Transcript Personal Health Devices - Electronic, Electrical and Systems

October 2007
Personal
Electronic
Health Devices
A summary of research and applications in personal health including devices based
on smartphone, handheld and other small mobile platforms.
A shorter version of this presentation was given in the University of Birmingham Biomedical Seminar series
Dr Sandra I. Woolley
http://www.eee.bham.ac.uk/woolleysi
[email protected]
Electronic, Electrical and Computer Engineering
Picture: http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/
Followed by an Example Application
“Supporting Children
with Anaphylactic
Allergies.”
Luis U. Hernandez Munoz
Picture: http://medfusion.wordpress.com/2006/04/
Personal Health Devices

Mobile computing has come a
long way. Can it help do good
things for health?

Personal health devices can
– provide information or
– sense and respond,
– or both.

They can provide emergency
or everyday support.

They can interface with wired
or wireless vital sign or
activity sensors to detect and
react to events, for example,
sending messages, making
calls or logging sensed data.
Mobile computing has come a long way.
Can it help do good things for health?
http://www.eee.bham.ac.uk/woolleysi/projects/index.htm
http://www.disetronic-ca.com/dstrnc_ca/rewrite/content/en_CA/3.2:20/article/DCM_general_article_53.htm
http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/
Technologies
As well as all manner of mobile computing platforms
we now have new sensing and communication
technologies.
Sensors

Location via: GPS, GSM cell, wi-fi/ network signal,
acoustic, etc.

Proximity: RFID tags
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Movement: Accelerometers, tilt switches, gyroscopes
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Environmental toxins
Health : Basic vital signs, Glucose, etc.
“Context-awareness” can be derived from multiple
sensors.
“Smart Spaces” can be created from environments
with embedded networks of sensors.
Communicating Networks

Local and Personal Area Networks

Wireless wi-fi, bluetooth, Zigbee (Sensor Network)
Berkeley Engineering News Nov 2003,
SMALL PACKAGE: The wireless mote
communication chip.
Glucose Biosenor detail
www.strath.ac.uk/bioeng/ pginfo/engd/pics.html
So Aren’t We “There” Yet?

With so much existing technology and
research activity ...
aren’t we nearly “there”? Is it just
a technology race?

Or is the cleverness in putting good
technologies together?

In…
… connecting cooperating
technologies with people and the
things they do.

An example, from “The Media History
Timeline”
– 1565 The graphite pencil
– 1770 The eraser
– 1858 Eraser fitted to the end of a
pencil
A carpenters pencil - the oldest known
pencil found in the roof of a 17thcentury German house.
Photo Sandra Suppa, FABER-CASTELL GmbH & Co.,
Germany
Research Questions

System-centred research question
– How can sensors, systems and
data interact and combine or
synergise?

User-centred research question
– How can users manage and
interpret all this new
information?

... more generally
– How can all this new
information more widely and
usefully inform human
knowledge?
Research Questions ... for health ...

Can we use new technology to
make more people more well more
of the time ... and maybe with less
money?

Can we help people keep well and
take control of their own health?

Can we avoid exposing people to
excessive electromagnetic fields?

Did you know about the great
medicinal properties of
dandelions? Can we also reinform
ourselves about traditional health
wisdom?
http://en.wikipedia.org/wiki/Medicinal_properties_of_dandelion
Picture: http://www.herbs-hands-healing.co.uk/articles/quality.html
Illness ... Wellness

Illness signals a need for
change. Education is a path
to wellness.

Personal health devices can
provide and collect
information to support
education and understanding
... and can therefore
potentially support wellness.

Though ... "It is easier to
change a man's religion than
to change his diet." Cultural
anthropologist Margaret Mead
Medicine ...
derived from the
Latin ars
medicina
meaning the art
of healing.
http://en.wikipedia
.org/wiki/Medical
Health, herbal and nature-inspired PDA software examples
Vegetable juice, and fermented kefir and kvass drinks
http://www.jbpub.com/catalog/9780763752941/
http://www.handango.com/SoftwareCatalog.jsp?platformId=2&siteId=1&language=english&N=96806+4294961135
http://classic.pocketgear.com/software_detail.asp?id=11138
http://www.mobiletopsoft.com/pocket-pc/download-butterfly-animated-free.html
http://www.answers.com/topic/vegetable-juice
http://www.skazka.co.nz/product-details.aspx?p=1209&pageno=0&Category=18
http://commons.wikimedia.org/wiki/Image:Glass-of-kvass.jpg
Natives Were Healthy

“These days the jaws are not big
enough for all 32 teeth to erupt and
usually there is only room for 28
teeth.”
http://www.dentecom.co.uk/patients/pa_wisdomteeth_faq.htm

These days ... we do see more
narrow jaws ... more endocrine
dysfunction, immune disorders,
degenerative diseases, learning and
attention dysfunction.

“Good dental health begins with the
diet of both parents. The Samoan
girl on the left was born to parents
who ate nutrient-rich native foods.
The Samoan boy on the right was
born to parents who had abandoned
their traditional diet. He has crowded
dental arches and will be more
susceptible to dental decay and
chronic illness.”
Weston A. Price
Nutrition and Degeneration
http://www.westonaprice.org/brochures/wapfbrochure.html
http://www.westonaprice.org/traditional_diets/native_americans.html
http://www.westonaprice.org/brochures/wapfbrochure.html
Pervasive and e-Health

“Perhaps the most important force behind the
current and potential use of pervasive health care
is the need to reduce, or at least contain, the
skyrocketing health care costs that affect
everyone.”
The Case for Pervasive Health Care, Part 1
Luis Taveras and Dadong Wan
http://www.hhnmostwired.com/hhnmostwired_app/jsp/articledisplay.jsp?dcrpath=HHNMOSTWIRED/PubsNewsArticleMostWired/data/07Spri ng/070808MW_Online_Taveras&domain=HHNMOSTWIRED

“Consumer health informatics is the branch of
medical informatics that analyses consumers’
needs for information; studies and implements
methods of making information accessible to
consumers; and models and integrates
consumers’ preferences into medical information
systems.”
(Eysenbach 2000) http://en.wikipedia.org/wiki/Consumer_Health_Informatics

Pervasive healthcare to save money...
 A new market of “consumers” too ...
http://www.pervasivehealth.org/
Most Wired and Wireless Hospitals

Preparing for the Worst
“Information technology will play a critical part in pandemic
readiness.” Greg Dworkin, M.D.

http://www.hhnmostwired.com/hhnmostwired_app/jsp/articledisplay.jsp?dcrpath=HHNMOSTWIRED/PubsNewsArticleMostWired/data/07Summ er/071017MW_online_Dworkin&domain=HHNMOSTWIRED

“Information technology provides a wide range of tools to
help hospitals improve quality.”
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/07JUL2007/0707HHN_CoverStory_Landing&domain=HHNMAG

Most wired and wireless hospital award criteria
–
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Use of Electronic Bed Boards
Project Analytics
Medications Ordered Electronically
Medication Orders Matched Electronically
Electronic Surveillance
Quality Indicator Compliance Alerts
Digital Clinical Imaging
Clinical Documentation in the OR
Primary Data Center Recovery
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/07JUL2007/0707HHN_CoverStory_Landing&domain=HHNMAG

“... 28% of medical schools require students to own
and use a PDA ...” (April 2006) http://medfusion.wordpress.com/2006/04/
http://medfusion.wordpress.com/2006/04/
Examples of Personal
Health Devices
My Last Cigarette

PDA and Smartphone application to encourage
stopping smoking. ~$10
 “Here's another example of mobile persuasion
technology for health ...”
http://software.palminfocenter.com/product.asp?id=168
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Nicotine level readout
Expected cravings readout
Daily motivational quote or medical fact.
Deaths since you quit readout
Carbon Monoxide level of your blood
Increase in life expectancy readout
Time you have been a non smoker readout
Number of cigarettes NOT smoked readout
Your risk of a heart attack compared to your risk before
Your risk of lung cancer compared to your risk before
Daily picture of what smoking does to your health
Money saved
Expected circulatory improvement
Expected lung function improvement
Readouts updated every second and are based upon your own
personal past smoking habits.
Screenshots from My Last Cigarette
http://software.palminfocenter.com/product.asp?id=168
http://www.pocketnow.com/index.php?a=portal_detail&t=reviews&id=427
Medic Alerts and Records

Traditional medic alerts are engraved
bracelets or necklaces bearing simple and
(hopefully) recognisable medical icons.

Important life-critical allergy or other
health data is engraved on the reverse.

There is a huge growth in this market
with the increase in allergies and lifethreatening anaphylaxis.


Also an increasing desire of patients to
have and carry their own medical record
information.
New ideas include USB keyring fobs …
and some Birmingham University student
PDA projects.
www.MedicAlert.org
www.MedicalTags.co.uk
Dying for Data
Robert N. Charette
IEEE Spectrum
October 2006
Photo: Joshua Lutz
http://www.spectrum.ieee.org/oct06/4589
PATIENT BEWARE: Cheryl Conrad [right] makes sure
she always keeps a copy of husband Tom’s medical
records on hand, after he experienced an excruciating
delay in getting treated at a local hospital.
Blood Pressure/Pulse Monitors

Automatic large LED blood
pressure systolic / diastolic /
pulse readout with fuzzy logic.

Automatic inflation & deflation

48 sets of memory to monitor
your progress plus date / time /
average pressure

Requires 2 x AAA batteries.
Tatung http://www.tatung.com/med/product.html
Wearable Insulin Pumps

The catheter at the end of the
insulin pump is inserted through a
needle into the abdominal fat of a
person with diabetes.

Dosage instructions are entered
into the pump's small computer
and the right amount of insulin is
injected in a controlled manner.
[Medline Plus]
AMON - Advanced Telemedical Monitor
A European project from ETH, Zurich
 Designed to be worn by cardiac
outpatients, the device allows remote
monitoring of blood pressure, pulse,
oxygen saturation, body temperature and
2-channel ECG signals.


AMON: A Wearable Medical Computer for
High Risk Patients,
P. Lukowicz, U. Anliker, J. Ward, G. Tröster, E.
Hirt, C. Neufelt,
ISWC 2002: Proceedings of the 6th
International Symposium on Wearable
Computers, 7.-10. October 2002, pp 133-34
SensVest


C.Baber, A.Schwirtz and J. Knight
The “Lab of Tomorrow” EU project
(C.Baber @ Birmingham) to enable
students to capture and analyse “activity”
sensor data.
Senses temperature Heart rate (ECG) and
activity via accelerometers.
HR
Body movement
200
180
160
140
120
Heart rate (bpm)
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100
80
60
40
20
0
-20
-40
-60
-80
-100
0
2
4
6
8
10
12
Time (mins)
14
16
18
20
22
Biofeedback and “Inner-active” Games
 Biofeedback
is a process for monitoring a
body function such as breathing, heart
rate, blood pressure and altering that
function through relaxation or imagery.
 “ANTENSE®
Biofeedback anti-tension device
Combat stress in the privacy of your
home” $160
 “Introducing
emWave Personal Stress
Reliever, an entertaining stress relief
technology to help you balance your
emotions, mind and body.” $199

“..The Journey to Wild Divine, the first in
a series of “Inner-Active” computer
adventures to combine the science of
biofeedback with a beautiful, enchanting
and entertaining multimedia experience.
Over 10 hours of game play!” $187.50
Top left: Antense® Anti-Tension Device
Top right: http://www.holisticonline.com/Biofeedback.htm
Bottom: http://www.myemwave.org/about_emwave_stress.html
http://www.luxevivant.com/index.asp?PageAction=VIEWPROD&ProdID=166
“Women’s” Health

Pregnancy and ovulation tests.

A substantial market potential for
personal health care, but fraught with
concerns over correct usage and
interpretation ... and the potential for
expensive litigation.
2002 BBC news - new Persona legal cases
The “Digital Plaster”

A device meant to be embedded in ordinary
plaster that includes sensors for monitoring
health-related metadata such as blood
pressure, temperature and glucose levels.

The “digital plaster” contains a Sensium
silicon chip, powered by a small battery,
which sends data via a cellphone or PDA to a
central computer database.

If the results show any worrisome signs,
patients and doctors alike would be notified
of the change in the data patterns. They also
plan to add a motion sensor to the device so
it could additionally serve in the role of
“granny monitor” by detecting things like falls
or complete inactivity.
[The Toumaz Digital Plaster]
A Short Selection of Notes on
Electrosensitivity and
Electrotherapy
Electrosmog?

3G telephone masts, indoor cordless
(DECT) telephones and Wi-Fi
networks are just a few examples of
new electromagnetic sources.

Electric blankets, microwave ovens,
computers, and bluetooth devices
also add to our exposure.

University campuses and many
public spaces are now wirelessly
networked.


Soon there will be many more
wireless devices including Personal
Area Networks or Body Area
Networks WSN (IEEE 802.15.4) and
Zigbee.
What about the health environments
of the future? Might we expect a
large amount of EMF?
http://www.electrosmog.org.uk/
http://www.sheffielder.com/SHAM/s10.html
“Hospital's phone mast has highest
signal in UK”
Feb 19 2003
By Susanne Elsworth Daily Post
Staff
“Hospital defiant over phone masts”
27 May 2005
Chartered Inst. Environmental
Health,
Addenbrooke’s Hospital now has around 30
masts on the roof of its main ward block.
Departments in close proximity to the
masts include the maternity and breast
units and the oncology centre. The masts,
or base stations, are used for mobile
phones, pagers, and the Tetra police radio
system
Electrosensitivity

Electrosensitivity: “A unhealthy sensitivity
to a particular source of electricity, for
example mobile phones, computers, power
lines or even minor electrical equipment.1”

The Health Protection Agency produced a
good summary of the condition in a
November 2005 report.2

The most high-profile case of electrical
hypersensitivity is Gro Harlem Brundtland
the last Secretary-General of the World
Health Organisation, W.H.O, she is a
medical doctor and former Prime Minister of
Norway.

"It's not the sound, but the waves I react
on. My hypersensitivity has gone so far that
I even react on mobiles closer to me than
about four metres,“
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Translation from Cover story in Norwegian newspaper "Dagbladet" March 9,
2002: http://www.dagbladet.no/nyheter/2002/03/09/318013.html © Dagbladet
http://www.electrosensitivity.org.uk/doctorsguidance.htm#Appendix%201
1http://www.electrosensitivity.org/
2http://www.hpa.org.uk/radiation/publications/hpa_rpd_reports/2005/hpa_rpd_01
0.htm
Left: Gro Harlem Brundtland
Right: http://www.electrosensitivity.org.uk/What%20is%20ES.htm
http://www.electrosensitivity.org/
FDA Reports
 “Kinetics
of Microbial Inactivation for
Alternative Food Processing
Technologies
Oscillating Magnetic Fields”
http://vm.cfsan.fda.gov/~comm/ift-omf.html
 An
FDA publication on the effects of
oscillating magnetic fields on pathogens.
 “Kinetics
of Microbial Inactivation for
Alternative Food Processing
Technologies
Pulsed Electric Fields”
http://vm.cfsan.fda.gov/~comm/ift-pef.html
 An
FDA publication on the effects of pulsed
electric fields on pathogens.
http://www.electroherbalism.com/Bioelectronics/FrequenciesandAnecdotes/CAFL.htm
 These
reports summarise the research
findings of these fields on a variety of
bacteria, including inactivation of microorganisms such as E. coli, Streptococcus
thermophilus and various strains of yeast.
and more links at http://rifehealth.com/index.html
TENS Transcutaneous Electrical Nerve Stimulators
 TENS
machines are used for pain relief,
for example, by chronic pain sufferers or
for pain during child birth.
 “TENS
machines deliver small electrical
pulses to the body via electrodes placed
on the skin. TENS machines are thought
to affect the way pain signals are sent to
the brain. Pain signals reach the brain via
nerves and the spinal cord. If pain signals
can be blocked then the brain will receive
fewer signals from the source of the pain.
We may then feel less pain.”
An NHS-Approved TENS machine
http://www.maternitytens.com/index.asp?function=DISPLAYPRODUCT&productid=9
http://www.patient.co.uk/showdoc/23069069/
 From
NHS Direct: “a pad that administers
small amounts of electrical current,
blocking pain signals and stimulating
endorphins”
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=914
http://www3.telus.net/chemelec/Projects/Tens/Tens.htm
“Electrotherapy” ... from IEEE Spectrum

There is slow but increasing interest in various
electrotherapies.

Zap
Schoenbach, K.H.; Nuccitelli, R.; Beebe, S.J.;
Spectrum, IEEE. Vol 43, Iss 8, Aug. 2006
p20-26

A huge voltage for a just billionths of seconds
kills cancer cells.

“Researchers from different disciplines;
electrical engineers, cell biologists and
medical professionals, work side by side at the
Center for Bioelectrics to explore the cellular
responses to nanosecond pulsed electric
fields.”
http://www.odu.edu/engr/bioelectrics/biogateway.htm

Zapping away the blues: a pacemakerlike device to treat depression takes a
giant step forward
Moore, S.K.;
Spectrum, IEEE Vol 42, Issue 5, May 2005
pp16-17
http://www.odu.edu/engr/bioelectrics/index.html
http://www.ece.odu.edu/nuccitelli.htm
http://www.odu.edu/engr/bioelectrics/biogateway.htm
Personal Mobile Electrotherapy?
 NovoCure
is currently performing clinical
trials using 100-200 kHz electric fields,
which they call tumour treating fields
(TTFields), to stunt the growth of cancer
cells. Animal and early human trials
appear very promising.
 “When
cells divide, a molecular motor
called the microtubule spindle helps
segregate chromosomes into the resulting
daughter cells. ... if a 200-kHz field is
applied to these macromolecules, the
spindle can't form properly. As a result,
cells stop dividing and eventually die.”
http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3
 Might
these be the personal health
devices of the future?
Safety cap.
A glioblastoma patient wears the NovoTTF-100A.
http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3
Personal Health Devices

Mobile computing has come a
long way. Can it help do good
things for health?

... and what about ...
– mobility and usability
– privacy and security
– accountability and ownership
... there are certainly many other
issues we should consider.

There may be challenges ahead,
but pervasive health technology
is undoubtedly on its way.

There is certainly great potential.
Hopefully these devices will help
in the art of healing.
Thank You
Sandra Woolley
[email protected]
Other presentations on-line
http://www.eee.bham.ac.uk/woolleysi/thebodyelectric.ppt
http://www.eee.bham.ac.uk/woolleysi/wearablecomputingreading2005.ppt
and student projects
http://www.eee.bham.ac.uk/woolleysi/projects/index.htm