Tuesday, July 14, 2015

Nag On My Shoulder

We seem to like to have help with our health.  In addition to a doctor (or doctors), we might have a case manager, a health coach, a pharmacist, a personal trainer, or a nutritionist, to name a few.  But we soon may be able to have all of their expertise whispering in our ear 24/7.

Whether that would be a good thing or a bad thing remains to be seen.

The Wall Street Journal recently profiled an interesting company called OrCam.  OrCam's origins were in helping visually impaired individuals.  A small wearable camera processes surrounding images -- faces, steps, even handwriting -- on the fly and informs the user, almost as if they were seeing the objects directly.  Now OrCam is testing what they bill as a digital personal assistant -- Casie -- to add even more value.

I can see all sorts of potential for health care.

The WSJ article gives the example of you walking down the street, and Casie recognizes the face of one of your Linkedin contacts.  Perhaps you hadn't spotted them or simply couldn't place them, but Casie could then discreetly murmur the correct information into your ear and suddenly you're Bill Clinton, able to remember everyone's face and key details.

If OrCam can recognize your Linkedin contacts, I would bet that it can recognize a donut, or a cigarette, and remind you about the health risks before you get either in your mouth.  It's not that we don't usually know these kinds of things are bad for us, mind you, but a little angel on our shoulder (or, rather, in our ear) could help battle those devils that tempt us into bad health choices.

Such a digital assistant might also notice you haven't taken your morning pills.  Lack of adherence to taking medication has been labeled a $300b problem.  There are a variety of apps to help remind people to take their meds, but an increasingly urgent voice in your ear the further out of compliance you get might be a more effective way to keep you on track.

Maybe it could be trained to look at that rash on your arm and offer an informed diagnosis, taking teledermatology to the next level (Spruce, are you paying attention?).  It might evaluate your gait, notice if your face shows signs of a stroke, listen to your cough, and advise you when any of those suggest you need to seek care.  If it is happening to or around you, the digital health assistant might be able to offer help.

Pack a portable ultrasound into the device -- this technology is already here -- and suddenly whole new worlds of things your digital assistant could help you with really open up, especially if paired with a Watson type of AI.

Ideally, one would like to be able to tell your digital assistant how you are feeling, much like you might tell your doctor or try to do with an online symptom checker, and get a diagnosis  The accuracy rate of the current symptom checkers is not perfect -- a recent study found they only came up with the "correct" diagnosis a third of the time -- but even these checkers triage pretty well, and they're only going to get better (the success rate already varies widely between different symptom checkers), especially as they are increasingly able to monitor your vitals.

I'd be curious to know what the equivalent rate is for in-person or telehealth diagnoses from physicians.  I'm not so sure that "only" a third is so low.

Fitness trackers are all the rage, but the attrition rate on the use is terrible; a third stop using after six months.  Perhaps something like Casie could have better luck keeping you engaged.  It could "watch" your fitness efforts -- then cheer you on when you're reaching your goals, coax you when you are faltering, even nag you when you want to quit.  You might pick the Dallas Cowboy cheerleaders to do the cheering, Richard Simmons to do the coaxing, and your high school gym teacher to do the nagging.

I don't think I'd choose any of those, but you get the idea.

Digital assistants aren't new, of course.  We've already got Apple's Siri, Google Now, and Microsoft's Cortana.  Even smart glasses aren't exactly breaking new ground, what with Google Glass, whose high profile introduction and retail pullback don't spell the end of Google's interest in the idea (e.g., reportedly it will allow users to "take pictures" using hand gestures and to get augmented information about things in their field of vision).  Google is reportedly focusing more on business applications for the product, perhaps because research shows consumer interest in smart glasses lags other forms of wearable devices, but is much higher if their employer pays for it.

Smart glasses have faced adoption resistance for a variety of reasons: people think current models look goofy, there are concerns about privacy when everything in sight is suddenly a picture/video, or perhaps it has just been lack of a perceived killer app.

OrCam addresses the first objection by being a fairly inconspicuous clip-on, and the second by deleting audio and video content after it has been processed and analyzed, sort of like Snapchat does for messages.  "Our goal is processing, not archiving, ” says OrCam's founder and chairman.

And maybe digital health assistant will be the killer retail app.

I think the concept of "augmented reality" raises the bar for digital assistants.  Instead of just warning you about eating that donut, the digital health assistant might flash a picture of you with an extra thirty pounds just to re-enforce the risks it poses.  Or what you might look like in twenty years, especially if you developed diabetes from eating all that sugar.  It'd be like the health care version of "scared straight."

And waiting for you to look at your computer screen or smartphone might not be soon enough.

OrCam is a reminder that our digital future doesn't necessarily lie in smart phones or smart watches or even smart glasses.  Devices may be cool but, in the end, it's not about the device but about the functionality it offers us.  The power of the Internet of Things is that our devices should become indistinguishable from our environment; some future generation of OrCam will use tiny cameras embedded in our clothes and elsewhere, broadcasting pertinent information to us -- audio, visual, even tactile.

This is why companies like Facebook and Google are pouring so much money into virtual reality -- not just to escape reality but to augment it.

People talk about "the digital doctor," but what really makes that concept interesting is that it may not involve a doctor at all.  I just hope my digital assistant knows when to be quiet and when to make me listen.

No comments:

Post a Comment