Researchers are making progress in developing portable and wearable electronics that can constantly monitor consumers' health and provide feedback. Recently, for example, Imec and Holst Centre announced a body patch that integrates an ultralow-power electrocardiogram (ECG) chip and a Bluetooth Low Energy (BLE) radio to support long-term monitoring in health, wellness, and medical applications. And at a recent DesignMed conference, Charles G. Sodini, the LeBel Professor of Electrical Engineering at MIT, described efforts of the Medical Electronic Device Realization Center (MEDRC) at MIT to revolutionize medical device design, including wearable devices.
Such efforts could revolutionize healthcare. Writing November 9 in the New York Times, Frank Moss, an entrepreneur and former director of the MIT Media Lab, envisions “…the next big technology-driven revolution, which I call 'consumer health.' When fully unleashed, it could radically cut health care costs and become a huge global growth market.”
Moss envisions an “…extreme transformation, in which advances in information technology, biology, and engineering allow us to move much of health care out of hospitals, clinics, and doctors’ offices, and into our everyday lives.”
According to Moss, a “digital nervous system” consisting of wearable wireless sensors would count the number of steps you take; monitor the quality of the food you eat; measure your levels of arousal, attention, and anxiety; and calculate your heart rate, blood pressure, and oxygen level.
In response, Moss says, you'd receive a stream of automated advice—”…data would enable you to truly understand the impact of your behavior on your health and suggest changes to help prevent illness—by far the most effective way to cut health care costs.”
I'm skeptical about the cost savings such an approach could bring. The problem with health care seems to be too much lawsuit-avoiding diagnosis and treatment, not too little. I could see the “digital nervous system” prompting perfectly healthy people to seek additional and expensive care they don't need.
But there could be a more pernicious effect. The Guardian on November 12 published “The nocebo effect: Wellcome Trust science writing prize essay,” by Penny Sarchet, which the author begins with the question, “Can just telling a man he has cancer kill him?” She recounts the 20-year-old case of a man misdiagnosed with cancer, who, although his tumor appeared to be benign, died, possibly from the expectation of death.
Such a death would be the extreme form of the nocebo effect—the inverse of the placebo effect. Patients told of a medication's side effects, for example, are more likely to experience those side effects than patients on the same medication who have not been so informed.
Sarchet explains that scientists are making headway in understanding how the nocebo effect works, using MRI and other techniques. But the effect is poorly understood, and I expect it could be exacerbated by constant nagging from our wearable digital nervous systems.
Don't get me wrong—I am a big supporter of research into wearable medical devices and am fully appreciative of the efforts of Imec, MEDRC, and other organizations in that area. Wearable devices can help people who would otherwise be confined to a hospital for 24×7 monitoring get back to their lives.
But I think we should exercise caution about advising perfectly healthy people to adopt such devices as part of their daily lives. The anxiety monitor that Moss envisions may result in a very unfortunate positive feedback loop.
Posted 11/14/2011 7:28 AM. Go to top of the “Rick's Blog” main page.