University Launches A Center For Future Health To Bring High- Tech, Low-Cost Health Care To The Home

The University of Rochester is out to change that. TheUniversity has launched its http://www.futurehealth.rochester.edu>Center for FutureHealth, whose mission is to create new, portable technologiesfor use by people in their own homes to prevent disease before itstrikes. A melanoma monitor, an interactive digital assistant,wearable computers, memory glasses -- engineers are alreadydeveloping these and other devices in collaboration withphysicians. The goal is to make technology affordable and easy touse, so that the home, not a hospital or a doctor's office,becomes thelocation where patients maintain their health.

"We're developing new technology with the goal of shiftingthe focus of medicine from treating and curing patients, topreventing disease," says Philippe Fauchet, center director."There are groups left and right developing devices forindividual applications, but we're talking about a fundamentalchange in the health care system. We will create new medicaltechnology, but on a personal scale. It will be technology youcan trust and use everyday without being bothered."

The center is conducting about 20 research projects,including several with the Media Lab at Massachusetts Instituteof Technology. Most involve taking a new technology -- patternrecognition, DNA computing, artificial intelligence software --and using it as the seed of a low-cost, portable health caredevice. Pattern and motion recognition software might be thebasis of a "gait monitor" that would give early warning of astroke, or of "memory glasses" to remind the elderly of the namesof relatives. Artificial intelligence algorithms are beingstudied as the basis of a communication aid that might be helpfulin curbing marital disputes. DNA could provide the computingpower necessary to identify bacterial strains almost immediately.University officials know of no other effort where the focus ison developing new technologies for everyday use by large numbersof people for the prevention of disease.

"This is a whole new vision for the health care system,"says Provost Charles Phelps. "The Center for Future Health offersone of the most interesting and vital opportunities for researchand teaching that has emerged from the University in years. Atits heart, the center will develop new uses of computingtechnologies, applied at a personal level, to help improvepeople's health. But the central idea is even more revolutionary:Returning control of people's own health care to them throughimmediately available and highly personalized information,collected routinely throughout the day in the normal course oftheir lives."

In each project engineers and scientists are working closelywith physicians from the outset, making sure the health-caregoals are realistic and appropriate. About two dozen core facultymembers come from the University, which is the lead institution.The MIT Media Lab is a long-term partner, with about half a dozenfaculty participants. There are also a few faculty participantsfrom the Georgia Institute of Technology and the University ofToronto, as well as dozens of graduate students.

The center is the brainchild of Fauchet, professor and chairof the Department of Electrical and Computer Engineering, andphysician Alice Pentland, James H. Sterner Professor and Chair ofthe Department of Dermatology. Fauchet serves as director andPentland serves as medical director. Sandy Pentland, academichead of the MIT Media Lab and adjunct professor at Rochester, isexternal director.

The engineers and physicians come from a variety of areas:computer science, neurology, electrical and computer engineering,chemistry, psychiatry, community and preventive medicine, andothers. The center also includes anthropologists and faculty fromdepartments like religion and classics, to help analyze thesocial implications of the center's research. There is a host offactors to spur creation of such a center at the University,organizers say. Both the medical and engineering schools arehighly ranked, and the campuses are right across the street,making collaboration convenient. Its researchers have alreadyformed alliances with interested engineers at other universities.And the University has expertise in licensing its technology,regularly ranking among the top 25 universities nationwide inpatent royalties.

Several companies have expressed interest in the center,which is currently pursuing funding from large agencies like theNational Institutes of Health and the National ScienceFoundation, as well as private foundations. Most of the projectsbuild on research currently being done and funded through grantsto individual investigators. As projects progress they will betested and demonstrated in a "medically smart home" beforecommercialization.

While it's tempting to think of the center as just anothermedical research center, its focus will not be on "big medicine,"says Alice Pentland.

"Medicine is about treating disease. This center is aboutmaintaining health," she says. "Currently medicine is centeredaround big machines in doctors' offices or in hospitals, and it'snot friendly for consumers to access. Your quality of lifedegrades before expensive technology is brought to bear on theillness, and information about your health is dispersed amongmany different providers. And the physician is in control. Wehave a new vision of medicine, where people can assess theirhealth in their own home, and consumers have more control overtheir own health." Last year more than $25 billion was spent bypeople on out-of-pocket costs not currently included as part ofthe "medical system," Pentland says, a sure sign that people wantmore say in their health care.

Adds Fauchet: "The current health care system is undertremendous stress. Now there are tools to keep you alive the lastfew years of your life, at tremendous cost. What aboutmaintaining your quality of life, at a minimum of cost? We wantto give you the tools to be good to yourself."

A question the organizers hear often is whether people areready and willing to use such technology. To help address thisissue, the center has joined the LINCOS project, a collaborationinitially set up between MIT, the University, and Costa Ricanofficials led by former president Jose Maria Figueres Olsen.LINCOS is a kind of "digital town center," providing isolatedrural communities with a box of technology that offersinformation and links to the outside world. The center isdeveloping the health component of the digital center, withinformation to assess one's health as well as instruments likestethoscopes and thermometers. The first box will be placed in aremote Costa Rican village later this month, and several more areplanned for Costa Rica, at least 20 in the United States, anddozens more throughout Latin America.

"It's a prototype for the integration of communitiesworldwide," says Alice Pentland. "It's vital that we understandthe needs of each individual community. This component will helpus understand a culture's decision-making on health, traditions,perceptions of computers, and a variety of issues. We don't wantour inventions sitting in a laboratory. We intend thesetechnologies to be used not just nationwide but worldwide."

A PARTIAL LIST OF PROJECTS

The projects being pursued by researchers at the Center forFuture Health are designed to address health issues that affectmany people. Most are being done at the University of Rochester,while several are the result of a collaboration with the MITMedia Laboratory. Some also include colleagues at GeorgiaInstitute of Technology and the University of Toronto, and it'slikely that other institutions will join as the center grows.

Some of these projects are just beginning, while several arein progress, and creation of a few prototype devices is expectedsoon. Among the tools in development:

• Memory glasses" that a person with early dementia or memoryproblems might wear which automatically detect certain patterns(loved ones, street signs, grocery items, for example) and thenoffers audio instructions such as "The person you're looking atis your brother Bill"; "You have bought milk and eggs, but youforgot the bread"; "This is Oak Street; turn left if you want togo home." One goal: Allowing such patients to live independentlylonger.
• A "melanoma monitor," a passive system that takes an image ofyour body, perhaps each week in the bathroom, and compares eachimage to the last one. When a mole starts growing, you receive analert to see a doctor, and you bring along a computer printoutwith details of the mole's size and how it has changed.
• A "smart bandage" that could quickly identify a tiny amountof bacteria through powerful computing and determine whichantibiotics it's resistant to and which could be used to treatthe patient, cutting the amount of time necessary between illnessand treatment.
• Convenient monitoring tools, such as a wristwatch-type devicethat monitors pulse, respiration and temperature constantly. Thismight be handy after a patient leaves the hospital and is proneto infection (fever), or for an older person who often hasdifficulty breathing. Such sensors could also be part of a "smartbed" that takes in this information during sleep.
• A "gait monitor" that would pick up subtle signs of stroke orearly signs of diseases like Parkinson's. Oftentimes an impairedgait is the first symptom and goes unnoticed for months or evenyears.
• A "digital assistant" that is as easy to speak with, in plainEnglish, as the "Star Trek computer," which people could turn towith many of their health-care questions. A conversation might beabout ear infections, for instance: "I think my son has an earinfection." The computer then converses with the person. "What ishis temperature?" "Has he vomited?" The outcome might be: "Thelast four times your son had these symptoms, it turned out to benothing. Let him sleep through the night, then check his symptomsagain in the morning."
• A communication aid equipped with artificial-intelligencesoftware that recognizes certain phrases and tones of voice andlets the speaker know, gently and unobtrusively, that his emotionlevel is rising, and suggests alternate phrases or actions.
• An array of sensors based on new types of materials underdevelopment at the University. Such sensors might be used todetect tiny amounts of bacteria on food, to check whether wateris safe to drink, or to check one's breath or sweat forelectrolyte levels, monitor breathing, or send an early warningwhen dehydration is possible.
• A "rehab trainer," a program that watches one's movementsduring rehabilitation, then compares them to the way theexercises should really be done and offers advice such as,"You're dropped your shoulder too much" or "Stretch your left legfor 10 seconds, not just five." It's based on the "Tai ChiTrainer" recently developed by the MIT Media Lab.
• "Smart socks," being developed in collaboration withSundaresan Jayaraman of Georgia Tech, that automatically detectthe amount of pressure within a person's foot and then alert thewearer when an ulcer is imminent. Foot ulcers affect the majorityof people with spinal-cord injuries and are a constant threat topeople with diabetes.
• A "Digital Town Center," a high-tech box that will be droppedin rural areas of the United States and Latin America to giveisolated people access to health and other information. The firstbox will be tested this summer in a remote area of Costa Rica.
• "Smart clothing" equipped with optical fibers, developed byGeorgia Tech researchers. Such a shirt might be able to detect aninjury like a bullet wound and then send that information back toa triage center, where medics could decide which patients aremost severely injured and to retrieve that patient immediatelywithout checking several healthier patients first.

CONTACT: trickey@admin.rochester.edu>TomRickey, (716) 275-7954.