Philips GoSafe: The latest PERS offering from Philips Lifeline. Like every other commercially available PERS offering, it does not claim to prevent falls.
According to the CDC, falls are the number one cause of injury death among older adults and the number one reason for hospital admissions for trauma. Falls are a serious problem for older people living at home, and a burden on our healthcare system as well: the CDC estimates the total medical cost of falls in 2010 was $30 billion.
Falls are also an area where a lot of mobile health innovators are focusing their attention, including the remote monitoring and telemedicine markets. Sensors, pendants, and panic buttons on phones are a great comfort and can improve outcomes, since they allow victims of a fall to get help right away, rather than being trapped for a long time. But the real game changer in mobile health would be technology that actually prevents falls.
Remote monitoring can also be preventative because falls don't happen out of the blue. They're often a result of a slow decline in balance that older people might not even notice. Technology that can detect subtle changes in an older person's gait can alert a doctor or caregiver of the increased likelihood of a fall before it happens.
Here's a roundup of technologies that are tackling the tricky science of fall prevention.
Sensors in Shoes
When MobiHealthNews looked at this space back in 2009, two of the most promising new developments were sensor-embedded shoes. AT&T was working on a prototype of "smart slippers" using technology from startup 24Eight. These shoes would be equipped with sensors that could detect slight changes from a patient's ordinary foot movement and transmit a warning to a doctor or caregiver.
Around the same time, then-MIT student, now Harvard fellow Erez Leiberman developed a sensor-laden iShoe which garnered a lot of press attention, and was, last we heard, being pilot tested by healthcare system Ohio Health and due out in 2010.
For some reason, neither of these products has emerged in the market. In fact, Laurie Orlov, who blogs about aging in place technology, pointed to the iShoe in a 2011 post lamenting how technology makes big news at universities and then disappears. A spokesman from AT&T declined to comment on the status of their product, but suggested there might be more information available soon.
Carpet could fare better
One drawback of smart shoes is that to be useful, people still have to remember to wear them. If their sensors are powered, they need to be charged or have their batteries replaced. Can we really expect people to charge their shoes each night?
Several projects making headlines recently avoid that problem by building sensors right into the floor. In the UK, The University of Manchester has developed a smart carpet. Plastic optical fibers in the underlay of the carpet track walking patterns in realtime. Just like with shoe sensors, the goal is to detect the changes in gait that can presage a fall. The University hopes to see the technology, which can be retrofitted at low cost, deployed in nursing homes and hospitals first, and possibly later for home use. Intel and GE's Care Innovations initiative is working on a similar technology, which has been referred to as a "magic carpet."
Similarly, researchers at the University of South Carolina have re-worked sensors used to measure stress on bridges to the purpose of tracking vibrations created by a person's movement. The matchbox-sized sensors, placed on the floor or baseboard of a room, are very sensitive and can determine the location and weight of any object hitting the floor.
Other wearables
At the University of Texas Dallas, a researcher has developed a sensor the size of a button that could be incorporated into a number of form factors. The breakthrough which allows for the small size is a power optimization system that deactivates sensors when they're not needed. So when the system detects that the wearer is sitting, it stops monitoring them as closely as if they were walking or standing.
An Australian company, iStoppFalls, is working on a necklace-worn inertia sensor, called a Senior Mobility Monitor. But the company will combine the sensor with a training system, designed to build up seniors' reflexes so if they do fall, they do so in the safest way possible. (AARP recommends this method as well.) iStoppFalls' program takes the form of an Xbox/Kinect game, meant to be played thrice a week.
Researchers and engineers around the world have been chasing fall prevention for many years now. A Japanese company called Prop went as far as to create a personal airbag in 2008, for instance. But developing something is one thing. Bringing it to market, as a product that is clinically proven to work and attractive or unobtrusive enough that people use it, is something else entirely. We'll see if smart carpets and floors fare any better than the still-absentee smart shoes.
At least one large personal emergency response (PERS) company has shared with MobiHealthNews in the past that one reason fall prevention technologies are so hard to bring to market is liability: If a device is going to claim to prevent falls, it had better prevent all falls. And what's the legal liability when it fails to prevent one?
