• Hacking Health at MIT

    At the core of our healthcare crisis is a crippling lack of patient engagement. I’ve talked about this before. Historically, this has been viewed as a compliance problem, but at the MIT Media Lab, this is viewed as a failure in healthcare infrastructure and attitude. Specifically, tools need to automatically connect patients, caregivers, and providers. And these tools need to be simple, consumer-friendly, and engaging. Dave Debronkart, better known as @ePatientDave, gets fired up about this. He writes on his site, e-patients.net,

    I mean, seriously: in what other industry can health leaders respond to “This is hard to use” and “I don’t like doing this” by saying “You’re just not good enough for our wonderful inventions?”

    MIT’s New Media Medicine project believes that people — ordinary people — have been undervalued in the healthcare system. What started as a problem of information asymmetry (doctor’s know all, patients understand little) has become a problem of information inequality (doctors have access, patients do not). The solution is simple: By embracing and building new technologies that enable seamless collaboration between doctors, patients, and communities, we can increase the chances of patient success through positive feedback loops. This philosophy drove 2012’ss Health and Wellness Innovation Week: “to build technology that empowers patients to take control of their health.”

    Over the course of ten days, I worked with an amazing team on the problem of childhood asthma.

    Problem: Asthma is the most common childhood disease, resulting in 18 million trips to the Emergency Room every year. Seventy-five percent of these hospitable visits are preventable with better asthma management. To properly self-manage asthma, a child needs to carry and know how to use a dizzying array of medications, an inhaler spacer, a peak flowmeter, and a asthma journal and an asthma treatment plan. It’s overwhelming.

    Solution: Make ONE device that combines the inhaler spacer with the spirometer, wirelessly connect it to the internet, quantify the data, design a simple game that motivates the child and parent, and share data with the pediatrician. Ultimately, increase awareness, understanding, and medication adherence to keep the child on the ball-field and out of the hospital.

    We call it Chameleon. Why? Because lizards are cute, non-medicalized, and chameleons especially have a magical ability to adapt to their environment to protect themselves. Note: at the beginning of the project I wanted to make the device curved like an elephants trunk or Jewish Shoffur. Wouldn’t it be fun if it made a big trumpeting noise? Or the annoying noise of a kazoo? Or the whirlygig sound of a party toy? I know something about the joy of making a LOT of noise: I played cello as a child until my sister picked up the french horn, after which I switched to trombone so I could outblow her. To a sixth-grader, decibels trump.

    Like heart disease and diabetes, asthma doesn’t necessary present its symptoms everyday. This makes taking a daily inhaler especially difficult for the child. And parents obviously don’t want to over-medicate their kids. That’s where the mobile application comes in. By linking the child’s daily adherence to the Chameleon game on their mobile device, we reward the child for taking medication as prescribed even when they’re symptomless. This positive feedback loop happens without the prompting of parents or the explicit nudging of a professional caregiver.

    Furthermore, because Chameleon is web-enabled, the child is alerted if there are environmental triggers like high pollen count that day in their zipcode. The family can see which areas have triggered asthma attacks in other children like them. A location-based app marks these automatically. Likewise, when the child has a cold or has the classic asthma symptoms like tightness in the chest, nighttime coughing, or shortness of breath, the parents can monitor the severity of these symptoms via built-in spirometer. We also connected the device and app to an online medical record for the doctor. MIT is developing on an opensource platform started at Children’s Hospital in Boston called Indivo. The power of this connection allows the doctor to see the child’s symptoms,triggers, spirometry data, and use of the daily or emergency inhaler then adjust medication and asthma plan accordingly to avoid that expensive and scary visit to the emergency room.

    With any luck you can get past the paywall and read the feature on the Chameleon Project, Putting Care In Patients’ Hands, by The Boston Globe.

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