Smart Home Care

Every year, more than 50,000 Americans with diabetes must undergo foot or leg amputations. In many of these cases, poor blood circulation is the villain. Imagine, then, having socks with built-in pressure sensors that would alert you to put your feet up for a while. Researchers estimate that about three-quarters of diabetes-related amputations might be avoided with this kind of simple warning system.

Smart socks are just one example of the growing push to make high-tech home medical devices a part of our everyday lives. “Health care is coming home again,” says William Herman, director of the physical-sciences division of the U.S. Food and Drug Administration’s Center for Devices and Radiological Health. “This is one of the most-if not the most-rapidly growing segments of medical technology. It’s driven by an aging baby boomer population, pressures to control health spending and the availability of new technology to implement decentralized care.”

Several companies have already developed remote sensing technology for health-care and lifestyle monitoring (see “Clothed in Health,” TR July/August 2001). Most of these first-generation gadgets grab data on your vital signs and then radio the information back to a home health station or a receiver hooked to your PC. Now physicians and engineers at a handful of universities and startups are pushing the technology even farther. Their goal is to harness new materials and powerful microelectronics to make devices that are even more intelligent and self-contained-to make not only data reporters but preventive aids that detect dangerous medical conditions.

One leading group in the development of the technology is at the University of Rochester’s Center for Future Health, which was founded in 1999 by Rochester engineer Philippe Fauchet and physician Alice Pentland, in collaboration with MIT’s Media Laboratory. “Today, we wait until you get sick, drag yourself to the doctor, and then we throw this multimillion-dollar heroic technology at you,” says Fauchet. “So we wondered if it was possible to do early detection, even before you got sick, with technology that is very inexpensive, consumer friendly, and doesn’t require a complex change in lifestyle.”

In addition to smart socks, the center is developing bandages that warn of the beginnings of an infection and even identify the responsible bacterium and the appropriate antibiotic needed to treat it. The bandages are made from either light-emitting polymers or luminescent porous silicon with microcavities that emit light. Areas of the materials bind to specific DNA sequences of different bacteria; the binding causes a detectable change in the light emitted from the polymers or the silicon cavities.

Not all the new home medical devices are meant to be worn-or stuck on your skin. “I don’t think we’ll have to wait more than three years to see devices that can be retrofitted into the home,” predicts Reuben Mezrich of the Center for Innovative Minimally Invasive Therapy, a consortium that includes MIT and Massachusetts General Hospital.

MIT’s Department of Architecture is working on a Home of the Future that will use a range of biometric sensors to track its occupants’ daily habits. One objective is a system for detecting the early onset of congestive heart failure in those at risk for the disease, says researcher Stephen Intille. Via handheld computers, the system would periodically ask the occupant questions about how he or she is feeling, and combine the responses with sensor data-say, how often the person gets up and walks around-to determine if a crisis is imminent. “The goal is to acquire meaningful data from a person in a nonannoying way over long periods of time and use it to detect a trend towards congestive heart failure and alert the doctor,” explains Intille.

These high-tech medical diagnostics have not escaped the notice of industry. Strategists at semiconductor maker Intel, for example, reckon there’s a $5 billion market for microchips in such home health-care devices. Nobody expects that smart devices will replace the judgment of trained physicians, but the future of health care will almost certainly include a brainy silicon gadget right in your home.