Health Monitoring Wearables for Elderly Sufferers of Chronic Diseases
To assess if 3D printed wearables have the potential to be more effective in the monitoring of chronic diseases in the elderly, compared to products currently selling on the marketplace.
- Assess the effectiveness of health monitoring wearables marketed towards elderly sufferers of chronic diseases currently offered on the marketplace.
- Identify user experience of the wearables when used by a elderly person, the person responsible for their care or a third party with reference to effectiveness of how data is sent and received.
- Develop methods for how 3D printed interactive wearables can be designed and put into practice to improve upon the usability of existing products, with focus on overcoming any issues identified, related to for example aesthetics.
- Test hypothetical products, applications, by comparing to collected marketplace data and results from user-testing to assess overall effectiveness of 3D printed wearables.
Parliament Report “The Ageing Population” by R. Cracknell (2010) states, “10 million people in the UK are over 65 years old. The latest projections are for 5½ million more elderly people in 20 years time and the number will have nearly doubled to around 19 million by 2050”. The report went on to discuss the economic impact, “in 2007/08 the average value of NHS services for retired households was £5,200 compared with £2,800 for non-retired. 65% of Department for Work and Pensions benefit expenditure goes to those over working age, equivalent to £100 billion in 2010/11 or one-seventh of public expenditure. Continuing to provide state benefits and pensions at today’s average would mean additional spending of £10 billion a year for every additional one million people over working age”. The impact on the NHS is due to age associated illness and disease, meaning the elderly are more reliant on care and less able to work. Disabled-world (2015) gives examples of age-associated diseases as cardiovascular disease, cancer, arthritis, dementia, cataract, osteoporosis, diabetes, hypertension and Alzheimer’s disease. However they comment, “Much of the illness, disability, and death associated with chronic disease is avoidable through known prevention measures. Key measures include practicing a healthy lifestyle (e.g., regular physical activity, healthy eating, and avoiding tobacco use) and the use of early detection practices”. T. Pettinger (2013) predicts “An increase in the numbers of retired people will create a bigger market for goods and services linked to older people (e.g. retirement homes)”. Products selling well are similar to the Be Close (2015) wristband that links to a mobile phone app, providing data to careers. The company describe the product (Anon 2015) as offering “Wellness leverages, real-time data from smart sensors throughout the home or apartment and monitors for dangerous situations or wellness indicators”. Malm (2014, cited K.Bishop 2014) forecasts around 3.5 million mobile tele-care systems will be in use in Europe and North America by the end of 2018, with roughly half of these being used on people with dementia. “People with dementia might forget the phone – or in the case of an emergency might not be able to use it,” Malm went on to say, “So you really need a dedicated device, a wristwatch or a pendant, so you can make sure the person actually has it on them.”
The wearable technology market is dominated by smart wristbands and watches. Currently globally health and fitness trackers accounted for 77% of overall volume of wearable technology sold in 2014 (GFK Survey, Oct 2014), compared to much lower sales of Smart Watches. GFK Press Release (March 15) commented this was due to a “significantly lower average sales price of HFT, making these devices more affordable than full-feature smart watches”. In 2015 GFK (PR, March 2015) predicts smart watches sales will be on level with HFT’s, as smart-watches are integrating many of the features such as activity tracking devices. In a CRR report (September 2014) commissioned by Samsung, data for 2014 showed key growth in the wearables market, in healthcare, fitness and activity trackers, multimedia and smart cameras. D. Ledger (CCS Insight report, July 2014) predicts that sales in 2018 for wearables, 43% will be wristbands, 44% smart-watches and others a mixture of eyewear, clip-ons/ jewellery and wearable cameras. The market for business-facing devices is expected to reach $8.5 billion by 2020, with employees, government, service providers and retail, entertainment businesses firstly adopting the technology for consumer interaction.
DALLAS is a programme from Innovate U.K, delivering, assisted, living, lifestyles, at, scale. Their collective aim is to, Calder.D (2015) “start a revolution in health services with citizens taking greater control of their own health and wellbeing; transforming the relationship between patients and health care professionals in much the same way as has happened in retail, banking and travel over the past ten years”. The total investment in DALLAS to improving health, wellness and quality of life for UK older adults, is £37.3 million. U.K Government Strategy for Future Retail Report (October 2013) predicts that in 2017 in the already digitally connected experience of shopping, “The typical M-commerce (via mobile phone) shopper is forecast to spend £905 per year by 2017, a 243% increase from 2012”. A Sales Force report (Feb 2015) showed the retail industry in the next two years is interested in creating a connected customer experience, “We will see a 3 x growth rate in areas like immersive experiences and location-sensing technology, showing an intent to improve customer touch-points with 1:1 interactions”. Stereoscape’s Digital Marketing Manager Saana Häkkinen (June 2015) highlighted that, “the physical store will remain the primary retail touch-point for consumers in the future, but it will become more omni-channel, a combination of physical and virtual”. Geert Lovik (2011, p.g 38) comments, “The distinction between the real and the virtual is diminishing and that offline and online are blending”, this acceptance of a on-line and physical identity is due to the rise of social media interactions. Joe Skorupa (2015, cited Vend 2015) states, “The opportunity cost of not being omni-channel today, according to recent research in the RIS/EKN Customer Engagement Tech Trends Study, is 10% in lost revenue”. TLT Retail Growth Strategies Report (2015) forecasts, “39% retailers will be investing in on-line stores, with 89% offering a click and collect counter. However 67% of retailers view physical stores as “vital” to their future and a stores’ primary purpose will be to showcase a largely online offering (31%)”. The Physical Web (Google 2015) and the Internet of Everything (Intel 2015) are concept’s that are prediction for the future and will contribute to the an overall digitally immersed society. Scott Jenson (July 2015) from Google describes it as, “A system that lets anyone interact with any device at any time. Enabling interaction when native apps just aren’t practical”. The idea that all objects, environments, people will be smart, acting as beacons. J. Nalder (June 2015) explains, “In essence, a Beacon allows for mobile devices to interact directly with objects and features in their immediate environment”, able to link directly via proxy. Stephanie Reiger (2015) in her lecture at Responsive Field Day, describes how this could be applied, “relationships we could develop with data, location and presence in physical spaces”, meaning data could be personalised, “knowing a user is nearby is also an opportunity to augment content to suit their location”. It could be argued that to many smart objects, mobile and buildings sending out signals that connect to the internet could led to a consumer overload. Technology however is available that can bypass the need for apps, mobile or the internet, such as tagging in use in car park fobs that uses bluetooth, radio waves and could directly link to objects and beacons. D. Wasylenko (July 2012) describes, “Bluetooth signals are very similar to the wireless signals used in WiFi devices, radio and television broadcasts and mobile phones. These signals are transmitted by electromagnetic radiation”.
Saana (2015) states 42% of digital shoppers are “Millennial”, defined as consumers aged 18-34 and “Gen X” accounts for 25% (born early 1960s to the early 1980s). A report by PWC (2015) included data that Millennials would most like wearables technology to tell them about health and retail information, their motivations to adopt wearable technology would be based on, “price, integration with other device, ability to track personal data and approve personal time productivity”. A Deloitte report (2014) shows that only that only 34% of adults over 65 own a mobile phone and only 29% have downloaded and used an app. Consumer concerns for the integration of technology surround security, personal data breaches and damage to our ability to relate to other humans face to face. Google glasses released in 2012 were quickly withdrawn from sale with Call.K (Oct 15) describing them as being ahead of their time. I. Pederson (2014) explains the public feelings towards the product, “We were terrified (and still are!) over the potential for such a technology to rob us of our privacy and de-humanise everyday life”, these claims can be backed by facts. CSA states, “The 2014 Identity Fraud Study reported an increase of more than 500,000 on-line fraud victims to 13.1 million people in 2013, the second highest number since the study began”. Endeavour White Paper (July 2014) states, “as of June 2014, about a third of owners of smart wearables still abandon these devices after six months”. I. Pederson (2014) reasons, “(Wearables) are invented, designed, adopted, and even celebrated before society is able to understand their impact on lives, culture, values, art, politics, privacy, and social practices”. Explaining, “Much technology goes unexplored as to its impact on people, and more specifically, the concepts and embedded meanings that affect human. We need to explore how devices will affect digital life at the design stage and not only rely on policy-making after the fact, when it is too late”. She further comments, there is a fundamental shifts in wearables that will shape the future of the market, including, “control and automation, smart wearables will increasingly extend our connection to the physical world as the smart-phone has begun to do”. D. Ledger (July 2014) explains, “Mass market adoption will ultimately be gated by the aesthetics and comfort of smart wearable devices”, technology developments such as shrinking of batteries will allow for “cleverly hidden technology that provide functional and well-thought interface and interaction modalities” and “wearables changing from a tool of convenience to one of unique utility”. Google is investing in project such as Jacquard where conductive fibres are woven directly into a garment, creating a interfaces that can be used to link to smart devices. Google explains (Anon, May 2015), “The complementary components are engineered to be as discreet as possible”, this links in with S. Ryan (2014) ideas on fashion, that we have a tradition of “Functional Anti-fashion in our society”, that there is a neutral or natural way to dress; the idea that clothing must be minimised, standardised and muted. Developments in technology mean 3D printing can also be combined with conductive fibres and smart inks, the benefits are electronics can be fully integrated into bespoke products. Recently Korean scientists (April 2015) have found solutions to integrate batteries into the very fabric of garments, with thermoelectric generators produce charge from the heat of the body. Smart Ink technologies offer a range of opportunities for application, J. Strickland (Nov 2007) gives examples of “Electroluminescent substances (that) give off light after being exposed to electricity” and Thermochromic inks change colour when a current is run through them. These inks could be applied to wearables to monitor chronic disease in the elderly, patients with Alzheimers (Disabled World 2015) are more likely to suffer from undiagnosed UTI’s as they do not understand the symptoms, a smart ink that responded to a temperature change could alert the carer without having to send data via the internet, reducing the need for a mobile phone; generating apparel similar to Studio XO’s (Peters, 2015) wristband that changes colour in response to body changes, already being targeted at the medical market. Theses technologies are still in the very early stages of development, the health care market for the elderly is still emerging and applications are yet to be fully explored, similarly the effects on improvements to the quality of life of those suffering from chronic disease still yet to be fully assessed.
This research will firstly require an analysis of the current marketplace for health monitoring wearables aimed at elderly sufferers of chronic diseases, effectiveness of these products will be assessed via quantitate data on for example consumer spending, government/care industry investment, forecasted strategies, technology reports and consumer user reviews; collected from sources including business, government reports and white papers. From this data areas will be identified as to where wearables in their current format are effective or ineffective as a tool to assist and monitor the elderly with chronic disease, this maybe due to social, psychological reasons, aesthetics, user experience, technical issues and expectation of technology; for example the over 65’s are less likely to down-load apps, so wearables that link to smart phones maybe ineffective. Methods for improvements upon existing technology will be developed, hypothetical products and application theories. 3D printing combined with electrochromic systems and smart inks, including Graphene, have been identified through initial research as offering the potential to develop fully integrated health monitoring products. 3D printing is a newly developed technology, the process of combining it with electrochromic systems is an experimental area and it will be this technology that is applied. Methods will be justified by referencing collected data and further reference will be made to additional literature surrounding for example symptoms of chronic diseases, the psychology of how humans interpret information and the science of creating 3D printed digital interfaces. Hypothetical design models will be user group tested, gathering qualitative feedback using questionnaires and interviews, data collected will be compared to earlier research into health monitoring products currently being offered on the marketplace. User-groups will be identified by developing a consumer profile based on current users of health monitoring products, due to the ethics of testing on vulnerable adults, consumers used in testing maybe more general such as those that have experience of using health and fitness monitoring products and do not suffer from chronic diseases; with the aim to gather feedback on social, psychological perceptions and users expectations of interacting with the technology in hypothetical situations. If the technology is available it would be invaluable to produce sample products and test in the context of a care environment, however this maybe unavailable due to availability of very specialist materials and equipment, in this case study will remain theory based. Symptoms associated with chronic disease such as difficulties with motor-skills will be applied to this data to justify design models and final conclusions will be drawn on does developed 3D printed digital apparel have the potential to be more effective as a tool to monitor the health of those suffering with chronic diseases then products currently on the marketplace.
The study will present a number of ethic considerations, firstly consumer reviews of health monitoring products will be collected and analysed. In some cases gaining permission to publish quotes from the individual reviewer may not be possible, any personal details such as names and specific locations will be removed to achieve complete anonymity for the contributor. User testing will take place to gain feedback on developed theories, participants will be made fully aware of the study aims and how any data will be used, full consent will be given and unless necessary personal details that could identify the participant will not be included in the report; data will be securely stored in a nonpublic domaine. User testing will be non-maleficence, conducted with the use of questionnaires and interviews to assess their experience and expectations of health monitoring wearables, users will be provided with questions and given opportunity to withdraw from the study if requested. Study is focused on wearables for elderly sufferers of chronic diseases, it is understood that this demographic would be categorised as vulnerable adults presenting immediate ethical issues, firstly surrounding consent as it would be difficult to assess if the person has the capacity to give consent to taking part in the study without access to private medical file, instead an alternative user group that has similar needs from health monitoring wearables that are not identified as being vulnerable will be invited to participate.
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