Pediatric and Personal Health Care

Until the advent of self-help books and the Internet, information regarding personal health care was largely in the domain of the health-care provider. We now live in an age where health-care information is everywheresome of it worthwhile, some of it misleading at best. Nevertheless, once connected to the sources outside the physician's office, we cannot seem to get enough information about our own health and that of our loved ones.

Most parents use "baby monitors" that enable them to listen for their infant while they are somewhere else in the house or outside. This monitoring brought significant freedom (albeit for one hour at a time) to apprehensive young parents. Baby monitors are mostly a simple one-direction communication device that provides remote audio monitoring plus a visual-audio bar graph representing sound levels in the baby's room. Beyond sound monitoring, simple devices could record other useful and possible critical medical metrics, such as body temperature or blood sugar level. Body temperature is a good indicator of stress in all species^[6] as well as general physiological status. In addition, a sick child's temperature can spike during the night without anyone ever knowing about it.

^[6] http://www.teagasc.ie/research/reports/beef/4806/eopr-4806.htm.

"As a pediatrician, one of the most fundamental diagnostic metrics we have is accurate body temperature," explains Dr. Meyerson, a local pediatrician in suburban Boston. "Unfortunately, many parents do not take a child's temperature accurately, and instead call us saying, 'My child is very hot and we're really worried.' If we, as doctors, simply had accurate measurements of current, recent, and historical body temperatures, we'd be better able to diagnose and treat problems confidently. Is the temperature 101.2 or 102? What was it an hour ago? What is the child's typical temperature at 10 P.M. at night when this child is healthy? Has it spiked in a very short period of time? These are simple but important questions, and having accurate and detailed historical information can make a huge difference."

Chip Implants

Here is an important Inescapable Data question: Are small, wireless electronic implants that measure a few but nevertheless fundamental body metrics possible and even practical?

Let's first look at more extreme implants to bound our expectations. Cyberkinetics is a firm that makes a brain implant chip that is the size of your small fingernail and attaches to 150 neurons that control major limb muscle movements. "Our device is clearly invasive, and so our first target audience is disabled citizens who need a mechanism for using a computer and the freedom that brings," explains Timothy Surgenor, CEO of Cyberkinetics. "The chip is placed on a key location of the brain and wirelessly transmits to an external transmitter and then is amplified and turned into computer mouse and keyboard inputs. This sounds extreme to many people now, but consider Lasik surgery. Ten years ago, if someone said to you 'Let me peel back the surface of your eye and use a laser to burn and reshape your cornea and then re-glue the surface of your eye,' what would you have said? The point, quite simply, is that seemingly dramatic alterations to small parts of your body can eventually become commonplace and accepted. More than 50,000 people today in the United States have chip-implants that control epilepsy and other similar diseases. It is entirely within reason to expect dramatic growth of lower-cost less-invasive implant devices."

There are a variety of less-extreme and noninvasive body-monitoring devices. Measuring livestock health is a major concern among cattle raisers and health-safety guardians. Several different systems exist today for real-time monitoring of bovine (cattle) body temperature. One system is a sort of "capsule" inserted into the first stomach of the cattle, and the other is a device inserted deep into the ear near the eardrum.^[7] In either case, the system consists of some battery source, a microprocessor, a receiver, a transmitter, and a temperature sensor (in an extremely small package). Once per minute the system wirelessly transmits body temperature information to some collection device. The information can then be stored or, if out of normal range, be relayed to a cell or PDA device. Rapidly controlling and containing sickness in livestock is a serious health concern.

In October 2004, the FDA approved use of an implantable chip in patients to pass on medical information.^[8] Delray Beach, Florida-based Applied Digital Solution's VeriChip is the world's first implantable radio-frequency identification (RFID) microchip for human use. About the size of a grain of rice, the device is inserted under the skin in a quick procedure. The goal is to allow doctors access to patient medical records, speeding care. They are currently targeting patients with chronic diseases such as diabetes, cardiac conditions, and Alzheimer's. The linked data could alert doctors to allergies or other important treatment and care needs. In a more unusual use, VeriChip devices have been in use in the trendy Baja Beach Club in Barcelona by VIP members for easier identification and payment for drinks and food.^[9] Implantable devices for either medical care or for fun seem to be coming our way.

^[7] http://www.teagasc.ie/research/reports/beef/4806/eopr-4806.htm.

^[8] http://www.boston.com/dailynews/287/economy/FDA_approves_use_of_implantabl:.shtml.

^[9] http://www.prisonplanet.com/articles/april2004/040704bajabeachclub.ht.

Whether we use an implant device for baby body temperature, or some sort of more acceptable bracelet or finger ring, the opportunity for more detailed and continuous body monitoring is possible due to microscale devices, Bluetooth and similar short-range wireless options, and RF and WiFi connectivity to higher-order devices such as your household computer. Let's explore the value chain of such technology. From the doctor's point of view, recent and historical trending is invaluable. (Not everyone's base body temperature 98.6 degrees Fahrenheit, for example.) For the parent, in addition to simple audio, the parent can now monitor and be alerted to important body temperature changes and catch problems before a temperature spikes to a worrisome 104.2 degrees.

The Inescapable Data interest is not so much in the creation of such devices (they will be created no matter) or even in the vertical utility of the device (the value directly to the patient or care giver), but rather the accelerated benefit of interconnecting the data. Indeed some of the value will be realized by the pediatrician for better care of the patient based on the patient's accumulated data. Other values will come from broad sets of data being amassed and then potentially analyzed by far-away people (due to networking and self-describing data sets) for potentially some important values. Is there a relationship between the number of early infant fevers higher than 102 and a later tendency to develop ear infections? As a group, do Asian Americans average a lower body temperature when living in Northeast urban America? Does average body temperature in specific geographic regions correlate with local weather in any interesting fashion, and is that then a predictor for some regional economic condition? Silly? Perhaps, but with vast data available, Inescapable Data users will tease-out relationships that are reminiscent of what the financial analysts have done for years to gain even the most modest edge in a market. Today, we have scant (if any) personal medical data collected, but in the Inescapable Data world, the data will be there and more readily mined.

Something as simple as an accurate body temperature sensing and recording device could have tremendous unforeseen value. Imagine if a device could also measure sucrose or salinity levels how the values would be notably higher. We could envision devices that measure electrical and chemical signals as well. Should your toilet have a built-in Ph sensor (along with salinity), because there could be valuable inferences to your health, especially if networked with your body temperature, time of day, and calendar (key stress source)? Is this silly (as silly as using a laser to reshape your most precious field-input device) or essential in the new world? Similar to Massachusetts General amassing petabytes of digital images for more than a decade, once information is collected, trended, and cross-correlated with other vessels of historical and real-time information, the values abound.