Track, Share and Compare: The Hot Trend of Self-Tracking

Track, Share and Compare: The Hot Trend of Self-Tracking Carol E. Torgan, PhD., FACSMKinetics Consulting :: From lab bench to park bench www.caroltorgan.com Twitter @ctorgan ACSM Health & Fitness Summit, March 2012 © Carol Torgan, Ph.D. 2012

Self-tracking is … Tracking your life weight, activity, nutrition, sleep, menstrual cycle, heart rate, mood, …. physiological, behavioral social, environmental Also known as: Life-logging Data-driven lifestyle Personal informatics Personal analytics Personal monitoring Living by numbers Quantified selfhttp://quantifiedself.com Gary Wolf, Kevin Kelly © Carol Torgan, Ph.D. 2012

The Economist, Mar 3rd 2012 print editionhttp://www.economist.com/node/21548493 © Carol Torgan, Ph.D. 2012

O, The Oprah Magazine, December 2011 © Carol Torgan, Ph.D. 2012

Who is trackingPatients ProfessionalsAcute and chronic health conditions AthletesAsthma AstronautsCancer SoldiersDiabetes FirefightersMental health … Scientists © Carol Torgan, Ph.D. 2012

Who is self-tracking27% of internet users, or 20% of adults, have tracked their weight, diet, exercise routine or some other health indicators or symptoms online:• 15% of U.S. internet users have tracked their weight, diet, or exercise routine online• Women internet users more likely than male users to do these activities• Internet users who experienced a significant recent health change more likely to track (gain/lost weight, quit smoking, pregnancy)The Social Life of Health Information, Susannah Fox, Pew Internet, May 2011 www.pewinternet.org © Carol Torgan, Ph.D. 2012

Patients Professionals Event-driven trackers © Carol Torgan, Ph.D. 2012

Why Track? © Carol Torgan, Ph.D. 2012

―For many self-trackers, the goal isunknown.Although they may take up tracking witha specific question in mind, they continuebecause they believe their numbers holdsecrets that they can‘t afford toignore, including answers to questionsthey have not yet thought to ask.‖– Gary Wolf, The Data-Driven Life,The New York Times, April 26, 2010 © Carol Torgan, Ph.D. 2012

How we track• Paper and pencil• ―How clothes fit‖• Apps• Gadgets & sensors• Images © Carol Torgan, Ph.D. 2012

www.medhelp.org/health_tools © Carol Torgan, Ph.D. 2012

PTSD Coach Chemo Calendar Healthy Habits Pregnancy Tracker Meal SnapPeriod Tracker Mole Measure iMapMyRUN Glucose Buddy iBP Blood Pressure © Carol Torgan, Ph.D. 2012

Adults who have downloaded an app to a cell phone or tablet • 29% downloaded a health app = 11% of all adult cell phone users • Similar to Sept 2010 data (no increase over the last year)Half of adult cell phone owners have apps on their phones, Kristen Purcell, Pew Internet, Nov, 2011www.pewinternet.org © Carol Torgan, Ph.D. 2012

Sensor technology moves from edges inward Patients Professionals © Carol Torgan, Ph.D. 2012

Lactate analyzers: Available from laboratory catalogs AND Amazon © Carol Torgan, Ph.D. 2012

Sensors that connect to the body © Carol Torgan, Ph.D. 2012

Best Buy: Health & Fitness © Carol Torgan, Ph.D. 2012

Pedometersspring-lever movementsteps, calories burnedActigraphtriaxial accelerometer, inclinometersteps, energy expenditureintensity, METsFitbitaccelerometer, altimetersteps, floors climbedcalories burned © Carol Torgan, Ph.D. 2012

Nike+ Fuelband (wrist)triaxial accelerometerlight sensor, LED lightssteps, calories, ‗NikeFuel‘Zeo (headband)electrical signalssleep patterns, sleep quality score (‗ZQ‘) © Carol Torgan, Ph.D. 2012

Wearable sensorsUnder Armour / Zephyr E39 biometriccompression shirtRemovable electronic monitor (‗bug‘)Heart rate, breathing rateSkin surface temperaturetriaxial accelerationAdidas adizero f50powered by miCoachPerformance metrics:speed, max speed, sprint numberdistance, steps & stride rates © Carol Torgan, Ph.D. 2012

ProeTEXT-shirt heart & breathing rate, body temperature blood oxygen saturationJacket triaxial accelerometers (collar, wrist) carbon oxide sensor (lapel area, near mouth) external temp sensor, heat flux sensor visual & acoustic alarmsBoots toxic gas concentrations (carbon dioxide) [at the request of the users] foot contact with groundMagenes G, et al. Conf Proc IEEE Eng Med Biol Soc. 2010:3594-7.www.proetex.org/ © Carol Torgan, Ph.D. 2012

MagIC (Maglietta Interattiva Computerizzata)Vest embedded sensors made of conductive fibers heart rate, breathing rate triaxial accelerometer washable, front or side openingMount Everest climbers telemonitoringCongestive heart failure patients discharged from the hospital wore in homes few minutes each day for a month data viewed remotely by cardiologist Patients felt ―safely supervised‖ and requested to continue the monitoring period!Meriggi, P. , et al. IEEE Trans Inf Technol Biomed. 2010 May;14(3):711-722. © Carol Torgan, Ph.D. 2012

Sensors on your skin: patchesZiocardiac monitoring (up to 14 days)arrhythmiasMetria wearable sensor technology disposable patch, worn up to 7 days on back of arm heart and breathing rates, steps sleep duration, activity levels © Carol Torgan, Ph.D. 2012

Ingestible core body thermometer pillPartnershipJohns Hopkins University Applied Physics LabNASA / Goddard Space Flight CenterPill in system 18 to 30 hours1988 Commercially available(research, university, military)1998 John Glenn used for medical experimentson Space Shuttle DiscoveryNASA Spinoff www.sti.nasa.gov/tto/Spinoff2006/hm_1.html © Carol Torgan, Ph.D. 2012

Heart Failure: CardioMEMS6 million heart failure patients in U.S.> 1 million hospitalizations each year$39 billion yearly direct cost of careHeart functions poorly, fluid builds-upTraditionally measure body weightMiniature wireless sensorMEMS = microelectromechanical systemPermanently implant in pulmonary arteryTransmits real-time pressure dataPatients take daily readingsSend to doctor (handheld or computer)Doctor modify meds = prevent hospitalization39% drop in hospitalizations in treated patients, shorter staysWT Abraham, et al, The Lancet, 377:658-666, 2011 © Carol Torgan, Ph.D. 2012

Visual tracking ‗Weight loss‘ on FlickrPhotos courtesy of Flickr, clockwise L to R: uneduex, 157/365; Christi Nielsen, Diet; bark, 40+290 Notch;Vernon_White, Weight_Loss_Montage_2009-03-04_side © Carol Torgan, Ph.D. 2012

Pinteresthttp://pinterest.com/sarahireynolds/the-sugar/ © Carol Torgan, Ph.D. 2012

Track, share, compare © Carol Torgan, Ph.D. 2012

http://nikeplus.nike.com/plus/ © Carol Torgan, Ph.D. 2012

1 in 4 internet users living with chronic conditions has looked online for someone with similar health concerns. www.patientslikeme.comPeer-to-peer Healthcare, Pew Internet, Feb 2011 www.pewinternet.org/Reports/2011/P2PHealthcare.aspx © Carol Torgan, Ph.D. 2012

Bipolar Managed Best Without Drugs: 227 Patients Reportwww.curetogether.com, data from Feb 15, 2012 by Alexandra Carmichael © Carol Torgan, Ph.D. 2012

http://asthmapolis.com/ © Carol Torgan, Ph.D. 2012

Track, share, compare, publish: Data donorship Study of patients with amyotrophic lateral sclerosis (ALS)who tried lithium carbonate treatment off-label through their physicians http://www.nature.com/nbt/journal/v29/n5/abs/nbt.1837.html © Carol Torgan, Ph.D. 2012

Track, share, compare*, care*N=1Case StudyPersonalized MedicineAthlete Biological Passport―The fundamental principle of the AthleteBiological Passport is based on the monitoringof an athlete‘s biological variables over time tofacilitate indirect detection of doping on alongitudinal basis, rather than on the traditionaldirect detection of doping.‖ – WADAWorld Anti-Doping Agency (WADA)http://www.wada-ama.org/en/Science-Medicine/Athlete-Biological-Passport/ © Carol Torgan, Ph.D. 2012

Issues Cost Ease of use Accuracy, reproducibility Tissue compatibility, safety Range, response timeClinically relevant information Literacy, numeracy Privacy Security © Carol Torgan, Ph.D. 2012

What can be tracked vs. What should be trackedPricewaterhouseCoopers, Healthcare unwired, Sept 2010 © Carol Torgan, Ph.D. 2012

AccuracySensors are like real estate: Location matters! ―Jawbone UP gives me 2,025 steps for 20 mins of drumming to REM and Smash Pumpkins. yfrog.com/mgrzudp‖ @dvansickle, Twitter © Carol Torgan, Ph.D. 2012

???Data visualizationCause and effect vs. correlationalFalse positives / false negativesSignal vs. noise © Carol Torgan, Ph.D. 2012

Health Literacy—the degree to which a person can obtain, process, andunderstand basic health information and services needed tomake appropriate health decisions.Nearly 9 out of 10 adults have difficulty using everydayhealth information that is available in health carefacilities, retail outlets, media, and communities.Innovations in Health Literacy - Workshop SummaryMarch 10, 2011 Institute of Medicine Reportwww.iom.edu/Reports/2011/Innovations-in-Health-Literacy.aspx © Carol Torgan, Ph.D. 2012

Health Numeracy―In general, I feel uncomfortable with health informationthat has a lot of numbers and statistics.‖ 54% strongly or somewhat agree 44% strongly or somewhat disagree―In general, I depend on numbers and statistics to help memake decisions about my health.‖ 57% strongly or somewhat agree 42% strongly or somewhat disagreeHealth Information National Trends Survey (HINTS), 2007 http://hints.cancer.gov/ © Carol Torgan, Ph.D. 2012

Opportunities When asked about the last time they had a health issue, 70% of adults in the U.S. say they received information, care, or support from a health professional.Peer-to-Peer Healthcare, Susannah Fox, Pew Internet, Feb 2011 www.pewinternet.org/Reports/2011/P2PHealthcare.aspx © Carol Torgan, Ph.D. 2012

Baby Boomers ~78 million baby boomers~56% have high willingness to use in-home health monitoring devices in tandem with care from their primary physician ―Boomers want to shape the technology they use,unlike younger generations who allow their lives to be shaped by it.‖ – Michael Rogers, Practical Futurist, in MIT Enterprise Forum Northwest Report © Carol Torgan, Ph.D. 2011

The future of sensorsMeasure compressive stresses in spineMonitor blood for medication concentrationsKnee implants, stents, …Monitor our MicrobiomeMicrobial cells : human cells = 10:1(10-100 trillion microbes in our intestine)PersonalizedDIY – mix and match your own sensorsTrack multiple conditions (not silo‘ed)Bottom photo: John Rodgers, Science, Vol 333 no. 6044 pp. 838-843, 2011www.sciencemag.org/content/333/6044/838 © Carol Torgan, Ph.D. 2012

―What used to take up a building now fits in my pocket, and what fits in my pocketwill fit inside a blood cell in 25 years.‖– Ray Kurzweil, inventor and futurist © Carol Torgan, Ph.D. 2012

Carol Torgan, PhD, FACSM Kinetics Consulting www.caroltorgan.com Twitter @ctorgan List of talk resources available at:www.caroltorgan.com/track-share-compare/ Gallery of tracking gadgets available at:http://pinterest.com/caroltpin/wearable-tech/ © Carol Torgan, Ph.D. 2012

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Track, Share and Compare: The Hot Trend of Self-Tracking

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