Non-Technical Challenges to the Emergence of Smart Medical Homes

OF SMART MEDICAL HOMES_____________________________

The greatest non-technical challenge to proliferation of smart medical homes technology is user acceptance. No matter how potentially useful something is, if users are distrustful of it, it will not spread.

Research suggests that the two biggest factors that negatively affect residents’ willingness to accept smart home technology are poor usability and privacy concerns. Yet, although privacy concerns are the most common reason for which older adults reject smart technology (Morris et al., 2013), fear of losing privacy is weighted against the desire for autonomy and aging in place, as opposed to moving to a residential care facility. When individuals perceive smart technology as enabling their continuing independence and view privacy concerns as adequately addressed, they usually welcome the technology.

Making It Specific: Some Examples

In the Wild

As mentioned previously, most of the chapter so far has focused on the concept of smart medical homes and their potential. Yet, potential aside, our actual living spaces are now much smarter than they were 10-20 years ago. Many homes have remotely controlled thermostats, motion-sensor-enabled lights, and remotely accessible security systems that will alert an absent resident about a suspected break-in while also notifying a security company.

While all-home-encompassing loT networks are still rare, many individual devices are connected with smartphones or voice assistants. Smartphones can serve to remotely adjust settings on cooking appliances and operate smart washers and driers, which can then send text notifications when their cycles are over. Voice assistants stream music, set alarms, make calls, and deliver tailored news reports. Moreover, web services such as IFTTT and Stringify allow users to program apps and supported devices to performed sequences linked by conditional if-then statements. For example, one can create a chain of events in which opening a garage door after 6 pm turns on the thermostat in the living room and starts a cooking appliance and a laundry cycle. Another possible chain focusing on older adults could involve turning off cooking appliances when the resident leaves home (as recorded by a security system) and notifying a caregiver if the resident left in the evening and did not return after a specified time.

With regard to technological developments with a more targeted focus on the health domain, chronic disease management at home has been made easier by smart home based or portable medical devices, wirelessly connected to apps that can analyze their data and issue alerts and suggestions. For example, many glucose monitors synch their data with apps and allow sharing results with a doctor.

While interoperability remains a challenge, tech-savvy patients and their families and friends start joining forces in search of creative solutions for overcoming it. A noteworthy example of a grassroots approach is the #WeAreNotWaiting movement by parents of children living with Type 1 Diabetes (HealthLine, 2020). The movement grew out of concerns about the lack of interoperability standards that would allow easy integration and communication of glucose monitoring data. Lack of interoperability prevents the optimal data flow that could connect everyone who needs to be involved. For example, a child’s continuous glucose monitor may record a dangerous value in the middle of the night and transmit it to a parent’s phone, but flexibly routing the alert to the parent/caregiver of choice is not computationally trivial. To overcome this problem, the community, comprised of diabetes leaders, entrepreneurs, and developers, many of whom are parents of children with Type 1 Diabetes, created an open-source Nightscout project. The project supports uploading continuous glucose measurement data from monitors to the cloud and accessing it in real time via a range of interfaces and devices. Tech-savvy parents can use the technology to add smart features to their homes. For example, one father who works in remote automation and smart homes networking used Nightscout to enable triggering the lights to turn on in the parents’ master bedroom if readings became too low. Parents in the #WeAreNotWaiting movement exchange DIY technology tips for using smart technology to make their children’s lives safer (Hoskins, 2018).

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