What Are Smart Medical Homes?

A smart medical home is a residential environment that uses technology to collect and monitor data related to its residents’ health, comfort, security, and well-being and responds in ways that protect, support, and promote these characteristics. If you think the notion has a dystopian ring and evokes the image of the omnipresent Big Brother, you are not alone. At the same time, a smart medical home is an environment that can give the gift of independent living to those who would otherwise require care in nursing homes or other residential facilities - older adults and those living with disabilities. Although we already live surrounded by robots and smart devices, the concept of a smart medical home is still in its infancy. Current and future research, development, and policy efforts will determine whether smart medical homes’ potential can be realized and their risks curtailed.

Smart Home Concept

The concept of a smart medical home grew out of earlier concepts of home automation and smart home technology. Smart homes have been defined by Demiris (2016) as follows:

A “smart home” is a residential setting with embedded technological features that enable passive monitoring of the well-being and activities of their residents aiming to improve primarily overall quality of life, to detect or even prevent emergencies and ultimately increase independence for the involved residents (p. 245).

Smart home technology refers to a connected network of devices and appliances that are equipped with sensors and actuators (controllers) that can be operated remotely. This is related to the concept of the Internet of Things (loT), or wireless connectivity among traditionally not connected devices. Examples of smart home technologies include lighting, temperature, and entertainment control systems that can be operated via phone, computer, or another device.

More controversially, in addition to devices being remotely operated by residents, the concept includes smart technology that independently responds to users’ states, behaviors, and perceived needs. For example, a smart refrigerator may issue an alert when its owner is running out of milk, as well as provide a recommendation to eat more fruit and vegetables.

Adding “medical” to the concept of “smart home” increases both its complexity and potential applications. A smart medical home environment can monitor its resident’s health indicators and alert the resident, a family member, or a healthcare provider in case of danger. It can turn a cooking appliance on or off, adjust the temperature of a smart electric blanket, and ring a wakeup alarm during an optimal stage of a sleep cycle. It may remind a resident in an early stage of dementia to take medication or to engage in self-care (e.g., brush teeth). It may also suggest making a video call to a friend or a family member or playing a cheerful movie as a result of assessing the resident’s mood.

While no currently existing smart medical home encompasses all of these features, many interesting research and commercial projects implement some of them. The rest of this chapter will review the technologies and functions related to the idea of a smart medical home, describe some existing projects, and analyze technical challenges and ethical implications.

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