Mirror, Mirror on the wall, Am I healthy after all?

Health gadgets continue to evolve in many forms and shapes - from something that fits in your pocket to something that is wearable or walkable. Everyday objects are turning into "Smart objects", building the foundation for the next version of the Internet. And it's not all smoke and mirrors. So let's talk about mirrors.

Fairy tales and science fiction stories often pave the way to real world technology. Magic mirrors have been used in Snow White and Harry Potter's world. Now you can get one, too - manufactured by a Hong Kong company James Law Cybertecture International.

Cybertecture mirror can tell you about the weather or your last weight readings reported by the scales. It can show you a TV channel, let you browse Facebook or twitter and help you to exercise. Impressive, yet so much more is yet to come.

Could a mirror tell us how healthy we are? For example, could it measure our heart rate at a distance? Sure, it could. And it has already been demonstrated as a concept prototype (Cardiocam, MIT media labs, Poh et al. 2010), although the designer is now focusing on mobile devices (check his company Cardiio).

What other health metrics could be performed by the mirror during your regular morning hygiene routine? If a camera can measure minute changes in the color of your face to determine your heart rate, it could also measure your facial expressions and emotions or perform observational analysis  - the first of four methods of diagnosis performed by traditional Chinese medicine.

Prototypes for computerized facial diagnostic systems already have been developed. One recent study, for example, (Li et al 2012) analyzes lips. The software segments lips from the rest of the face and extracts color, texture and shape features. Special supervised learning algorithms are then able to classify lips as deep-red, purple, red or pale and make inferences related to energy levels and circulation.

Health management applications will not be limited to smartphones or smart homes. All objects in our lives will gradually become "smarter." Mobile phones can already manage vacuum cleaners and thermostats. Refrigerators can tweet, check Google calendars, download recipes, play tunes and alert us about food spoilage. Mirrors can monitor our weight and exercise. There is still more emphasis these days on technological wizardry than on actual benefits, but data collected through different channels can be brought together for analysis and context. Aurametrix, for example, can find common ground to make connections between specific symptoms and weather, air quality, food, weight, heart rate, exercise, work-related and personal care activities - and generate suggestions on what could be affecting the symptoms, and in which amounts and combinations. Systems like Aurametrix could eventually integrate our observations with data coming from smart objects surrounding us and then generate valuable insights. And perhaps, one day, we won't regard the mirror on the wall nagging us about losing weight or commenting on the bags under our eyes as invasion of privacy. Let's build the future piece by piece - and they will come.


REFERENCES

Poh MZ, McDuff DJ, & Picard RW (2010). Non-contact, automated cardiac pulse measurements using video imaging and blind source separation. Optics express, 18 (10), 10762-74 PMID: 20588929

Li F, Zhao C, Xia Z, Wang Y, Zhou X, & Li GZ (2012). Computer-assisted lip diagnosis on traditional Chinese medicine using multi-class support vector machines. BMC complementary and alternative medicine, 12 (1) PMID: 22898352

Littlewort, G., Whitehill, J., Wu, T., Fasel, I.R., Frank, M., Movellan, J.R., Bartlett, M.S. (2011) The Computer Expression Recognition Toolbox (CERT). Proceedings of the 9th IEEE Conference on Automatic Face and Gesture Recognition. 

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