Technology and Trends

Imagine patients who receive regular, quality care without leaving the comfort of their homes; who follow instructions to the letter--even when it is changed mid-treatment--and whose vital signs are monitored hourly by specialists miles apart.

Manufacturers worldwide are quickly developing "smart" home health products that efficiently and cost-effectively connect patients to caregivers--while virtually eliminating product misuse.

What's behind the technology revolution? The unprecedented aging of the global population. On Jan. 1, 2011, the first American baby boomers will blow out 65 candles. By 2030, the U.S. population age 65 or older is expected to double, and 20 percent of Americans--some 70 million people--will break through to the other side of their 65th birthday.

The number of seniors will increase significantly during the next three to four decades. This increase will, in turn, result in an increased demand for support and special services. Right now more than 60 percent of those 85 years and older suffer enough disability that they need help to manage the basic activities of daily living.

The electronic house call is already a reality.

As people age, they need more help to compensate for their decreased abilities. Older people's quality of life is curtailed by chronic diseases, such as hypertension, heart disease, cancer, diabetes and strokes as well as memory and motor impairments. Smart home health products will balance the equation and restore some of that quality to everyone's lives.

Experts predict technology, particularly wireless technology and advanced sensor technology, will increase the amount of independent living enjoyed by those who need a varied amount of help with day-to-day life. Advances in electronic components will create smaller, cheaper, more rugged, reliable and adaptive systems. Only a lack of imagination will hinder further advancements in home health care.

The Future Is Here

The electronic house call is already a reality. Telemedicine programs are being conducted with small test populations in several parts of the nation, particularly in rural areas, for people exhibiting chronic conditions such as diabetes and kidney and heart problems. Telemedicine uses interactive audiovisual and data communications to diagnose, consult, monitor, treat, educate and transfer medical data. Some of the available systems use special telephone and computer combinations; some use satellite links and some deliver health care over traditional cable TV lines.

In a time when post-operative hospital stays are shorter, but care is still required, smart technology will cut down on in-office physician visits and ease the minds of patients, caregivers and physicians. Ongoing medical office visits that are particularly challenging to the elderly and others with chronic health problems will be significantly reduced--without affecting the level of care.

For example, technology is available to allow the patient and doctor to confer by a networked system, via a monitor and videoconferencing equipment, connecting the patient's home to the doctor's office. With special monitoring devices, the patient can relay significant information about current physical conditions. An electronic stethoscope can send high-quality sound so the doctor can listen to the heart or lungs, evaluating the sounds as well as cardiac rate and rhythm. Other vital information such as blood oxygen concentration and temperature also can be gathered.

Soon, patients will put an arm in a cuff, and step on the scales to electronically and automatically transmit blood pressure and weight results to a doctor's computer. The doctor will then send an encouraging e-mail or phone call about a change in medication or activity level. At the same time, a physician with the aid of the home-placed video camera will be able to survey an elderly patient's environment, noting if the patient is capably managing his or her home.

Diabetes may be one of the first areas impacted by smart technology. By using digital photography or videography, patients will monitor critical areas such as eyesight as well as foot and hand skin conditions. Technology will provide a level of regularity that is superior to periodic, with fewer actual visits to the doctor's office.

Patient comprehension and compliance of physician instructions and medication management already is changing. With an electronically automated and computer-enabled medication dispenser, a smart system can remind someone to take medicine at the appropriate time and deliver the appropriate dose while recording and monitoring data. When the medication supply becomes low, a sensor can automatically contact the physician's office and electronically transmit a prescription to the pharmacy. In turn, this can be delivered directly to the patient's home.

Technology-enhanced mirrors may shortly replace the mundane with the futuristic. Each morning as a patient brushes her teeth, the bathroom mirror could flash reminders from a doctor.

The Healthy Home Environment

Smart technology isn't limited to medical care. People's health will be further enhanced with the intelligent use of technology throughout their homes.

Eventually the ubiquitous remote control will be replaced with voice-activated capabilities. Sensors throughout the home will adjust and monitor the environment--including lights, air conditioning, heating and security--by responding to voice commands. Those with arthritic fingers and failing eyesight won't have to struggle with stove knobs. A mere voice command will turn on stove burners or ovens and turn off appliances after use.

A networked kitchen might feature a variety of health-smart devices: an Internet-enabled refrigerator to download a heart-healthy recipe that corresponds with a doctor's dietary recommendations, monitors that tell the cook if he or she has the correct ingredients on hand, and connections that send instructions to the mixer, stove and oven and automatically set appropriate speeds and temperatures. Step-by-step instructions and perhaps appropriate video instruction may be projected on the networked video screen. The refrigerator also will read the date-codes of products on the shelves, letting people know when something is past its prime. For the visually impaired, a code reader will also identify goods.

Health Care Outside The Home

Clothing and personal accessories will eventually be transformed into "high-tech personal assistants" that provide total health care.

Intelligent clothing filled with tiny, flexible sensors will monitor and regulate physical functions such as heartbeat, blood pressure and temperature. This monitoring technology can be packed into a watch and include someone's complete medical history in case of emergency. Exercise garb can urge the weekend athlete to push through that last five minutes in an exercise routine and notify a physician or emergency team if there are signs of extreme physical distress.

Small, information-packed sensors placed under the skin to monitor blood chemistry and other physical parameters already are in use. Several U.S. hospitals are now testing chest-implanted devices that monitor the hearts of several patients while they go about their daily routines. The patients digitally collect the information and transmit the data to the participating hospitals through the Internet.

Some dentists pop tiny digital sensors into their patients' mouths and immediately evaluate the X-ray on their computer monitor or e-mail it to a specialist across the country.

With face-recognition software and sensors, eyeglasses can flash gentle reminders when greeting people, supporting faulty memories with appropriate prompts of names and pertinent information.

Such technology might someday be woven into a favorite sweater, which then will control the health smart functions throughout the house as residents move from room to room.

Another technology that is transforming home health is thermal imaging. Every individual has unique thermal signatures. Blood cells generate a heat pattern following the veins beneath the skin and this vascular profile is totally distinctive to each person. An infrared system can read this profile and identify or verify based on this information.

Telemedicine uses interactive audiovisual and data communications to diagnose, consult, monitor, treat, educate and transfer medical data.

This technology can be used to monitor a person's location as well as general health. If someone falls at home and needs physical assistance, the thermal signature will alert the necessary support agency. Special senior communities are already looking at this technology to provide constant health and security monitoring to residents without hovering and infringing on their privacy. This greatly increases personal security levels without diminishing important independence.

Engineers are making daily advances to provide seamless, sensor-to-sensor, component-to-component, machine-to-machine, system-to-system communications, working quickly and efficiently to digitally improve home health care. As technology helps us to live independently for longer parts of our lives, it also will effectively resolve the significant societal quandary of too few resources to care for a rapidly aging population. These digital personal assistants will recognize what we need, learn and adapt, and continually work behind-the-scenes to make our lives, and most specifically, our health better.

This article originally appeared in the November 2001 issue of HME Business.

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