Look after your heart with more chips

Rupert Goodwins: An ageing population is a huge problem - but it might spur research into affordable IT for better health.

Growing up is a very grown-up thing to do. You have to start to take things seriously, and accept as truth certain unpleasant facts that once seemed best ignored. The truth of getting older is just no fun -- and that's as true for us as a society as individuals.

The statistics take time to turn into reality. With 11 percent of the worldwide population over 60, a figure that will double over the next 50 years, it doesn't seem to be too much of an issue. But the situation is very different in the Western countries, where low birth rate and excellent healthcare -- two things that might seem purely good -- have combined to fuel a demographic crisis. If you live in Europe or America and were born between 1946 and 1965, then congratulations: you'll be the first generation who'll have to spend more on supporting your parents than you do your children.

That might seem sobering enough, but consider where you'll be in 30 years' time -- or however long it is until you expect to be within hailing distance of the shores of decrepitude. You'll have spent all your money on expensive care for your incredibly ancient parents, your children will have seen which way the wind is blowing, changed their names and fled to Chile, and all you'll have for a lifetime of compassion and thoughtfulness will be an increasingly desperate state healthcare system. Short of turning the whole of the South-West peninsula into a self-governing octogenarian reservation, or making tobacco and alcohol abuse compulsory, it's hard to see how our 20th century model of health provision can cope with what's going to happen in our lifetime.

It's barely coping at the moment. By any standards (except, annoyingly, that of ever having any cash) I'm a fabulously well-off individual, living in one of the wealthiest nations on the planet under a system that spends more than 5 percent of national income on a national health service, free at the point of delivery. But my experience of the state of the GP system in North London is anything but salutary, and private healthcare is way off the list of affordables.

So, what's the answer? This was the subject of part of a keynote session at the 2003 Intel Developer Forum in San Jose. You can probably guess what the answer is -- more chips for a healthier lifestyle. But while it's normally safe to dismiss many predictions from Silicon Valley as being 30 percent marketing, 30 percent wishful thinking and 40 percent shareholder opiates, the Intel picture of the digital home as health tool is already coming true.

GPs have long known of and complained about IDS - Internet Dump Syndrome. Otherwise known as A4itis, the symptoms are a patient with a gleam in their eye and a ream of printouts from various dodgy Web sites. It's true that the Web has been the hypochondriac's best friend, but it's also true that three of my friends have successfully self-diagnosed their illnesses to the point where they convinced sceptical GPs to refer them to specialists -- and got proper treatment. One pal even scanned in parts of his body, printed them out in the style of a medical textbook, and left the results in the pigeon-hole of the local hospital's specialist for That Kind Of Thing. Worked a treat. In short, the Web as it stands is an excellent resource: lots of work needs to be done in supplying better expert systems to filter out the bad and the misleading.

The real challenges come in diagnosing the Big Three diseases that will see off most of us -- cognitive degeneration, cancer and cardiovascular. Although there will always be conditions in those categories that defy everything we can throw at them, advances on all fronts are quite spectacular. Common to all of them is the fact that if caught early, treatment is easier, cheaper and far more effective. And in all cases, low-level automated surveillance of people during their normal daily lives can pick up clues long before anything else.

Take cognitive degeneration. Changes in the way we think and act as we age are normal, but the sort of thing that triggers the need for care can be quite subtle. People who always spend five minutes at a cooker start spending 15; televisions don't get turned off; baths are taken twice in a morning. That's the sort of thing that quite simple sensors in a home can detect. For cancer, enzyme or other metabolic changes can be picked up by a suitably equipped toothbrush or toilet, while a number of radio-based very low power radar systems can monitor respiration and heart patterns at a distance. All this can be fed back to the home hub, where patterns can be spotted and advice dispensed to the user long before anything becomes serious.

How about privacy? How do you feel about living in a home where your every movement is monitored by machine? There's no need for the data to go outside the home unless you say so, and something that lets you stay out of care longer is a strong protector of privacy, dignity and freedom.

All this technology exists to some extent, the need for it will grow ever greater and there is no alternative. If you're looking for the next technological boom area: here it is. If you're looking for ways to stay healthier, longer: here it is. If you're looking for a way that society can continue to look after its elderly long enough to look after you when you get there: here it is. All we have to do is make it happen.


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