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CISCOINTERNET OF EVERYTHING THE CONNECTED SELF

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n 2012, Nicholas Felton’s phone started asking personal questions. A custom-built app, called Reporter , sent him a reminder to complete

a questionnaire at irregular intervals. Each time, he reported where he was, what he was doing, who he was with, what he was wearing and four other details. Meanwhile, the app took more information from his phone – latitude and longitude, the local weather, the peak and average sound levels. Over the year, Felton filed 4,739 reports – nearly 13 daily.

At the end of the year, he took these data inputs and created an annual report – an account of his entire 12 months, drawn from these regular updates. His life, reported through a smartphone.

THE CARRIER WAVEWhen humans carry connected devices, they become connected themselves – points on the Internet of Everything. The smartphone – a ubiquitous technology in much of the western world – provides a two-way gateway to the virtual world. We draw information from that world and we contribute data – from our location to our restaurant reviews. The more we tell our phones, the better they understand us. Google Now, Google’s mobile “personal assistant” cross-references present location and past behaviour, adding information drawn from the user’s email account. Apple’s Siri and Microsoft’s upcoming digital assistant, codenamed Cortana, offer competing services.

Eric Schmidt, Google’s executive chairman, described Google’s policy as

When things go wrong with health, time becomes critical and connectivity is vital. First responders can access medical data quickly, consult remotely and prepare the hospital to receive the patient.

In a connected hospital, every patient, member of staff and device can report their status and location at every moment – so doctors know where patients are, staff can always find the right doctor and in-demand resources can be scheduled efficiently.

Hospital networks need to be secure to ensure confidentiality and protect against data theft and malicious intrusions. With a “medical-grade” network, records can be shared instantaneously and experts from around the world can be brought into play using HD telemedicine solutions, supported by the Cisco TX series of immersive telepresence systems’ webconferencing.

However advanced and connected a hospital may be, they are still often large, intimidating buildings, full of people under stress. When every patient and visitor has a mobile device, location-based services can keep them informed. Cisco’s Connected Mobile Experience connects to mobile devices to help hospitals understand and deliver what patients and visitors need, be it directions, advice or information – from the route to the gift shop to an alert for when a prescription is ready. Meanwhile, analytics track how people move through the space, informing and improving logistics and management.

DEVICES #2

Connected medicine

In a world of growing, ageing populations and increased pressure on resources, the emphasis of the health industry is on minimising the length and number of hospital visits. Connected citizens with long-term, managed conditions can use the internet to check in with their doctors from anywhere. Using voice and video through a “patient portal”, care workers can reassure the worried well and identify real problems earlier through secure, confidential remote consultations.

Health information systems can collect data actively, through direct inputs, and also passively, by monitoring movement and other activities. The kinds of connected devices used by fitness fans to check their pulse and motion can also inform platforms such as Cisco’s Extended Care or uMotif, which both provide solid, factual data to inform discussions between outpatients and staff.

Hardware is also being developed to address the needs of an ageing population.

The GlowCap is an internet-connected pill-bottle cap – when it’s time for the patient to take their medication, the cap glows. If it is not opened within two hours, an automated system calls with a reminder. From the Owlet baby monitor – a “smart sock” that reports to an iPhone app – to unobtrusive monitoring devices helping older people to stay independent, ingenious ways are being found to use the Internet of Everything to take care of the old, young and vulnerable.

DEVICES #1

Remote care

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“to get right up to the creepy line, and not cross it”. Sometimes, the knowledge a phone can now display about its owner comes close to that line. You might forget a meeting, but your phone won’t – and it can check the traffic to get you there on time.

As sensors become smaller and more sophisticated, the ways phones can listen to us multiply: Samsung’s new S5 includes a dedicated heart-rate monitor, designed to integrate with its new fitness app.

The mix of health-consciousness, mobility and connectivity enables unconventional and revealing new approaches to personal health. Massive Health – acquired in 2013 by Jawbone – built a simple app called The Eatery. Users photographed their food, uploaded the picture and gave it a score for how healthy they thought it was. Other users then rated the photograph. It rapidly became

clear that people believed that they ate more healthily than others, even when eating the same food. A slice of pizza would, on average, seem 2.5 times healthier to the person eating it than the others who judged it.

Fitness has also driven adoption of what promises to be the next wave of devices connecting us to the network: wearable technologies. The first of these to take off were little more than smart pedometers. These have developed into a competitive market of smart, fitness-oriented products, which includes the likes of the Fitbit Flex and Jawbone UP.

Meanwhile, just as demand from customers has made phones evolve, a new generation of versatile wearables is making its presence felt. Google Glass is still the preserve of early adopters, but new, more fashionable frames are being released, continuing a move from geek to chic.

The wristwatch, nearly made extinct by the phone, is making a comeback using smartphone components. Pebble Technology raised $10 million (£6m) on the crowdfunding site Kickstarter to make its e-ink “smartwatch”, designed to synch with a phone, but with apps for the watch itself. Samsung and Sony have launched their own connected watches, with Apple’s entry into the market a persistent rumour.

Consumer analysts Canalys say that 2014 is the year smart watches and other wearables become a key consumer technology, with sales expected to reach 8 million, growing to 23 million in 2015 and 45 million by 2017.

The smartphone brought many devices – phone, diary, watch, camera – into a single form. As connection becomes simpler and more intuitive, wearable devices m a y c r e a t e a network on every body, as specialised, wearables – lapel cameras, audio recorders, heart monitors, watches or lenses – connect to a smartphone or tablet that forms the hub and control centre. Freed from the form factor of a slab with a screen, designers can experiment with new applications and new designs, such as Bionym’s Nymi wristband, which uses the wearer’s unique heartbeat as a key to unlock other devices, or the electronic tattoo that has been patented by Motorola.

TRANSFORMING HEALTHO n e o f t h e o b s t a c l e s h e a l t h professionals have faced when treating patients is a lack of accurate data: patients often misreport or misremember their conditions. Just as The Eatery found that pizza seemed healthier when we ate it, patients might remember their symptoms incorrectly – or not at all.

The most effective way to gather information on patients is to run tests. But moving a patient into hospital, or keeping them for a prolonged period, can be disruptive and difficult. And, with a growing, ageing population and increasing pressure on resources, hospitals need to find ways to reduce the number and length of stays, without risking patient safety.

The current system is struggling with changing demographics: US healthcare costs in 2012 totalled $2.6 tri l l ion, with an estimated $750 billion wasted. The average

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elderly patient sees seven doctor s in four d i f ferent practices – an exhausting and confusing process. And 20 per cent of elderly patients are readmitted within 30 days of a hospital stay, as the same issues recur.

Patient-centred care is aimed at empowering patients with information about their care, and doctors with the information they need to deliver the best possible care. But this demands new methods – especially with pressure to find progressive cost savings in the health sector.

The technology that enables people to photograph their food, or track their heart rate, is not too far from delivering the data that doctors need to make patient-care decisions. Apps such as Glooko – used to monitor glucose levels – can be combined with traditional medical records to inform clinical decisions.

For some groups – such as the elderly, people in remote locations or prisoners, who are hard to transport – travelling to

hospital can be a major undertaking. Today, institutions and homes can easi ly be f itted with telemedicine

systems to connect medical experts with people, combining remote consultations with tools to monitor and register health information.

Patients with long-term needs, or the elderly who still want to maintain independence, can be at risk when isolated. In an increasingly networked world, a light, unobtrusive level of monitoring can help to reassure family and carers. Connected technologies can check how often the refrigerator is opened, whether pills are being taken on time, house temperature and other warning signs. Cisco’s Extended Care solution is designed to take advantage of a networked world to maintain links between carers and vulnerable people, even outside regular contact hours.

For connected care to work , communications between doctors, carers and patients need to be secure to maintain privacy, and robust to ensure the network can alert staff to changing circumstances quickly.

CONNECTING THE UNCONNECTED

Cisco – Tomorrow starts hereThe Internet of Everything is a force for positive change – is your network ready? Cisco is enabling the IoE by ensuring that people, processes, things and data are connected quickly, safely and constantly on the busiest network in history. Cisco network architecture and wireless access points, and its cloud solutions, help connect and direct tomorrow’s technology.

Its web security services protect smart networks from malware, exploits and compromised devices.For more about the Internet of Everything: internetofeverything.cisco.com/en-gbTo see how Cisco is making the IoE possible: cisco.co.uk/tomorrowFor more info about the Connected Self: bit.ly/1fyhNXZ

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DEVICES #3

Connected fitnessThe fitness market is booming, with multi-purpose and specialised hardware and software driving the revolution.

Nike’s FuelBand monitors the wearer’s body movement, reminding them to exercise and offering encouragement. Fitbit’s Aria smart-scales upload weight, body fat and BMI readings to its website, so weight watchers can track their progress.

As wearable devices record more, the lines between fitness tracking and medical data blur. The Basis Health Tracker monitors heart-rate, body temperature and perspiration as well as speed and steps taken.

Mobile apps and web services plug into connected fitness, offering a range of incentives. Endomondo allows friends to track each other via their phones’ GPS, and offer

support – or mockery, depending on mood.

RaceYourself promises to bring fitness to Google Glass, with routes, distances and a range of motivating games – including one to race the “ghost” of your previous run – delivered to the wearer’s vision. As more personal data is stored on cloud services, network providers such as Cisco are working to ensure our information remains secure.

TRICORDERS AND MOREThe XPRIZE Foundation is probably best known for its support of low-cost space flight. But it is also encouraging the exploration of another frontier – the human body. Thirty-four teams are competing to snatch a $10 million prize

by creating a functioning “tricorder”. The aim of the competition is to create a single consumer device that can record blood pressure, respiration, temperature and other medical data, and which can be operated without extensive training.

Lifecasting is the hyperconnected equivalent of keeping a diary – instead of writing an entry, lifecasting software and hardware records events as they happen, and stores or broadcasts them. Perhaps the most famous piece of lifecasting to date is Felix Baumgartner’s 39km-high sky dive, which was streamed live to eight million YouTube viewers.

Microsoft’s SenseCam was originally developed to help people with Alzheimer’s disease to record their lives, and to help with recall. Designer Lyndsay Williams’s Autographer uses similar technology: when its sensors detect a change in light, heat or motion, the small, wearable camera snaps a photograph. The Narrative Clip, another miniature camera, takes a photo every 30 seconds, with a cloud-based system sorting the huge number of images for saveable pictures.

The crowdfunded Kapture wristband aims to do the same thing for sound – it continuously records the last 60 seconds of audio around it. The 60-second loop is overwritten, unless its wearer taps the face; then it is saved and downloaded to a smartphone app to be reviewed and shared.

Wearable devices such as the Samsung Galaxy Gear smartwatch and Google Glass, with built-in cameras and recording devices, will revolutionise lifecasting. However, the most common device for recording modern life will remain the smartphone – with services such as Facebook, Instagram and Foursquare, users are already sharing more about their lives, in real time, with more people and machines than ever before.

DEVICES #4

Lifecasting & personal data

The name may come from Star Trek, but the technology is real. At the 2014 Consumer Electronic Show, Scanadu showed the prototype of the Scout – a sensor-packed device about the size of a hockey puck. Pressed to the temple, the prototype takes a reading of the key metrics – temperature, blood pressure, oxygen levels and heart rate – which would be taken in hospital.

Monitoring technologies not only allow patients to keep a personal record, but help them to play a greater role in managing their own care. These devices can integrate with a portal such as Cisco’s Extended Care, which connects patients and care teams through a simple internet browser-based solution. Wherever a patient has internet access, they can connect and collaborate on maintaining their health and well-being through scheduled or unscheduled video conversations with care staff, use highly secure messaging to share sensitive information, and by tracking readings from devices such as blood pressure monitors.

THE NEXT LEVELWhen an entity is connected to the Internet of Everything, it becomes clear just how much data it generates, and how much of it is usually lost. For some, that information is where they had lunch, or how far they ran. For others, it could be life-saving data on the progress of a long-term medical condition.

Aggregated and anonymised, big medical data could contribute to breakthroughs in medical treatment. Google is already able to predict flu outbreaks by analysing searches. Some supercomputers have been “trained” to identify cancer and can interrogate patient data over the cloud.

When billions of people generate, capture and share information about their physical condition, new possibilities for understanding how the body behaves, and how to treat it, will open up. The smartphone and fitness band are the beginning of a journey that ends in big-data analytics, tailored treatments and new, data-driven approaches to the human body.

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