In our last post (“Behavior, disease and the support required for success“) we discussed how better lifestyle, diet and therapeutic choices can actually halt and reverse disease progression, but noted that the scientific literature establishing this is based on a level of caregiver support that is unrealistic for the general public. In future posts, we will review and discuss new technologies in development that aim to solve this problem by enabling continuous, ‘anywhere-anytime’ therapy delivery, wellness monitoring and decision support systems. However, many of these approaches will not be broadly available for several years. How can we fill the gap and get started today?
SportBrain's iStep
There are some widely available and increasingly interesting products that are beginning to provide a map to the intelligent medicine future. These products measure and connect us to something obvious, simple and incredibly powerful: our physical activity. I have been using an internet-connected pedometer from SportBrain for a few months now. The iStep product, like many similar devices, connects my daily steps and overall level of physical activity to a personal website where I track my progress, benchmark myself against the activity of others in my demographic, and have online community support tools available. For me, the access to this continuous information and the online support tools has been very motivational, and my average steps per day has increased from around 4,500 to 12,000. Nike and Apple have also developed a very slick product system in this field, where a Nike+ shoe sensor communicates with a wireless iPod receiver to transmit work out
The Nike+ Sensor
information, link run intensity to personally motivating music, and connect the user to an online world of virtual races and like-minded groups. Similar capability is also beginning to be integrated into mobile phones–Nokia’s 5500 Sport phone is a good example. More complex and integrated systems have been developed by such companies as ActiHealth and BodyMedia. In each of these cases, the activity monitoring technology is getting more sophisticated and the key is presenting, shaping and connecting the user’s personal information in a way that will support behavior change and better wellness choices. The scientific literature shows how powerful this can be; see a recent Journal of the American Medical Association paper concluding that the use of a pedometer is associated with a significant increase in physical activity and decrease in body mass index and blood pressure.
Activity monitoring will continue to play a critical role in next-generation intelligent medicine products. As we develop our intelligent pharmaceutical products at Proteus, we are integrating sensors of drug ingestion with sensors of physiologic response to therapy. Physicians have consistently ranked change in physical activity as one of the key measures they would like to have to better optimize therapy with their patients, and this is true across areas as diverse as cardiovascular, metabolic, psychiatric, inflammatory and other diseases. How we move around, and how this changes over time, is a key window into our health, and is as important a biomarker as any new more sophisticated molecular tests that will be developed in years to come. So start monitoring your own activity now and connect to this first phase of intelligent medicine.
January 14, 2009 at 11:25 pm
Thank you for creating this blog. This is great. I read you previous posts but I will just reply to this one.
I am personally looking forward to the day where medicine is personalized, meaning immediate feedback on therapeutic effectiveness and move away from the trial and error method used today. However, I think we are many years away from this. I have worked in the medical diagnostic industry for a number of years now and I think that there are several major hurdles – FDA, doctors, and patients. I find that FDA and doctors are very conservative. I am in the POC tests business and the FDA scrutinize with a very close eye even on new POC tests. Regardless, these can be overcome with time and positive data.
Unfortunately, I think the majority of the population is just not motivated enough to take a proactive role in the healthcare, esp in preventive healthcare, unless they have immediate financial incentives. The activity monitors you posted are great but I think the audience for those products are people who are already health-conscious and probably not the majority of the population.
The healthcare system is so complex and intertwined with numerous stakeholders. Even if we get data from intelligent medicine, the full value of it cannot be realized without a database to analyze therapeutic effectiveness on a macro-scale to allow physicians to optimize treatment protocols. Yet, we unbelievable don’t have an EHR system. Healthcare effectiveness, imho, has not been limited by technology but has been kept back by an ineffective system, public policy, and patient ownership. Maybe intelligent medicine technology may be able to leap-frog some of these problems to direct resources to administering clinical effective therapies. However, why take the big step to in-vivo diagnostics if you can do it ex-vivo? Or can you??