ten years.

The first generation of IoT devices fell short of user needs and was rather primitive. Over a third of people who bought a smart wearable abandoned it a few months later. Yet, the "new" has never been hotter. It seems a new wearable is launching every week and we are constantly waiting for something newer and better, hoping it will finally answer the question "what can we do now that we could not do before?"

However, the current generation of "smart things" is focused mostly on better designed hardware and higher-end consumers. Fashionable elegant-looking devices are supposed to make wearables more appealing and "design thinking" is one of today's hottest buzzwords. Withings Activité, Fitbit pendants from Tory Burch,  Yves Béhar's designed Vessyl, Diane Von Furstenberg's Google glass, Rebecca Minkoff's tech-enabled jewelry, and the new bracelet from Intel - MICA  - highlighted by pearls and other precious stones - are getting ready to conquer attention of consumers and developers. Especially developers - as the size of the market will depend on the number of developer-entrepreneurs creating value in it.

The app economy taught hardware manufacturers that when people experiment they find ways to create value, often in unexpected ways.  But it also taught developers that they need to invest considerable time to build a marketable app and the chances of that app to make money are about 1 in 25,000. As the average age of developers keeps decreasing getting into the middle and high school years, the main benefit of app development becomes education and learning by itself. But will this be sufficient for the Internet of Things or will inter-networked things remain a toy for the wealthy?

References

• Ashton K. (2009). That 'Internet of Things' Thing, in the real world things matter more than ideas RFID Journal (June 22)
• Gartner's "Hype Cycle for Emerging Technologies, 2014" at http://www.gartner.com/document/2809728
• Harvard's Clayton Christensen on the economics of 'disruption' (techflash.com)
• Schreier G (2014). The internet of things for personalized health. Studies in health technology and informatics, 200, 22-31 PMID: 24851958
• Perera, C., Zaslavsky, A., Christen, P., & Georgakopoulos, D. (2014). Sensing as a service model for smart cities supported by Internet of Things Transactions on Emerging Telecommunications Technologies, 25 (1), 81-93 DOI: 10.1002/ett.2704
• Anderson J. amd Rainie L. (2014) The Internet of Things Will Thrive by 2025. Pew research
• Mackinlay M. (2013). Phases of Accuracy Diagnosis: (In)visibility of System Intersect, Vol 6, No 2

Building a 23rd Century Tricorder in the 21st

The $10 million Qualcomm Tricorder X Prize and $2.25 million Nokia Sensing XCHALLENGES are trying to identify the best portable technologies for diagnosing disease - as easily as Dr. McCoy's tricorder of the 23rd Century could. What scientific knowledge could help us to develop it in this age? Detecting metabolites, sensing DNA, imaging the nanoworld of the human body or interaction between matter and energy?


Medical diagnostics was always a multi-modal procedure. Even ancient physicians used optical sensing (observation), audio (auscitation) and olfaction along with interrogation and pattern recognition techniques. "The best diagnostic test" was always different for any given situation.

And the so much sought after tricorder can't be only about a single technological innovation or the right combination of existing measurement technologies, it is also about putting all the pieces together in a system that's smaller, lighter, cheaper, faster, better.

21st-century innovation is proving to be even more prolific than that of the 20th. Too many ideas, too few financially-supported ventures pursuing some of them. Yet, these 12 finalists of Nokia Sensing Challenge give an idea of what technologies are among the most popular. Here's the list:

Diagnostic Device	Sensing platform	Examples of diagnostic applications
Apollo	Optical - Spectrophotometer	Noninvasive glucose monitoring
Holomic	Optical - lens-free microscope	Blood analysis, HIV monitoring
i-calQ	Optical	Blood and saliva analysis, Ebola monitoring
InSilixa	Electrical	Genetic diagnostics
MoboSens	Electrical	Water pollution monitoring
Gene- RADAR	Biochemical	Virus detection
Programmable-Bio-Nan-Chip	Flluorescence, Immunoassays	Heart disease
QUASAR	Electromagnetic, ECG	Heart disease
Silicon BioDevices	Immunoassays	Blood analysis
ABUS-urodynamics	Ultrasound	Disorders of urinary system
Elfi-Tech	Occlusion Spectroscopy	Noninvasive cardiac monitoring
Owlstone	Chemical - Field Asymmetric Ion Mobility Spectrometer	Noninvasive glucose monitoring

REFERENCES

Waters H (2011). New $10 million X Prize launched for tricorder-style medical device. Nature medicine, 17 (7) PMID: 21738131

Close your eyes and tap your heels

How can you tell an extroverted engineer? When he talks to you, he looks at your shoes instead of his own. And now there is a good reason to do it - as new "No place like home" GPS shoes will be pointing to where the person is going. And displaying the progress bar - marking the beginning of the journey with one red light and indicating successful arrival to the place of destination with a green light on the top of the right toes. A red light on the other shoe will  display the correct direction to walk, illuminating on the circle of LEDs like an arrow of the compass. How will the shoes know where to go? By consulting the map uploaded via USB and its own GPS receivers, wirelessly communicating with each other. For future models, you could probably set up WiFi to let your shoes download more information, talk with other people's shoes and modify your route on the go.
So your footware might need its own network access, like agent Maxwell Smart's left shoe with a mobile subscription plan.
The "No place like home" shoes are built around two microcontrollers called Arduinos: A magnet in the right shoe and sensor in the left shoe communicate with each other and with the GPS antenna in the red tag at the back. Clicking the heels starts the GPS. So all you need to do is to close your eyes and tap your heels together. And there will be no need to follow the yellow brick road or say the magic words.

The smart shoes - designed by artist Dominic Wilcox and custom-made by Stamp Shoes might be a bit costly: £1,100 (about $1,750). A bit less sophisticated Aetrex Navistar GPS shoes developed for sufferers of Altzheimer's disease and dementia cost $299.99, and come with two monthly subscription plans - a basic 30 minute tracking plan, which reports every 30 minutes ($34.99) and for an additional $5 per month a premier 10 minute tracking plan. Nike was offering their own GPS footware too, for fitness enthusiasts, but decided that it's cheaper to use iPhone's location sensor to figure distance and serve as a pedometer.

Yet, sensors in high-tech shoes could be helpful. For example, they could detect if their owner is tired or exhausted. Fatigue Monitoring System (FAMOS, recently developed and tested in patients with multiple sclerosis (MS) and healthy individuals) continuously measures motions of feet, in addition to electrocardiogram, body-skin temperature and electromyogram. And the system can reliably distinguish the symptoms of fatigue. The shoe sensors could provide a wealth of information about motion and assess such things as the risk of falling. And this information can be combined with data collected through other channels.  Aurametrix, for example, can determine how food, air quality, the weather and various activities affect energy levels and generate suggestions on what to do - at the right time and right place. Systems like Aurametrix could eventually integrate our observations with data coming from smart objects such as shoes and heart monitors, to speed up not only walking but also the understanding of the human body, for a healthier world.

PUBLICATIONS

Yu F, Bilberg A, Stenager E, Rabotti C, Zhang B, & Mischi M (2012). A wireless body measurement system to study fatigue in multiple sclerosis. Physiological measurement, 33 (12), 2033-2048 PMID: 23151461

Marschollek, M., Rehwald, A., Wolf, K., Gietzelt, M., Nemitz, G., zu Schwabedissen, H., & Schulze, M. (2011). Sensors vs. experts - A performance comparison of sensor-based fall risk assessment vs. conventional assessment in a sample of geriatric patients BMC Medical Informatics and Decision Making, 11 (1) DOI: 10.1186/1472-6947-11-48

Cars That Care

Health technology of the future promises an easy life with no interruption in your daily activities. For example, information about your health could be collected while you're driving. A car is already viewed as a health platform and wellness coach by leading manufacturers. How would this work?


To begin with, by measuring our heart rate. The electrocardiographic (ECG) seat built by Ford is based on studies of sensors in beds for intensive care units. Unlike traditional monitoring systems, it does not require attaching electrodes to the skin and can measure signals through relatively thin cloth. Toyota's response to Ford's seat is an ECG-sensing steering wheel.

Regardless of what type of system incorporates the sensors, clever algorithmic science is needed to account for artifacts caused by lateral movements. Wartzek and colleagues showed that unobtrusive and reliable measurements of heart rate are indeed possible during driving by identifying useful intervals in heavily distorted ECG signals (which is easier on the highway than in city traffic). Moreover, data from ECG, GPS and optical devices could  be combined  with other measurements though, as Doherty and colleagues showed, significant data processing issues still remain. Companies like Aurametrix are addressing the problem of noisy environments with innovative approaches. 

So in a few years cars will start to take care of us. We need to polish up the sensor and data processing technologies and also manage the chemicals added to the interior of the car--including those contributing to the "new car" smell.  Unhealthy particles in some automobile interiors already exceed US EPA standards, especially in heavy traffic situations (although bicyclists and pedestrians have their own problems). The latest report by HealthyStuff.org ranks over 200 of the most popular models based on chemical-emitting steering wheels, dashboards, armrests and seats. As the table shows, stylish and sporty models are at the bottom of the list.  


There are many reasons to believe these problems will be addressed. If so, we can look forward to a future with safely built in to the systems we use in our every day lives.


REFERENCES


Wartzek T, Eilebrecht B, Lem J, Lindner HJ, Leonhardt S, & Walter M (2011). ECG on the road: robust and unobtrusive estimation of heart rate. IEEE transactions on bio-medical engineering, 58 (11), 3112-20 PMID: 21824839

Doherty ST, & Oh P (2012). A multi-sensor monitoring system of human physiology and daily activities. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 18 (3), 185-92 PMID: 22480300

Can Software help Health care?

Apps, apps and more apps. Software is everything and everything runs on software.


Almost every industry in the U.S. has been disrupted by software. The health care field is not one of them.

Easily accessible consumer information makes everyone a little bit doctor. Emerging portable diagnostic devices will strengthen the transition. Are we up to it?

Not yet.

A large majority of people want to own their health information. Many want to store it online and have better control over it. Yet, most people don't want any extra work associated with updating and maintaining it. As public health record (PHR) expert Jim Tate said:

My 'dream PHR' continues to evolve. What I want now is a elegant interface which gives me a real time dynamic look into my record located somewhere in the stratosphere. I don’t want to have to do anything. Please don’t ask me to input anything or make more than 2 or 3 decisions. Make it simple, intuitive, powerful, and available on the internet and I will use it. Maybe."

Yes, we are inherently lazy, always trying to find shortcuts and reduce the amount of work to get a task done. Why spend time creating and maintaining our own records when a doctor can do it for us? Or even better, why not just live and enjoy life before we get sick?

Problem is, most of us at various stages throughout life suffer from subtle conditions like food sensitivities or allergies that doctors can't easily diagnose. They're relatively minor in severity, but if managed properly our lives would be a lot better off. So maybe all we need is a doctor who's just a mobile app away, always ready to answer our questions for free.

But will these legions of online doctors have enough insight into our everyday lives to know what we eat, what we breath, and what it is we're not saying to form an expert opinion?

Not likely. Even if we could wear mobile devices - always on, always connected, counting our steps, cataloging our night sweats, and equipped with miniature cameras to photograph what we eat - would the doctors be able to process all that information to form a useful diagnosis?

Aurametrix is an advanced analysis tool that correlates our symptoms, reactions and feelings based on what we enter into the system about our diet, exercise and conditions. Results from early usage of the tool show that even occasional sparse information - entered on days we feel better or worse than average - if properly evaluated can provide a snapshot of our health with sufficient insight to connect the dots to better health.  It's a form of collective intelligence that's already providing interesting discoveries without the need for us to know all the details. For example, it already knows what our foods consist of, how our daily activities or feelings align with past events, and that there are commonalities among many different things.

The future is already here but are we ready for the future?

REFERENCES

Archer N, Fevrier-Thomas U, Lokker C, McKibbon KA, & Straus SE (2011). Personal health records: a scoping review. Journal of the American Medical Informatics Association : JAMIA, 18 (4), 515-22 PMID: 21672914

Kim J, Bates DW. Analysis of the definition and utility of personal health records using q methodology. J Med Internet Res. 2011 Nov 29;13(4):e106.

Geissbuhler A, Kimura M, Kulikowski CA, Murray PJ, Ohno-Machado L, Park HA, Haux R.
Confluence of disciplines in health informatics: an international perspective. Methods Inf Med. 2011 Dec 6;50(6):545-55.

Macedo LG, Maher CH, Latimer J, McAuley JH. Feasibility of using Short Message Service (SMS) to collect pain outcomes in a low back pain clinical trial. Spine (Phila Pa 1976). 2011 Dec 3.

Lo Piparo E, Worth A, Manibusan M, Yang C, Schilter B, Mazzatorta P, Jacobs MN, Steinkellner H, Mohimont L. Use of computational tools in the field of food safety. Regul Toxicol Pharmacol. 2011 Aug;60(3):354-62. Epub 2011 May 12.

Benito PJ, Neiva C, González-Quijano PS, Cupeiro R, Morencos E, Peinado AB. Validation of the SenseWear armband in circuit resistance training with different loads. Eur J Appl Physiol. 2011 Dec 6.

Yoshiaki Sugawara,Chie Sugimoto, Sachiko Minabe, Yoshie Iura, Mai Okazaki, Natuki Nakagawa, Miwa Seto, Saki Maruyama, Miki Hirano and Ichiro Kitayama. Use of Human Senses as Sensors. Sensors. 2009, 9(5), 3184-3204; doi:10.3390/s90503184

QS#14: There are more questions than answers

Quantifying self: there are more questions than answers

Notes from QS Show&Tell #14 held in the San Francisco Bay Area Tech Museum of San Jose on June 22nd.

Quantifying Productivity

Bill Jarrold used a simple script to record his Unix activity with timestamps on the commands he typed. By quantifying the number of operations per hour he determined that he is usually on the roll at about 3pm, but is slowing down around 10am and midnight. The talk spurred discussions about other ways to analyze productivity - number of builds per time unit? keystrokes? content analysis of the commands? There also were suggestions on using GUI-based tools. For example, CoScripter Reusable History that records everything one does on the web. Or DeliciousDiscovery that analyzes Delicious bookmarks and tags. There are even commercial software tools such as SpyAgent that capture everything a computer user does: keystrokes typed, websites visited, chat conversations, applications ran, emails sent and received, files opened, and more.

One needs not only sophisticated screening and recording of performance related measures but also more sophisticated data analysis methods. There is a good discussion on HN about More-Hours-Worked not equal to More-Work-Getting-Done (it started from this post: Something Deeply Wrong With Chemistry). Dependence of productivity on hours worked is bell shaped and very individual. Some may be most productive when working 35 hours a week, others could increase workload to 60 hours. Number of keystrokes may not necessarily correlate with meaningful output either. Remember Jack Nicholson in The Shining? Besides, sometimes we need to think before turning ideas into action. And how could we measure what is going on in the brain?

Quantifying Thoughts

Mark Carranza is probably the most notable collector of thoughts among the Bay area quantifiers. His database has more than one and a quarter of a million thoughts and keeps growing, with more entries than the diary of Samuel Pepis and the collection of Lion Kimbro, the man who wrote down every though he had.
Jim, the second presenter of QS#14 is collecting thoughts too - he has 65,000 of them connected by associations and represented by colorful visualizations. He uses spreadsheets and Personal Brain software to create and display the results. TheBrain's display is organized around a central Thought, surrounded by all its Children, Siblings and Jumps - like an ontology - helping to follow a train of hought, flowing from one to the next or just wandering around. Navigation through the data is interesting although rather chaotic. Questions from QS participants addressed the usefulness of the tool. Does it really help to to leverage the power of visual thinking and understand the context of information before taking action?

Quantifying Stress

Bharat Vasan of PulseTrace Technologies gave a great impromptu talk on how he is using his watch reading real time heart rate from his wrist. Data may be uploaded via USB or wireless connection. One good application is managing stress. Bharat wants to be a good public speaker - and he certainly is, but his pulse rate always skyrockets during a presentation. Of course, some of us don't need to have a watch like this to know if pulse rate is elevated - the tendency to blush lets everybody around to take the readings. Shortness of breath, nausea and sweating may add to the picture. As Jerry Seinfeld said about delivering the eulogy, most people would rather be in the casket than speaking in public. One the other hand, some increase in pulse when talking is rather good and he trick is to use it as energy to fuel the presentation.
Pulse rate is a good measure of stress levels. Other measures would complement it and contribute to meaningful analytics. For example, recovery heart rate, a measure of how quickly ones heart could return to resting state. Standing vs sitting - normally there is 5 to 10 beats difference. Temperature in the room. Coffee or spices in food...

I have not tried the PT100 sensor-based watch, but my complaints about similar monitoring watches include their inability to measure heart rate during running at full speed, sensitivity to humidity, rain, food vapors, limited time intervals between repeated measurements. I also question reliability of measurements in 1-5% of cases.

Quantifying Motion

Indeed, quantifiers are improving their lives not only with spreadsheets and software - gadget usage continues to rise. ("Zeo's broken" was among two-word introductions of meetup participants). There were many Fitbit fans proudly showing their devices and less proudly measurements for the day - Wow, we are becoming ashamed for not stepping enough! Popular motion gadgets do not work for everyone and are generation 1.0 or rather 0.5 - some like swimming instead of running and elliptical trainers instead of treadmills, others are surprised to find that rocking baby in their arms was counted as calorie-burning steps. BodyMedia Fit (GoWear Fit), for example, measures not only acceleration, but also skin temperature and galvanic skin response reflective of physical stress, but is not water proof and can't measure emotional stress. Fitbit is less pricey but also not quite ready to do what most people want. The next talk was devoted to fitbit's corporate competitor - DirectLife.

Alex Bangs, co-founder of Entelos now working on a spinoff - DigitalSelf, likes this little white plastic box and DirectLife program. The device has accelerometers to quantify how much you move. The program starts with a one week assessment to get a good idea of individual's current activity and create a baseline. The plan has daily activity goals that increase slowly week by week (hopefully not as in The Red Shoes by Andersen!). Alex showed how his device was flashing congratulating him with good activity levels for the day. It could be even better, he said, the little box can almost sing a tribute to you if you walked more than your goal. The device fits in the pocket, but can be forgotten at home - which makes every wearer sad as the accomplishments of the day will not be logged and recognized. We love to be tapped on the back and told well done, are not we all?

Open source health gadgets

Sports Watch
How would you like to have a 3-axis accelerometer, pressure sensor, temperature sensor, RF wireless, and an LCD screen in a development package? You can actually have it - as a wristwatch offered by Texas Instruments. for just $49.
The package includes a USB programming and emulation dongle so that you can develop your own firmware. It uses Texas Instrument’s SimpliciTI and BM Innovations’ Blue Robin RF protocols that enable developers to establish wireless links right out of the box. The firmware transforms it into a sports watch with heart rate monitor, it is written for Windows but could be adopted for other platforms too.
First hackers that got hold of the package used it to wirelessly unlock doors with the buttons and accelerometer. You could utilize other functionalities as well, and jog around while configuring your Linux.

Peripheral nerve stimulator

The jfish peripheral nerve stimulator is a device used in anesthesia or intensive care to assess the degree of neuromuscular blockade (normal communication between motor nerves and skeletal muscle can be blocked by a drug). The device can detect both the magnitude and type of neuromuscular blockade. Itis developed by Daniel Jolley, a doctor and anaesthetic registrar, at The Austin Hospital in Melbourne, Australia. His device uses Texas Instruments' MSP430 line of microcontrollers - ultra-low power 16-bit RISC mixed-signal computers-on-a-chip. Check the document ‘The science and use of the peripheral nerve stimulator‘ for how to use the stimulator.

OpenECG
Open source hardware and software solution for electrocardiography was presented at the
34th Annual Conference of the International Society for Computerized Electrocardiology
The device is battery powered, it can also use an isolation transformer plus defib protection in front of the op-amps on the front-end.

OpenEEGMany EEG-based gadgets - like Zeo personal sleep coach - are in the market. OpenEEGproject can assist your brain-computer interface, bi-directional serial communication or neurofeedback experiments. The modularEEG is currently the most popular of all the designs Check online documentation for more. Then, go to the SourceForge page and download the ModularEEG project zip-file. You will find schematics, board layouts and parts lists that can be ordered from various distributors.

What a paradise for Hackers - they can design gadgets and let other people manufacture them. The open source hardware companies are predicted to be making over one billion in revenues by 2015. Most of them are offering educational electronics, but some of the packages could be utilized for health gadget development. See this talk presented at O'Reilly's foo camp east 2010.

Open source hardware $1m and beyond - foo camp east 2010 from adafruit industries on Vimeo.

Aurametrix is working on low-cost personal diagnostic devices to improve individual health