Wanted: Adaptive Encouragement

Or, Health Horizons S&T Map Blog Posts, New Year’s Edition.

I am sick, writing in bed, but that seems to be good, since I don’t really want to do anything, so I might as well write.

Bang! Posted.

 

It’s that time of year again. The global holiday of January 1, and with it, the annual ritual of self-improvement: setting New Year’s resolutions.  It’s a time when we’re called on to reflect on our lives and the behaviors we might want to change—and bombarded with ideas on how to do so.  It’s the time of year that makes me crave the realization of one of our Science and Technology forecasts: Adaptive Encouragement.

Adaptive encouragement: From self-quantifiers to life doulas

 Imagine a digital advisor that interprets your raw health data and offers continuous support along with interactive data visualization and recommendations for changing—and maintaining—daily routines or medications. 

 Embodied in intelligent programs, mobile devices, and the cloud, a life doula (like a birth doula) will remind us of our goals in moments of weakness. It will offer suggestions and encouragement in context to help us make healthy choices. 

 This kind of adaptive, personalized support will improve chronic illness management with automated diet tracking, in-home blood marker monitoring, and realtime analysis of genetic, metabolic, and protein data.

A quasi-intelligent automated system that takes the heavy lifting out of learning about your habits and changing them? Sold!

This vision is part of a future when roles like life coaching are automated and extended through ever-present technology.  It also points to the possibilities of adapting care systems to optimize the well-being of people with chronic ailments: rather than a slap on the wrist at the doctor’s office, you get a gentle vibration to get you out of your chair and moving.  Haptic feedback and sensitivity, emotional support and peer interactions are the future of this softer side of mobile health, beyond the expert-fed prescriptive reminders. This is a future of gentle nudges to show us the actions that will help us increase our capacity for well-being, but also remind us to do nothing when that’s what’s really best for us.

Our colleague Alex Charmichael over at the Quantified Self wrote this forecast, and I’ve heard it echoed in the desires of my of the quantified selves I’ve been interviewing for our project for the RWJF building and refining the QS Guide to Self-tracking Tools. For those of us who generally only embark on self-improvement binges once a year, there are a lot of lessons and tools we can learn from both the continuous and episodic efforts of the QSers.  One tool I learned about in interviews that might be of particular interest to New-Years Resolvers is Health Month—a game that helps you focus on making progress towards your goals on a daily basis.  (The game starts promptly on the first of each month, so start on Jan 1st to get credit for your progress!)

Most importantly though, one of the key lessons I’ve heard that’s especially crucial for  new years resolutions is self-compassion in all your self-tracking and self-improvement efforts.  Shame and frustration at little slip ups can do a lot of harm—so this year, try staying future-focused and forgiving.

Writing, death, and vat-grown kidneys

Hey, wasn’t I going to blog more and stuff?  Did somebody die or something?

Oh wait.  Actually, yes.

So my SB challenge and so many other things have been on hold for the past week.  I’m not done grieving, and won’t be for a good long while, but I do need to start writing again.  My kick in the pants came from the realization that it was Viv’s turn to do the regular blog post in our blogifying map forecasts series.

I started writing it and then I stopped.  I decided to share her words instead.  It still took me most of the day to track down links and proof and whatnot. It was both cathartic and helpful to tiptoe around the cognitive dissonance of writing about forecasts bathed in optimism bordering on hubris with ruminations on mortality rattling about my brain.

Here’s the post:

Replacement parts: “We can rebuild him, we have the technology”

Regenerative medicine will replace, restore, maintain, or enhance tissue and organ functions, dramatically improving patients’ health and quality of life, and potentially reducing the cost of their care. Tissue engineering will heal diabetic foot ulcers, reducing the need for amputations; organs grown in a lab will ease our dependence on donor transplants; and tendons, cartilage, and bone regrown with autologous cells will be used to repair injuries and joints. Advanced prosthetic devices and biomechatronic-based limb replacements will interface with the body’s nervous systems to give users a range of natural function and movement.

 When we first presented this forecast at a conference, our colleague Vivian told a story that illustrates the potential, and some possible pitfalls, of the growing capacities of regenerative medicine. It was part of a complicated dance of vignettes and exposition with Vivian, Bradley and myself that will remain one of my fondest memories of working here.

Viv presenting, by Rachel Hatch

Image by Rachel Hatch

Of course, when you get sick enough, you end up having to go to the doctor for help.

That’s what finally happened with Eric, who has Type 2 Diabetes.  He is a very successful 56 year old lawyer.  He has a history of working too much and not taking very good care of himself.  He was overweight, ate poorly, and didn’t track his blood sugar levels consistently.  As a result, he has had some serious complications from his illness.  Last year, he developed a foot ulcer that just wouldn’t heal.  The doctors had to amputate his foot.  His eyesight also deteriorated because of damage to his retina.  And his doctors have been warning him that he may need to go on dialysis.  Eric’s body is failing him.

Remember that TV show in the ’70’s?  The Six Million Dollar Man?  Do you remember the show’s tagline?  “We can rebuild him. We have the technology.”

Continue reading

Eco-Risk Artifact from the Future Post is Up

Years ago my colleague Jason Tester coined a term for a visual forecasting format: artifacts from the future.  They’re pictures of what it might be like to encounter some future force in an everyday situation, in the minutiae that are archaeologists’ usual trade.   Recently, my team and I have been doing a series of blog posts explaining and showcasing the artifacts we made for our newly public Health and Health Care 2020 Map.  Here’s a bit from my latest entry in this series:

Myriad minutiae in our environments impact our health in countless ways.  While we can look at this from many perspectives, one is to identify the risks in our environments, to empower us to avoid, change, organize and agitate around them.

This artifact from the future challenges us (from the perspective of a passerby on a Milwaukee sidewalk) to make the invisible visible: to share places at patterns in our lives that stress us out.  If we looked at the mash-up online that this poster advertises, we could validate our experiences, find ways to avoid particular places for our own health. Or, we could focus on the experiences of others that surprise us, ad be more considerate and caring as we move through places that stress out our neighbors and fellow citizens.  It posits that the ability to quantify and visualize the health impacts of our surroundings will increase our interests and engagement with eco-health issues.

HC2020 Artifact, Eco-Risk Tracking

IFTF HC2020 Artifact, Eco-Risk Tracking

In other awesome news, our Health Horizons’ BodyShock The Future contest scored more entries than a white house challenge on a similar topic.  There are some pretty fun ideas in there.

Emotional Networking (Crosspost)

Here’s the piece I wrote over the weekend for the Health Horizons blog.  I didn’t get to meet them, but on Friday I listened rapt and gawked at the webex of Emota.net, our neighbors in Palo Alto who are doing some seriously cool stuff. It’s on the HH and Future Now blogs HERE.

I just got a note in my email.  My aunt is busy with her own appointment, and nobody had yet volunteered to pick my uncle up from the VA hospital tomorrow, after he recovers from surgery.  Hey, it’s a Friday.  I can take off a little early to pick him up, and get him to my cousin’s place over the hill.  I respond to the email, volunteering. In a grocery store across town, my aunt’s phone chimes in her purse.  On the tray attached to my uncle’s hospital bed, a digital picture frame brightens, and my little bobble head avatar floats forward and let’s him know he can expect me when it’s time for him to check out.

I could live with this future. A couple years ago, the same arrangement would have taken at least a dozen stressed-out calls between my aunt and my mom, my mom and me, me and my five cousins, me and my aunt, and finally me at the VA with my mom, trying to find my uncle’s room in the biggest dead-cell zone in the valley.  At the end of the day, while everyone’s relieved when the surgery goes well, everyone has a headache.

This streamlined future of ambient, collaborative caregiving isn’t quite here yet, but today at IFTF we heard a fantastic talk from one of our neighbors, Emota.net. They’re bringing this future to life. They’ve coined their discipline “emotional networking, which complements existing telehealth solutions to address not just clinical health, but emotional and social aspects of elder care.” They’re building a platform that can operate across numerous devices, and facilitate the convergence of multiple communications media to bring different generations together.

The purpose is to distribute caregiving practices among a support network of family, friends and care professionals, while giving this network a tangible presence in a person’s everyday environment.  It takes “ambient co-presence” to a functional extreme, creating a gentle convergence of email, updating services, and virtual worlds. Image that you’re hanging out on your grandma’s kitchen table, tossing her hearts and flowers on a break while she reads your status updates (if she’s so inclined). And she bobs around in an app on your desktop, or phone, or tablet. If she needs help, you’ll get a notice, or if she’s really sick, her nurse will get a notice.  Otherwise, you’re just there: framed on the table with her other family, friends, caregivers.

This all sounded awfully familiar.

Continue reading