Vital Signals: Exploring Intersections of Wireless Technology, Health Care

Reprinted from Unbound, the Engineering School magazine

July 18, 2012 — Fully a decade ago, John Lach, associate professor electrical and computer engineering at the University of Virginia, knew that engineers held a significant stake in the future of the American health care system.

At the time, industry observers and policy analysts made bold predictions about rising costs and an impending shortage of care providers. Chronic conditions requiring frequent monitoring were on the rise. That trend overlapped with an expanding population of seniors and the unprecedentedly large cohort of baby boomers looming just around the bend.

Lach strongly believed in the future ubiquity of wireless technology and the virtually unlimited potential of its application in health care. Soon after joining the faculty of the School of Engineering and Applied Science in 2000, he dedicated a significant proportion of his research to creating wireless health-monitoring devices, with a goal of contributing to a sustainable future for the health care system and empowering patients to take better control of their own health.

Now, the U.Va. Center for Wireless Health is an emerging leader in a market that could touch millions of lives spanning every community in the nation.

"Not long ago, there were few who listened," Lach said. "Today, there is acute need. Now I regularly get calls about the progress we are making and where we are headed next."

Three key facets of Lach's work tightly align with the future of health care. First, wireless monitoring can help people live independently longer. Second, the data flow dramatically enhances the ability to deliver personalized care during clinic visits or inpatient hospital stays. Third, the data are more accessible to patients and their families, enabling an increased role in maintaining and improving health at home.

Caring for aging parents is becoming a leading concern for the baby-boom generation. From a cost and a personal preference perspective, assisted-living communities are fast becoming an option of last resort rather than a preferred choice for seniors advancing in age.

One of the keys to independent living is early detection of major health problems. In most cases today, intervention takes place in response to a condition or an event, such as a fall, instead of with a goal of prevention.

Through wireless technology, Lach's teams are working to enhance living environments so behavior or actions preceding an event can be noted, with appropriate family and health care providers alerted so that modifications to care or the household can be made. In the case of mobility, sensors can detect subtle changes in a person's gait, and identify those changes as likely predictors of a fall. The data trigger a call for evaluation and remediation, such as physical therapy or reassessment of the patient's living environment.

Other events for tracking include instances such as an elderly loved one opening the front door in the middle of the night, failing to enter the kitchen for an extended period of time, or getting in and out of bed throughout sleep hours. Each could signal a behavioral or health change that can be addressed before a major condition presents.

Translating this U.Va. research into a market-ready solution, two engineering alumni have launched BeClose, a Northern Virginia-based company providing home monitoring technology. Featured in news outlets such as The New York Times, USA Today, National Public Radio, ABC News and others, BeClose equips homes with sensors and provides dashboard and alert services to family and caregivers via phone, email or text. Mark Hanson, who received bachelor's degree and, in 2009, a Ph.D. in electrical engineering, is responsible for the company's technology and product strategy, while Adam Barth, a 2011 Ph.D. in electrical engineering, serves as the principal engineer.

"The most important question in a physician visit is the first one," Lach said. "'How are you doing?' The answer heard most often, especially from men, is a single word. 'Fine.' What we are attempting to achieve is greater automation of the information exchange so that visits become more focused and productive, and so that subtle information that may be critical to the caregiver but overlooked by the patient can be entered into the assessment."

Lach and the Center for Wireless Health also focus on engaging patients in enhancing their own health by providing information in a way that is both understandable and actionable. He said a question from a participant at one of his talks changed their approach.

"That question was, 'Instead of focusing on what we give the doctors, what can you give me?'" he said. "The traditional response was that health information was best left in the hands of professionals. But that notion is changing rapidly, and could be the key to engaging and empowering seniors in a whole new way."

Information may help improve therapy and recovery, or provide assurance that therapy is providing the intended benefit. The technology also helps patients better understand their bodies so that changes are easier to detect, and makes those changes simpler to describe to a physician, nurse or therapist.

Lach cannot imagine a better place to pursue his research than U.Va.

"The fact that U.Va. is a comprehensive university means a tremendous amount," he said. "It would be impossible for me to solve these problems myself. I walk across Grounds and get input from leaders in dozens of fields. On top of that, the cross-pollination and collaboration is encouraged and welcomed.

"The participation of undergraduates in meaningful, hands-on research at U.Va. is also tremendously gratifying," he said. "Even first-years are involved, to the extent that they work beside graduate students, physicians and patients. The blend of theory and practice creates a career-shaping experience. The fact that our students are moving on to launching successful businesses based on the technologies we are creating is a clear testament to what is so special about the U.Va. Engineering School."