Home: the healthcare of the future?
Strains caused by an ageing population will inevitably force healthcare further into the home, and blur the lines between our conceptions of healthcare institutions and our everyday lives, and we should design our homes, and our medical devices with that in mind, according to Stuart Karten of Karten Design, speaking to HIT Consultant. Remote monitoring solutions can help take some of the formidable load off caregivers, and save costs for hospitals. Tests are being run on filling the home with sensing technologies to detect falls, or irregular movement patterns. It is predicted that as many as 90% of the elderly will want to live in their homes by 2050, and the important groundwork to ensure this is viable and cost effective is just beginning. 

Editor’s Note: Editor’s Note: Stuart Karten is the principal of Karten Design, a product innovation consultancy creating positive experiences between people and products specializing in health technology. This is an essay adapted from a talk he will give at the 2015 USC Body Computing Conference on October 9, 2015.

Our design firm has been studying how the future of medicine is becoming “invisible”—powerful, ubiquitous, and intuitive. In most cases, technology has outpaced design. In its early stages, digital health technology is largely obtrusive and unintuitive, so we are imagining ways for technology to blend into people’s lives.

Our research has lead us to believe that the home will become the healthcare center of the future.

More and more people are working (13.4 million people currently work from home in the United States, up 41% from a decade ago), and growing old in their homes. Last year, we set out to study the future of the home. There are fundamental shifts happening in home life—how people interact, how their time is compressed, and the overall impact of technology on our relationships with each other and ourselves. We went into bedrooms to study snoring and its impact on family life. We went to the kitchen to better understand meal preparation and distribution, and into bathrooms to better understand people’s ceremonies around “toileting” and hygiene. We observed the living room and the convergence of devices that cause people to be “alone together.”

The home is a profound environment where we live our lives and experience our most personal, emotional moments. Because of digital technology, our lifestyles have changed, but the home itself remains mostly the same. Perhaps not for long.

Societal forces have started pushing healthcare into the home. Hospitals are now accountable for patient outcomes. With reimbursement tied to a patient’s health, professionals have a new incentive to care about their patients’ behavior outside the walls of the hospital. Patients are taking more ownership of their health. More patients are taking on high deductible health plans, giving them a financial incentive to seek timely, proactive care. And Seniors want to age in place. There will be almost 90 million people age 65 and over by 2050. Most of these people—as many as 90%—will want to continue to live in their homes. The Airbnb-Uber-Facebook generation advancing to old age will demand a paradigm shift in which they have individualized choices.

This is perhaps the most powerful force pushing health into the home. Digital immigrants and natives have developed an incredible expectation for convenience. The Internet has made entertainment and information available on demand, and has radically changed our expectations. We want instant gratification, and we want things where we are—usually at home. Services are popping up that make goods and services available in the home (like Amazon Fresh) within the same day—sometimes even in minutes. I believe healthcare will be no different.

The future “Connected Home for Health” will:

-Take advantage of the Internet of Things and apply it to health and well-being

-Collect data from our bodies, our activities, and our devices to support better living and more healthy, informed decisions

-Blend with our lives and all of the things we love to do. It won’t be a distraction from those things—it’ll happen seamlessly

We are knocking on the door of the Connected Home for Health.

In the early 2000s, before the introduction of smart phones, we had various devices that weren’t interconnected to take pictures, to talk on the phone, to track our calendars, or to do any level of computing.

Today, we are at the same stage with the Internet of Things at home. There are myriad solutions: health apps, smart products like scales or blood pressure cuffs, fitness and sleep monitoring devices, etc. But they are essentially passive devices that don’t talk to each other or integrate to form an ecosystem.

The home needs to move toward where the smart phone is today: where everything lives under one roof, where we carry around one device that gives us everything we need and helps us manage our lives. The interconnected home of the future will provide higher levels of connectivity, and higher levels of artificial intelligence. We’re working on products that incorporate algorithms that decipher connections between behaviors and outcomes.

The home is already morphing. The University of Texas at Arlington just announced a “Smart Care” apartment that uses smart technology to reduce the risks of independent aging in place. They are building sensors directly into the floors, walls, and mirrors. And the USC Center for Body Computing has announced a Virtual Care Clinic in which virtual care physicians make hologram house calls.

Right now, the industry is using digital health to help the most vulnerable people maintain their health—those who are currently consuming the biggest portion of healthcare resources. Monitoring chronic conditions helps improve treatment and drug adherence, providing a cost-saving opportunity for hospitals and individuals. Monitoring of seniors helps give caregivers peace of mind, but the solutions don’t always appeal to the end users.

All of this is important work. However, there’s a bigger opportunity to affect behavior change holistically for the entire population. If we look at people from birth to death, before their health deteriorates and they start having frequent interactions with the healthcare system, we have the opportunity to inform their decisions and train their behavior to keep people healthier longer. We need to pull back our focus and look at health as a journey.

We have the ability to help people navigate all of their life milestones with the information and guidance they need to make decisions. With the interconnected home, we can start helping people when they are born with sleep training and potty training. As they move on to more independent self-care in childhood we can help with bathing and hygiene, and acne. In adolescence, we can help people maximize their performance when it comes to sports and fitness, and develop self-confidence. In early adulthood we can help people with fertility management and pregnancy. As people begin to notice the effects of aging, we can help with things like skin health, menopause, and memory loss.

All of these key life milestones happen in the home, and technology can address them all.

There’s an opportunity for the connected home to help people live not just longer lives, but more fulfilling ones. Wellness is an important stepping-stone to self-esteem and self-actualization. For example, if a teenager is able to manage acne, it’s going to help his or her self-esteem and sense of belonging. Or, if a person is able to optimize their brain function with the right levels of sleep, exercise, and nutrition, it’s going to lead to higher levels of creativity and self-actualization.

Home is an important place. If technology is implemented the right way, home will play an even more important role in people’s lives. So how do we reach this home heaven?

Technologists and designers must:

-Focus on end users. Design for the way people live.

– Move beyond physical and cognitive needs to focus on the whole person.

As healthcare moves from the hospital to the home, we need to design systems that will solve human problems, and address the way we live.