Register for the free webcast, “Life Streams, Walled Gardens, and the Internet of Living Things.” Brigitte Piniewski and Hagen Finley will discuss the Internet of Living Things, what makes sensoring and monitoring data emanating from our bodies unique, and why we should elect to participate in this seemingly Orwellian mistake of open-sourcing our personal health data.
The majority of the 3.8 trillion dollars spent on sick care today is spent on treating chronic ailments that took decades to become symptomatic.
Making better day-to-day health decisions is by far the least costly way to avoid spending trillions on late-life care. Further, much of people’s health-related suffering can be significantly reduced or eliminated by making better lifestyle choices earlier in life. The business value is clear, but will wearables deliver on the promise to better inform and influence our health decisions?
The IoT model
Network-connected industrial devices have increasingly captured the imaginations of technologists and manufacturers. Real-time reporting from embedded sensors not only changes the way machines function, it changes the way they are sold and operated. GE, for example, rents its jet engines to carriers, then extends that product offering by wrapping the engines with a full-service contract. Sensors embedded in the engines provide consumption-based billing information and allow GE to perform just-in-time maintenance on field-replaceable engine parts. The carrier’s maintenance model is dramatically more effective and efficient than the previous non-sensored model, which either pulled engines out of service based on mileage or based on part failure, both of which translated to waste for the carriers.
While the number of products that fully exploit this new model is relatively small today, the Internet of Things (IoT) appears to be rapidly expanding into new markets. For example, Michelin is now selling sensor-enhanced tires on a ton-kilometer revenue contribution basis:
“Payment is proportional to the tire’s productive contribution to extraction, using the basic unit of the ton-kilometer on which is applied a unit price. It is therefore a factor which quantifies the work effectively done by the tire over a defined period.”
The embedded tire sensors also allow Michelin to offer large-fleet trucking companies a new service that monitors and manages fuel consumption.
The Internet of Living Things
Another one of these emerging markets is the Internet of Living Things (IoLT). Scientists have been monitoring animals in the wild and domesticated livestock on the ranch for decades. Hospitals attach sensors to patients to monitor their vital signs. In that respect, the concept of “wearables” isn’t really new. However, outfitting healthy human beings with sensors in a manner similar to industrial products is a new idea, made possible by swift advances in miniaturization and wireless communications. Assuming an IoLT for our bodies is feasible, what makes monitoring data about living things unique, and why would you and I elect to participate in this seemingly Orwellian social mistake?
Beginning with the archetypal GE jet engine example, there are some striking similarities and dissimilarities between the Internet of Things and the Internet of Living Things.
Probably the most profound dissimilarity is we didn’t design or build the human body. Consequently, we don’t fully understand how it works or how to fix it when it breaks. Placing sensors in or on the body isn’t trivial, unobtrusive, or without risk. Human beings have limited options when it comes to Field Replaceable Units (FRUs) — when an organ fails, generally we can’t simply order a replacement off the shelf. However, rather than weakening the case for the IoLT, these “shortcomings” make the case that much more compelling. If we only get one machine, and the proper maintenance of that machine is literally a matter of life and death, then it would seem we’d want the best sensoring and component service contract we can get. The case for the IoT is actually more compelling for living things than it is for manufactured products.
The benefits of knowing now
Early indications of component health and malfunction yield huge economic benefits. First, not having to disrupt carrier service just to assess the condition of a component allows both GE and the carrier to maximize the ROI on the machinery. Second, early detection of component degradation often means minor repairs or maintenance can extend the life of the engine. Third, foreknowledge of what components need to be fixed allows the maintenance team to pre-order the proper parts and have the appropriate technicians on hand to conduct the repairs. Lastly, the ability to collect and analyze data from a large set of jet engines can point to unrecognized contributors to component failure. Longitudinal studies can model failure scenarios and lead to changes that can postpone or even prevent failures.
Likewise, early indications of component health is critical to human health. One of the greatest challenges for managing our personal health is the protracted feedback loop our bodies provide to alert us to accruing health issues. The pain from a burn is immediate and generally leads to real-time behavioral changes — yanking one’s hand away from the heat source, for instance. However, the symptoms of heart disease, diabetes, and hypertension don’t cause pain until decades of incremental component damage has occurred. Too often, by the time that degradation is discovered, much of that damage is irreversible. Likewise, early discovery of cancer is often the difference between life and death, but our innate monitoring and alerting system is not effective in warning us about early stage faulty cell division; there is a critical gap in the human body’s ability to alert us about incremental “component failure,” which the IoLT could effectively address.
This shortening of the feedback loop would allow a person to be alerted to component damage at a point in which they’d still have the opportunity to make changes to reduce or eliminate that damage. That immediate feedback is a critical opportunity afforded by the IoLT. Healthy lifestyle decisions focused on diet and activity are the best prognosticators for long-term wellness and are within reach of most individuals. However, in the same way the component damage caused by unhealthy behavior is slow to exhibit measurable symptoms, the benefits of healthy behavioral choices don’t light up a dashboard of meters announcing one’s wellness. Furthermore, there is a cultural misconception that young bodies are robust enough that they emerge from youthful excesses such as drinking, drugs, poor diet, and poor sleep habits more or less unscathed. However, the reality is just the opposite. Even lifestyle choices in our childhoods can have a lasting impact on our wellness. Our laissez faire cultural attitude leads us to assume all is well (or at least not so bad) until our condition is overtly symptomatic. Real-time feedback on how today’s diet and activity decisions impact our engine would offer a wakeup call before our lack of proper maintenance takes its toll.
Wellness services: A new business model
As is the case with GE and Michelin translating data into new businesses, there is a huge evolving market for wellness services. The health care industry today is really a sickness treatment service. In the absence of actionable symptoms, sickness treatment services are not equipped or organized to support managing wellness at scale. Wellness is a different mindset, which requires different processes, systems, and reimbursement models.
Wellness services require an entirely new kind of organization with an entirely new kind of financial model in support of a wellness management service. The business value is clear: the majority of the $2.7 trillion spent on sick care today is spent on treating chronic ailments that took decades to become symptomatic. Making better day-to-day health decisions is by far the least costly way to avoid spending trillions on late-life care. Further, much of people’s health-related suffering can be significantly reduced or eliminated by making better lifestyle choices earlier in life. The IoLT could represent an equal or greater commercial opportunity when compared to the IoT. For example:
- Foreknowledge of component degradation or failure can dramatically reduce the treatment time required and cost of maintenance. Escalated treatment involving ambulances and emergency rooms is exponentially more expensive and time consuming than planned or urgent care. Having the right expertise and equipment available becomes more of a supply chain and logistics management challenge.
- Collecting longitudinal data about people’s biological functions could lead to statistical models that identify precursors to maladies well before they become symptomatic. As stated above, we live in our bodies, but unlike jet engines, we didn’t engineer our bodies, and we don’t know all there is to know about how they work. This is especially true when it comes to life-long behaviors and exposures. Those behaviors might appear idiosyncratic when presenting at an individual level but could point to population health issues if we had population data by which we could identify commonalities and trends.
In today’s fragmented sickness treatment service and research model, population data for a million people would be considered huge. However, given there are billions of potential participants, it’s clear that we’ve barely scratched the surface of the health research benefits that could be realized if we had more population data. Even if 10% of the world’s population were to don sensors and anonymously share that data with research institutions, that would represent an exponential increase in the available data for research. While it’s nice to employ statistics to discover some hidden cause of jet engine failure using longitudinal studies, the possibility that the sensor data you shared would lead to a treatment of a disease that’s threatening to kill your child has the potential to be life changing. The IoLT addresses challenges about which we deeply care.
There are, of course, a raft of related questions about privacy, insurability, and the degree to which better information actually impacts our decisions. We don’t pretend to have answers for those and others the reader may have top of mind. However, ready or not, technical innovation has goaded our society to change dramatically in the past few years without much introspection as to the ultimate benefits and detriments that have accompanied those changes. We may find the IoLT has crept into our lives in the same manner that smart phones have done today and, as with smart phones, there will be things we like and dislike about that development.
The IoLT is not just another possible application of the IoT. Monitoring living things points to benefits which, in terms of direct human impact, far exceed the benefits thus realized by technologists and industrialists. In addition, the wellness care commercial opportunity could be equal to or even exceed the commercial opportunity in the industrial verticals. While there are still many challenges that will need to be overcome, the IoLT promises to revolutionize our world.
Cropped image by Jonathan Zander on Wikimedia Commons, used under a Creative Commons Attribution-Share Alike 3.0 Unported license.