Written on Wednesday 26th February 2014
The intersection of smartphone, wearable devices and healthcare is possibly the most exciting place to be in technology at the moment. Smartphone applications have been shown to be clinically effective in treating depression in children, facilitating cognitive behavioural therapy for patients with mental health issues, supporting people recovering from Stroke, and have demonstrated a clinical impact with patients in the early onset phase of Parkinson’s disease. This is not even touching on the plethora of health and fitness applications available that purport to help people lose weight, hone the perfect fitness regime, or motivate individuals to reach their life goals. Some are good, some not so good; but the possibilities are evident. Technology powerhouses are now fully in the game, with Samsung setting up a digital innovation lab, and Apple reported to be on the cusp of redefining mobile health with the upcoming iWatch and iOS 8 release.
The ubiquitous nature of the smartphone makes obvious the opportunity for pharmaceutical companies to develop both clinical interventions and support programs for smartphone devices. However, what if you were to learn that a device that has been available now since November 2010, and is synonymous with gaming, could actually lay claim to a greater impact on health than any other consumer electronic device?
I remember being demonstrated both the Kinect device and Microsoft HealthVault in November 2010 at Microsoft’s Silicon Valley location. As a pharmaceutical professional, I loved the possibilities for Kinect in health and fitness, and conceivably as a solution for telemedicine; however the practical nature of HealthVault interested me more at the time. How wrong I was. Since then the Kinect device has run up an amazing CV in healthcare: From Xbox powered medical simulations to virtual reality game training in patients with Metachromatic Leukodystrphy; clinical improvements with therapeutic modality for children with cerebral palsy; significantly improved function in patients recovering from stroke with hemiplegia; and therapeutic potential in burn rehabilitation, to name only a handful of examples.
The new Xbox One Kinect is a sophisticated piece of engineering with high-resolution digital camera and high fidelity microphones; the sensor can now even read your heartbeat. However I feel it is the development of application software where some of the amazing possibilities could be uncovered for pharmaceutical companies. Here are five ways pharma could use the Kinect:
The Xbox One’s new fitness application, which enables people to work out in their own homes using the Kinect device, has had an impressive start with 1.5 million workouts logged since launch in November 2013. The interactive fitness regimes can give feedback on muscle usage and heart rate, enabling development of truly bespoke programmes for users. Imagine if we took this a stage further and created patient support programmes that utilised the technology. Measurements, vital signs, and even facial recognition; adherence applications could be captured and shared with doctors, dieticians or home care nurses, providing a new level of connectivity to current patient support programs run by pharmaceutical companies. Theoretically the technology already exists to track improvement in psoriasis with the camera technology, or even changes in mobility with conditions such as rheumatoid arthritis. There is already the technology that would allow virtual visits by health professionals such as home nurses, they would be able to utilise the highly sophisticated voice and gesture recognition to interact with patients in the same way they would in a real‑life setting.
The technology offers great opportunities for both at-home and in-clinic physical therapy; there are already a number of start-ups with programs in clinical trials. The feedback systems give real-time information on how a patient is moving and if they are doing an exercise correctly, which to me seems to offer real clinical value. If we think beyond this, there could be very exciting therapy programmes run by pharmaceutical companies in disease areas such as Parkinson’s disease, Cerebral Palsy and Multiple Sclerosis, where the Kinect has already demonstrated a clinical impact.
Telemedicine has long divided opinions, and the efficacy of telemedicine programmes have been called into question. I can remember my very early days in pharma when technology giants such as Cisco and IBM were promoting telemedicine technology; it was quite uninspiring and also very expensive. Telemedicine could still have great potential for patients living in remote locations or who are socially isolated. It can enable healthcare professionals to collaborate over multiple locations and can drastically reduce the need for outpatient visits and enable remote prescriptions. The Kinect would allow for a high-end telemedicine solution that would enable the measurement of key functions, detect changes to facial expression, colouration of the eyes, skin and tongue, inflammation of lymph nodes or a throat infection. Without ‘plugging a patient into a machine’ it can run an instant report on weight, joints and physical mobility.
The Kinect device is always on (something that caused some controversy at launch). The passive nature of the device could therefore have fantastic applications for managing age-related conditions in the home. For example, it could monitor a person’s gait and supply an early warning that there is an increased risk of a fall. The passive nature of the device could also form a support network for patients with Alzheimer’s disease or dementia, allowing people to live alone for longer as the Kinect monitors behaviour and feeds information into a support or care network.
Group therapy can be a powerful intervention in complex conditions such as alcoholism. The Kinect could be extremely useful in reaching those people who have high risk behaviour with alcohol but who would not be willing to open themselves up to strangers. The technology would allow them to join a support network anonymously, being represented with an avatar that shares voice and body language. It would also allow far more people to access alcohol services, something that is not easy at the present time, and begin interventions earlier to prevent escalation of the condition.
Arguably it is easier to commission a smartphone application or build patient support websites, as that is technology we are used to. But Kinect technology is also already with us, and with it comes the capacity to pilot truly innovative programs that add real clinical value. Access to the hardware is obviously one issue, however if the program and the application is powerful enough, this cost should not be a barrier to new thinking. Microsoft have already indicated that health applications for the Xbox will in future be integrated into the broader Microsoft eco-system, so the opportunity to integrate applications with companion devices such as the iPad is a realistic proposition. I have also not even mentioned the capacity for games themselves to add real health benefits for patients; I will leave that for a future post.