Is Innovation a Healthcare Solution?

While we don't yet have holographic physicians to consult, healthcare is moving online, encouraged by an international coalition of medical and technology companies.

Medical devices from weighing scales to asthma inhalers could soon carry the technology to connect directly to the web, shuttling data between doctors and their patients.

For practical reasons, health workers are often unable to talk to home-based patients with chronic conditions on a daily basis but they could keep in contact online. Medical records automatically updated whenever the patient measures their own blood pressure, checks their weight, or takes their medication. Such technology could help medical workers ensure remote patients are healthy, and detect any problems at an early stage before they become serious.

The move beyond traditional telehealth, remote contact with a patient through phone calls or video conferencing, is being encouraged by the Continua Health Alliance, a non-profit open industry group. The alliance boasts some powerful players in both the technology and medical arenas, including IBM, Intel, Google, Kaiser Permanente and the UK's National Health Service.

We're moving into a 'Web 2.0'-style healthcare model. The medical provider doesn't have to be logged in at the same time as the patient to see the data.

Remote control

The technology for a "Health 2.0" model already exists, but the standards needed to guarantee its smooth running have been lacking, until now. In February, Continua announced guidelines aimed to ensure the interoperability of new medical gadgets. Continua-certified devices will use USB or Bluetooth, and data transmitted between devices will use an IEEE standard in the same way that Wi-Fi networks do.

At the beginning of the year US firm Nonin unveiled the world's first Continua-certified product, a USB handheld pulse oximeter for blood oxygen monitoring.

More devices have followed: in May, international technology development firm Cambridge Consultants announced a wireless inhaler built around the company's Continua-compatible Vena platform.

The device receives a wireless signal and alerts the user when a dose should be inhaled. Once it has sensed the medication being issued, the gadget transmits a confirmation signal back to a central server, and the patient's health record is automatically updated.

'Ecosystem approach'

"To be honest the technology is the easy bit," says Paul Jones, chief technology officer for the National Health Service. "It's all very well having a clever weighing device in your room that notices your weight has increased and you're at risk of diabetes but if that alert doesn't reach the right people the whole system falls apart."

The UK Department of Health has begun trials involving thousands of patients to test whether patients and medics could benefit from the Health 2.0 system, although it's too early yet to draw any conclusions.

Parker is confident that tests of this nature will show the power of the Continua model, because the Continua Alliance already links professional healthcare workers with technology providers. "It's a whole ecosystem approach," he says, which provides technology companies with feedback from healthcare experts to improve their products.

FaceBook for health?

Health 2.0 might involve more than patient-medic interactions. The social networking sites that have emerged in recent years could have their healthcare counterparts, says Paul Williamson of Cambridge Consultants, which is based in the UK.

"We made some concept websites that go with our inhaler to show how you could use the data to benefit the patient," he says. The sites receive signals from medical devices and award points for every compliant dose of medicine. Friends with similar conditions could then informally compete against each other to improve compliance.

Watch a video of Cambridge Consultants' inhaler and concept social network site in action (YouTube)

In research, it's been found that the biggest motivation to take care of your health is co-workers and family. If we can tie compliance to social situations we can create the right environment for people to help themselves.

Sharing society

Parker acknowledges that some may find talk of merging health records and social networks unsettling given the privacy concerns dogging existing services like Facebook. Indeed, any talk of moving medical records online is met with unease, when Continua Alliance member Google launched the Google Health service last year, privacy and security issues were raised. Data security will always remain a high priority.

Thankfully attitudes are changing. With online services like Twitter, people are sharing more personal information than ever before, and some web users may have few qualms about sharing personal data. There's been a sociological shift from not sharing any information to sharing everything, your location and what you're doing every hour of the day.

Jones stresses that patients won't be forced to use the new technology, even in the publicly funded NHS. Those in the UK that do opt for an online service can expect their data to be stored in NHS-run systems rather than Google Health or similar private-sector databases.

"It's about understanding that there's a trade-off," says Parker. A patient might decide that the benefits from using the latest technology to interact with medics, and their peers, outweigh the potential privacy cost – or they might not. "I think a lot of people are now looking at this and deciding it's worth it."

Strictly Confidential: The Cloud of Silence

The Cloud of Silence! No it has nothing to do with the Triads and it's not a criminal organisation, it's a privacy concept that has been considered for many years by sci-fi writers, film makers and Machiavellian managers.

The problem: how can you hold a confidential conversation in an open office without everyone overhearing? The answer that is being considered here is a device that will create an intimate 'cloud of silence' around the selected participants.

The proposed modern cloud of silence, we are assured, will work as it says on the box. It is being patented by engineers Joe Paradiso and Yasuhiro Ono of the Massachusetts Institute of Technology.

Patented solution
Their idea, revealed in US patent application 2009/0097671 on 16 April, is to make confidential conversations possible in open-plan offices and canteens, the two places most regularly occupied by US employees. It will even let a conversing group move around a room and still remain in a secure sound bubble, like a 'cloud of silence'.

"In open-plan offices, the violation of employees' privacy can often become an issue, as third parties overhear their conversations intentionally or unintentionally," the inventors say in their patent. Their aim is to relieve people of that concern. Presumably the intentional eavesdropper is going to have to make other arrangements or choose a new hobby.

The Plastic Dome scenario

Initially people considered using plastic domes, this was temporarily attempted but quickly fell out of favour, partly due to the obvious suffocation risk and the unbearable humidity. So, the idea of the plastic dome was scrapped but the name and the concept clung on, regardless. The need was still strong in them.

The Modern Solution
In the modern 'cloud of silence' they use a sensor network to work out where potential eavesdroppers are, and mini speakers to generate subtle masking sounds, at just the correct audible level.

It sounds simple, but it needs quite a bit of smart infrastructure. The walls of the room must be peppered with light-switch-sized units that include a microphone, a speaker, an infrared location sensor and networking circuitry connected to a server. When somebody wants to activate what the MIT researchers call the "sound shield", they do so on their desktop computer.

By responding to the position of the computer, the sensors identifies the person's location and maps out the locations of the other people around them. Smart software assesses who is so close that they must be participants in the conversation and who might be a potential eavesdropper.

The array of speakers then aims a mix of white noise and randomised office hubbub at the eavesdroppers. The subtle, confusing sound makes the conversation unintelligible or more unintelligible, depending on which of your colleagues is talking. Good luck! with this new system guys and success in replacing the older low-tech ways.

Low-tech solutions
Clearly, as a human, you will be able to see which of your colleagues around you is wearing their headphones, staring closely at their screen, whilst pounding the keyboard and is completely unaware that they are in the office at all. For convenience, we will call this colleague Troy.

From his behaviour you can quickly determine that he is not listening in on your chat. To further disguise your conversation and to drown out your voice completely, you should encourage Troy to sing along to whatever Country & Western album he is listening to. This is what is called 'white trash noise.'