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    Smart Homes for Healthcare


    House Wired for Health

    Some computer scientists envision that one of the first uses of "ubiquitous computing" at home will be in the field of proactive healthcare. Currently, MIT and other research institutions are developing "living laboratories" places where the effectiveness of technologies such as sensors, cameras, and monitors can be studied with actual users.

    Eventually, architects will routinely design such "smart" homes, offering new opportunities to improve people's lives. The potential is that ubiquitous computing technology will negotiate communications between multiple computers embedded in the physical environment in ways that are effectively invisible to the user.

    Some of the ubiquitous computing technologies that might be used to support health monitoring systems are: wireless broadband networks to allow communication between devices; nonintrusive biosensors, activity sensors, and bodily diagnostics; information processors to dampen inherent noise and correctly infer high-level behaviors from low-level sensor data; displays to allow communication between the user and the system; and natural interfaces that enable communication through natural media built into the user's life style.

    As smart homes become realities in urban centers, it is inevitable that such technologies will eventually trickle down to the rural housing. One question is: as we design for rural areas, do we work with the same constraints as those of urban counterparts or do we develop new guidelines and standards?

    To initiate a discussion on what constitutes a smart home for rural America, we should consider the concerns a person may have when first introduced to these technologies.

    Homeowner Concerns "I can't afford it." Ubiquitous computing initiatives are available today for those who can pay out of their own pockets. The rural population is significantly poorer than its urban counterpart. Ironically, though, it is the rural population that perhaps requires these technologies more than those in the cities, especially for healthcare access.

    One way these technologies can reach the rural poor is if the government mandates their inclusion as part of the medical insurance system. The challenge for designers is to work with government agencies to introduce the technologies into rural architecture. The initiative may begin with population centers and finally trickle down to the rural poor. Electricity, another ubiquitous technology, followed a similar path to common acceptance.

    "I don't know how to use it." In the early days of computing, system administrators were an important part of everyday operations. As computer systems became more common, the administrative role shifted to the user.

    In contrast, traditional appliances like telephones or televisions are commonly accepted because the intelligence of the system lies in the network and not the device. One approach to enable widespread technology use would be encourage a shift of the intelligence from the device to the network.

    This would mean that the house only contains the most simple and minimal "front end" functionality needed to connect to the network. In short, we would make ubiquitous computing devices as simple as the ordinary appliances people already use every day.

    "Where do I buy it?" While new houses may eventually be built for such smart applications, existing homes are not. So most "smart" residential technologies will need to be available "off the shelf" from retail stores.

    The challenge for the architect is to anticipate change in the design of spaces when these technologies are brought together incrementally to ensure impromptu operability and interoperability between technologies.

    Such spaces will need to accommodate "hot-pluggable" devices and to sense the addition or subtraction of individual devices. The spaces will need to accommodate "collaborations" between different devices and the home as a whole. This is roughly analogous to, in the current context, a thermostat telling the central air conditioning system to adjust air flow based on ambient temperature.

    "Will it interfere with my life?" Elderly people tend to differ from younger people; in traditional households, cultural and social concerns may take precedence over technical and aesthetic ones. Smart technologies must be able to respond such differences. Designers should be sensitive to whether a particular technological approach will work with the user's lifestyle. Also, most smart home technologies have substantial privacy implications.

    "Will it take over my home?" Science fiction movies and books sound alarms about computers being in control. Realistic research, however, takes a very different approach: offering persuasive options instead of issuing coercive orders.

    This approach leaves decision making to the user and provides "just-in-time" information highlighting the benefits of engaging in particular behaviors. An example would be for a device to indicate that it is time to take medication in contrast to a mechanism for forcing the person to take medications.

    "I don't want to be isolated." Technology should aspire to catalyze rather than replace human interactions and social connections. Successful and comfortable aging requires the elder to reach a balance between self-confidence and increasing reliance on others. Designers of "smart" homes should address issues of a rural population that is living alone yet looking for connections to their relatives and friends.

    The Role of the Architect

    Products developed in laboratories may fail when introduced into residential settings if they are designed without understanding the human behavior they're intended to complement. Architects can help in the development of these technologies by understanding the idiosyncrasies of how people use spaces and by suggesting changes to products so they will better meet the cultural, ethnic, and socioeconomic requirements of the users.

    Elegant and usable design will be achieved only through conversations between researchers in various disciplines and through widespread awareness of current literature and research in this realm. To learn more, look for the Aware Home Initiative at the Georgia Institute of Technology and the Smart Medical Home project at the University of Rochester.

    Hopefully, architects will participate in a dialog with technologists about the opportunities of designing rural houses of the future and working together to find a common solutions.

    Discuss this article in the Architecture Forum...

    Anijo Punnen Mathew is an assistant professor at Mississippi State University's School of Architecture. His research at the Design Research & Informatics Lab (DRIL) explores computer mediation in architectural spaces and the impact of ubiquitous computing on architecture.

    This article was excerpted from a paper presented at the ACADIA conference on Smart Architecture: " Smart Homes for the Rural Population: New Challenges and Opportunities," Savannah College of Art and Design, 2005.



    ArchWeek Image

    The "shotgun" vernacular house is an example of adaptation in the rural South despite remoteness from modern infrastructure.
    Photo: Kevin Matthews/Artifice Images

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    "Ubiquitous computing" will require communication between multiple, networked computers embedded in the physical environment without interventions by users.
    Photo: Matthew Bowden

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    Current healthcare delivery models in the United States.
    Image: Anijo Punnen Mathew

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    Projected healthcare delivery models with the help of computing at home.
    Image: Anijo Punnen Mathew

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    Relative availability of doctors in Mississippi compared to the rest of the United States.
    Image: Anijo Punnen Mathew (Source: American Medical Association)

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    Consumer attitudes about healthcare.
    Image: Anijo Punnen Mathew (Source: Forrester Research)

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    Consumer attitudes about acceptance of technology.
    Image: Anijo Punnen Mathew (Source: Forrester Research)

    ArchWeek Image


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