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AURAMETRIX

From "Dr. Knows Best" to Health 4.0

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What is Health 4.0? To answer this question, let’s take a look at the evolution of World Wide Web.
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1st Generation Web, a.k.a internet before the bursting of the dot-com bubble, was a dial-up, 50K bandwidth, built around fixed content, with static pages and framesets providing one-way web of information. 

Web 2.0 – first used in January 1999 by Darcy DiNucci and popularized in 2004is is "an average 1 megabit of bandwidth" – according to Netflix’ Reed Hastings.

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Everybody has a slightly different vision of generations 2.0, 3.0 and beyond. In a nutshell:

  • Web 1.0 is “read-only”
  • Web 2.0 is “read-write” (blogs, RSS feeds, tagging, shopping carts)
  • Web 3.0 is “read-write-execute”: small apps with data in the cloud –  google vision; or a true communal media – yahoo vision. It is semantic and executing. 
  • Web 4.0  is "read-write-execution-concurrency", open, symbiotic and fully executing, it will form when all of the above come together to form the learning self-aware Web, the era of artificial intelligence.

According to by Tim O'Reilly', in the Web Squared everything and everyone in the world casts an "information shadow," an aura of data which, when captured and processed intelligently, offers extraordinary opportunity and mind bending implications. Web 3.0 will be some sort of virtual reality. If 1990-2004 was the match being struck; 2005-2009 was the fuse; and 2010 will be the explosion.


Web 1.0                    Web 2.0
DoubleClick---------->Google AdSense
Ofoto------------------->Flickr
Akamai----------------->BitTorrent
mp3.com-------------->Napster
Britannica Online-->Wikipedia
Personal Websites-->blogging
evite------------>upcoming.org and EVDB
Domain Name Speculation-->Search Engine Optimization
page views------>cost per click
screen scraping--->web services
publishing--------------->participation
content management systems-->wikis
directories (taxonomy)--->tagging ("folksonomy")
stickiness--------->syndication


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We are now at the fork of Web 2.0 and Web 3.0, focusing on the usability for humans and on internet architectures for machines. Some call web 3.0 a 3D game-environment web or a semantic web. Semantic Web was envisioned byTim Berners-Lee as  a universal medium for data, information, and knowledge exchange easily understood by computers. Semantic technologies are already out there - examples are TrueKnowledge, Zemanta, NewsSift, WolframAlpha, NextBio. And there are many more " next generation"  technologies and concepts - for example, Entrepreneur 2.0, Women 2.0, DNA Sequencing Technologies 3.0…  

Business models for health care are also evolving  - from solution shops to facilitated networks,  transforming the organization of health care delivery.

​So, what is Health 4.0? Here is Jen McCabe's opinion: 
  • Health 1.0 = content
  • Health 2.0 = content + community
  • Health 3.0 = content + community + consumer-centric commerce
  • Health 4.0 = content + community + working commerce models + coherence

Blog of a non-for profit hospital chain CHW gives the following definitions:
  • Health 1.0    Disenfranchised patients, a “Dr. Knows Best” approach.
  • Health 2.0    The empowered consumer
  • Health 3.0.   Personal responsibility becomes part of the social contract we all have with one another. Not only will consumers be given the tools and information they need to make better choices — they’ll be expected to do so. And there will be consequences for not doing so.

But consumer owned healthcare’ isn’t quite here yet, even though number of US Health 2.0 consumers is at 60 million. 10 million adults use their cell phones and PDA/smartphones to look up health and medical information, and “a growing number of patients are rating prescription drugs and treatments on sites likeiGuard.org, DailyStrength.org, PatientsLikeMe, and WebMD.” See the top health web apps, the trends to watch in health 2.0, the latest industry stats and Health 2.0 updates by ReadWriteWeb.

Long Live Health 2.0! Welcome first concepts of Health 3.0!  And let’s start planning generation 4.

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Watch for Health 2009

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The first reported person to actually wear a watch on the wrist was the French mathematician and philosopher, Blaise Pascal (1623-1662). With a piece of string, he attached his pocket watch to his wrist. In the late 1800s, the wrist watch was officially invented by the Swiss watch maker, Patek Phillippe. The first wristwatch for men was designed by Louis Cartier in the early 1900s. And almost a century later watches started to incorporate more functions - from the 1977's Hewlett Packard’s HP-01 with a personal calculator, and a calendar and 2001's Linux-based WatchPad developed by IBM  and Citizen.

Then came the health monitoring. 
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​The Cyber Heartbeat LED watch (shown on the right) won’t measure your actual heartbeat, mimicking an EKG spiking in correlation to the time. But many watch-like devices nowadays actually measure a multitude of vital functions. Ranging in price from less than $30 to $400 and more, a variety of real heart rate monitors are available in the market. 

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Suunto, for example, can calculate metrics like oxygen consumption, respiratory rate and training effect. On the lower end, the Omron HR-100C is easy to use and doesn’t have a lot of fancy functions to confuse novices,measuring heart rate with a chest strap and transmitting data to the wrist-mounted display. If you want more features than the basics, reviewers recommend the Polar F11 heart rate monitor.
The Garmin  305 (image on the left) has an integrated GPS antenna, so unlike most heart rate monitors, it can tell how far and how fast you’re going and keep a history of your exercise. 

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Animas Corporation, which is now a Johnson & Johnson company, is no longer selling the current model GlucoWatch G2 Biographer System, shown on the right. Cygnus Inc. (Redwood City, California) is already working on second and third generation products that will overcome some of limitations of this watch which include skin irritation and calibration, meaning additional finger-stick tests redone about 20% of the time.

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TeleMedIS System combining the TeleMed HC Platform developed by Karolinska and Telehealth Monitoring Wristwatch (TMW) developed by Tadiran LifeCare, connected over the Wireless Network (provided by TeliaSonera Sweden), is able to measure user vital signs by using integrated biosensors. This includes 1-lead ECG, Blood oxygen saturation level (SpO2), Pulse (heart rate) and includes 2-way data and voice telecommunications. It could help to manage Congestive Heart Failure (CHF), Arythmia, 
Respiratory diseases and COPD follow-ups. 

Australian researchers have developed a wristwatch that continuously monitors the health status of people with Parkinson’s disease to help doctors manage their treatment, Victorian Minister for Innovation Gavin Jennings said in May 19th press release. The wristwatch, which is still at the prototype stage, was introduced onto the world market by Mr. Jennings at BIO2009 in Atlanta, USA. Professor Malcolm Horne and Dr. Rob Griffiths are the inventors of this technology. 

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Dreamate Sleep Inducer is a non-invasive sleeping aid wristband. This watch-sized device on a strap uses acupressure techniques to “retune the biological clock and train your body to relax and sleep by massaging key acupoints on your inner wrist”. The Taiwanese gadget provides a double-frequency micro-massage (via a vibration motor) to specific pulse points—termed the “Sleeping Golden Triangle” points in traditional Chinese medicine. The company says it helps in relieving stress, inducing sleep and is especially beneficial for people suffering from jet lag.Health equipment manufacturers such as Omron Healthcare Co Ltd, Nipro Corp, and Matsushita Electric Works Ltd, all of Japan,have been announcing terminals to measure physical activity.  These “life recorders” are specifically designed to make it possible to accurately measure the amount of physical activity, pulse, skin temperature and motion. They also measure external factors such as atmospheric pressure.
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If you wear the GoWear fit armband during the course of your day, then log onto your personalized GoWear fit online activity manager, you’ll get information about the calories you’ve burned, plus a calorie consumption calculator and tips for how to best reach your fitness and lifestyle goals. GoWear fit also measures sleep duration and efficiency – so that you can begin to understand the influence your bedtime has on your overall health. BodyBugg is very similar to GoWear Fit and they both also have a food log. Sensewear has the sleep monitoring capabilities. 

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In the early 2000s, the watches were not a huge success. They were bulky and power hungry, delivering a limited amount of information and asking for a substantial ongoing cost of subscribing. Many projects have been shuttered but new models continue to appear. One of them is the Watch without a Face.

So if you do not want the world to know what exactly you are measuring, consider design suggested by Hironao Tsuboi for an LED watch. It looks like just a metal band. The . Push a button, and you get the time or what you’d like to get. Don’t push the button: no numbers, no curves, no pie charts. Very simple.

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Telemedicine 2.0

 
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The term telemedicine was coined in the 1970s by Thomas Bird although the origins of this technology - the remote communications with patients - date back to smoke signals in ancient times  - when an orange glow across the nighttime sky was signalling an outbreak of an infectious disease.  

The first uses of telemedicine to transmit video, images, and complex medical data occurred in the late 1950s and early 1960s. In 1959, the University of Nebraska used interactive telemedicine to transmit neurological examinations, which is widely considered the first case of a real-time video telemedicine consultation. Earliest electroni devices included STARPAHC – a van staffed by two paramedics with a variety of medical instruments including electrocardiograph and x-ray. ATS-1, the first Applied Technology Satellite was in use in 1971-1975 to provide rural health care in Alaska. Minimal television system for remote diagnosis was developed in early 70s. Applications of telemedicine in early 2000s included remote consultation and diagnosis, specialty clinical care (anesthesia, dermatology, dentistry, cardiology, psychiatry, radiology, critical care, oncology, etc), patient education, home monitoring, and continuing education.

Telemedicine became practicable at the end of the 1980s with the availability of low-cost computing and digital telecommunication (e.g. ISDN), but most of its applications failed to survive past the initial funding stage.  

The rise of the Internet in the 1990s also brought with it the information explosion and another attempt at Telemedicine, Telemedicine 2.0 

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The health care cost is rising each year, it’s already 16%-17% of the GDP. Wide utilization of wireless communications can reduce the health care cost by billions of dollars on an annual basis. Here are some examples of new developments.
Cisco HealthPresence combines state-of-the-art video, audio, and medical information to create an environment similar to what most people experience when they visit their doctor or health specialist. First Cisco HealthPresence booth was installed in January 2008.

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Another California company, CardioNet provides the next-generation ambulatorycardiac monitoring service with beat-to-beat, real time analysis, automatic arrhythmia detection and wireless ECG transmission.
A startup in Redwood city, CA, works on ingestible technology: microchip-enabled medications that provide patients with valuable information to customize their therapy. Proteus’s implantable ChipSkin™technology adds tiny active electronics to devices that use electrical energy to deliver therapy inside the body. Similar technologies are being proposed (like a medication reminder watch by a UCLA student and the MedTracker device) or are being developed.

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If you experience unpleasant gastrointestinal symptoms, such as abdominal pain, diarrhea, bleeding, anemia or GERD, you may be tested by capsule endoscopy with PillCam® family of products from Given Imaging. Vitamin-sized capsules with miniature video cameras inside will send pictures of your GI tract to a computer for your doctor to review. For GERD diagnosis, BRAVO pH monitoring system could be most useful.

Swallowable devices such Radio pill can monitor players temperature. Researchers are planning larger volunteer testing events this year.

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This gadget is displaying your identification card, if you need it, but is also a Bluetooth headset device and has the features of other wireless headsets. With up to 40 hours of talk time on a full charge, the Smart Badge by Iqua is easy to carry and use, is stylish and smart. Its standby time is up to 600 hours, it vibrates to alert incoming calls silently during meetings and allows 3-way conference calls.
It also has LED lights displaying Bluetooth connection, call status, and low battery indication. With supporting cell phones, this badge also allows for voice activated dialing. For full features and specification, you may find the Pdf of the product brochure here.

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