Monday 24 September 2012

Exercise Video Game: A Future Digital Patient?

The most difficult task of the roadmap for the digital patient currently being built is trying to ascertain what technologies will be required to make the digital patient happen.  This month saw the circulation of a questionnaire to industry and academia by DISCIPULUS (the European Commission project tasked with building the digital patient roadmap).  The questionnaire contains general questions, scenario-stimulated questions, and technology-stimulated questions.  The technology-stimulated questions start with a known technology with the aim of sparking people's imagination.  The exercise video game (or 'exergame') has been identified as one such technology that could spark imagination into a future digital patient prototype.  Exergames already have many of the features that will have to appear in the digital patient program: avatar generation, real-time feedback, basic personal information such as identity, body mass index (BMI) and heart rate.  Exergames have also been scrutinised in clinical trials and published in journals such as the BMJ 2007;335:1282-4 and Am J Clin Nutr 2011;94:156-63.  These trials show that exercise video games do in fact have a beneficial health effect compared to non-exercise video games, but not as good as actual exercise itself.  What subpopulation could exergames really be of benefit to?  If such a population could be identified and exergames can already monitor your heart rate, combined with information on your calorie burn, could they be given multiple levels of calorie burn monitoring, from total burn to more specific burn such as glucose utilisation?  If glucose utilisation monitoring bacame possible in exergames, could that be extended to diabetes modelling?  If diabetes modelling in turn, became possible in exercise video games, why not include the modelling of some of the complications of diabetes?  This "bottom-up" approach has proved hugely successful for the Apple Mac franchise, and such approach is being explored for the roadmap.

3D Scanning App for the iPhone

One article from the online science and technology news, Singularity Hub, of significance to the future digital patient caught our attention this month (15th) - a 3D scanning app for the iPhone.  Although the real cleverness of the digital patient will lie in its potential for high performance computing, for most of the public however, it will only really be appreciated in its visuals and accessibility.  These two points are crucial if the program is to get widespread uptake (as was the case with PCs).  3D scanning is of course, one of the core component technologies that the digital patient program will have to have, but today, it is still very much a "professional's art" (partly because of the price).  However, as 3D scanning comes down to iPhones (and presumably, it's only a matter of time before the technology makes it to android devices), the price is surely going to come down and accessibility will conversely go up.