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bring a whole new level of collaboration and interaction to primary and long-term patient care. John Moore, who leads this project, is a physician who ran into an incredibly frustrating problem during his residency. Whether it was HIV, glaucoma, diabetes, or some other disease, there were often very effective treatments that would prolong a patient’s life, and yet patient adherence to treatment for chronic diseases was 50 percent or less. “It didn’t matter how I worked and how hard I tried to really help patients understand what was going on with them and give them compelling reasons to make changes in their lives,” Moore says. “The way things were structured and the tools I had, I just couldn’t do it.”
Which is what brought him to the Media Lab. “I was compelled to leave clinical training and work on this aspect—to design technological tools that fundamentally change the way we can practice medicine.” For a very small pilot this summer at the Center for HIV/AIDS Care and Research at Boston Medical Center, Moore created a touch-screen interface that shows patients a picture of each medication they’re on and a timetable for which medication should be taken when. If the patient doesn’t like those times, she can just drag and drop one setting, and the program will automatically adjust the entire schedule. Moore also created a simulation that depicts the HIV virus attacking T cells when a medication is skipped and the body fighting the virus off when medications are taken on schedule.
The HIV work is built on what Moore calls CollaboRhythm, a software platform that enables doctors and patients to work together in real time or asynchronously, with patients checking or recording data about their health, or asking questions about treatment whenever they want, and doctors reviewing it when they have time. Moore stresses that patient communication with a doctor doesn’t have to be “live.” A personal message, left in a video clip, that simply says: “Keep up the good work,” can do wonders for patient motivation, he says. It’s still personal, but faster and far less costly than arranging for patient and doctor to be in the same place at the same time. You can see a video that shows the system in more detail here.
—Public health: How can society detect influenza and other pandemics earlier? Figuring that out is the goal of this effort, which is led by graduate student Clark Friefeld, who co-created HealthMap, a website that culls reports from news outlets and healthcare organizations around the world to map where diseases are breaking out. One product of the project is Outbreaks Near Me, an application for the iPhone and Android phones that enables people to report activity indicative of an outbreak, such as someone on a plane coughing and sneezing. Moss calls it, “participatory epidemiology.” No report means anything by itself, but taken as a whole the data might point to something important—far earlier than traditional reporting through healthcare organizations would. “The vision is that we will empower ordinary people with mobile phones and technologies to be part of this front line in detection of flus and pandemics,” Moss says.
—Preventative care and wellness: This effort, formally called Social Health, started only about three months ago in partnership with another Media Lab group, Human Dynamics, run by Sandy Pentland. “How can people make better decisions and control their lives from an overall wellness point of view to prevent disease,” is how Moss describes the central question that the group seeks to answer.
Their work draws on some of the interface and mobile apps projects mentioned above, adapting them for preventative care to help people make better decisions about diet and exercise. Forget about alarms that remind you to exercise or calorie counters for your iPhone. Instead, think of a mobile device as an assistant that will know where you are, how many steps you are taking, the calories you are burning—and can give you some advice on whether more exercise might be needed on a given day. Moss also brainstorms about a kitchen avatar that monitors what food you eat and helps you eat healthier. Or a robot that acts as a fitness or diet coach (I mentioned earlier that he liked robots, and the lab previously built a prototype robotic weight-loss coach called Autom). Or a razor that samples your blood and beams data via Bluetooth for analysis, or smart toilets that sample your stool and urine. “It hurts to think about it, but it’s not going to be that long,” says Moss. “People are not going to be hung like a Christmas tree with sensors. Social health technology is going to be embedded in everyday life.”
Moss and Pentland are planning a pilot project to test some of these concepts. The Media Lab director says he can’t yet name names, but that a half-dozen sponsors—including a technology company, a retail distribution company, insurance firm, and a consumer products company—are helping fund the pilot, which will probably employ mobile phones and home sensors and involve collecting data from “real living situations.” The Harvard School of Public Health and the Mayo Clinic are also partners in the effort.
The principle that ties all these projects together is revolution, says Moss. There is a lot of work going on in industry and academia in what’s often termed Health 2.0, “and I think it’s all pretty lame,” he says.
“In the big picture, what I’m trying to do is create platforms and ideas at the Media Lab that will stimulate a whole new wave of research and innovation that goes beyond the wave that’s out there today. The industry, I think, has underestimated what people can do to control their health. I’m really passionate about having this group be a beacon and a shining light of innovation—and a catalyst—that’s going to change the game.”