Exploring the Connected Medical Home

Over the past few weeks, I've been exploring the combination of internet of things, artificial intelligence, and ambient listening with a focus on how these technologies might improve care management, patient/family navigation of the health system, and wellness.

Google, Apple, and Amazon all have ecosystems that include the functionality I'm writing about.  Purely because I'm spending January investigating the Android/ChromeOS environment, my first exploration has been with Google products.    I'll explore Apple next.

Here's my test bed:

Unity Farm Sanctuary heating and cooling is controlled by Nest Thermostats.

The animal areas are streamed from Nest Cameras.

In the living room, I've installed a Google Home Hub, a Chromecast Generation 3, and Chromecast audio (now discontinued).

I'm currently carrying a Google Pixel 3 phone running Android Pie.   My personal computing platform this month is a Google Pixelbook.

What does this infrastructure enable me to do?

Here's a sample dialog (Google product responses are in italics)

Ok Google, what is the temperature in the living room?

The farm living room is at 66 degrees.

Ok Google, increase the living room temperature to 68 degrees

The farm living room temperature has been increased to 68 degrees.

Ok Google, show the cows on TV

Showing the Sanctuary Cows on the Farm Living Room TV

Ok Google, play music on the speakers

Playing selections from Google music on the farm kitchen speakers

Ok Google, pause.

Music paused.

Ok Google, call Mom

Calling Mom

This internet of things, artificial intelligence, and ambient listening example illustrates the many possibilities for any internet connected home.    As 5G cell phone technology is deployed in 2020, gigabit internet will exist over the air throughout the country - no wires/fiber needed.   The potential is only limited by our imagination.

What exactly is the potential?   Google Home enables the definition of routines - a kind of macro that links commands together, including "if this, then that" kinds of controls.

For example

Ok Google, Good Morning

Good Morning John

It's 22 degrees outside and today will be dry with a high of 32 degrees.

Your commute to work today will take 47 minutes because traffic is heavy

Increasing the temperature of the kitchen and decreasing the temperature of the bedroom

Playing morning music

Ok Google, Good Night

Turning off the lights

Activating the security system

Reducing the temperature of the kitchen and increasing the temperature of the bedroom

Sleep well

All of this has worked so well, that it makes me believe the future of computing is not limited to phones and apps, but increasingly a voice driven integrated ecosystem that requires very little technical expertise to use.

The artificial intelligence components can be startling.

Ok Google, play NCIS on TV

NCIS is available on CBS All Access and The CW

CBS All Access

Playing NCIS from CBS All Access on the Farm Living Room TV.  I will play from CBS All Access next time you ask for NCIS.

This required identifying that NCIS is a television program, offered by certain vendors, each with a different way to play it.   Notice also that I was vague about which TV to use, but Google Home figured it out.

Fast forward to healthcare. As we think about the integration of wearables and other in home wellness devices, this technology can integrate devices, routines, and voice commands to measure activities of daily living, suggest healthy behaviors, evaluate compliance with care plans, and communicate with care teams.

Today, only those with technological literacy and dexterity can perform these functions with a collection of apps, but it takes diligence, planning, and a steep learning curve.

Assembling all the connected home functions described above was done by me, in a few minutes, by unboxing devices and doing minimal setup - a one time only event.

As we move from fee for service to value-based purchasing, reimbursement reform will align incentives for wellness in the home rather than the treatment of sickness.  I predict that healthcare delivery organizations will restructure themselves for success  by shifting work from building more hospital beds to empowering patients outside of the hospital.  This will require training clinicians in  telemedicine  (let's call the new medical specialty "virtualists"), home support people (both visiting nurses and connected home technicians), and care managers who ensure all services are coordinated to maximize quality while reducing total medical expense.

To me, this tech works so well, and is so affordable (compared to treating sickness), that the future of the connected medical home looks very bright.