How the IoT will impact Charles Rabbit’s life?

The arrival of the Internet of Things will, in time, have a major impact on our everyday lives. One important area that will be affected is health. Let us see how this new world might work in practice by considering how a typical heart patient – we’ll call him Charles Rabbit – will be treated in the future.

Charles is in his mid-60s and has been under treatment for a heart condition for a few years. His father had a similar problem but Charles’ treatment is altogether different. For while Charles’ father had to go into hospital or see his GP for regular monitoring, Charles’ monitoring will be done at home. The sensors woven into Charles’ clothes will be continually monitoring his condition and sending data back to his doctor via his avatar. This is a smart program based in the computing cloud that Charles bought to look after his interests. It usually takes the form of a 3D talking figure – an avatar – that can appear on phones or on web pages to receive instructions. In Charles’ case he has opted for a complex machine endlessly performing calculations that he calls ‘the Difference Engine’.

Using a combination of pre-programmed information on what Charles likes plus information the Difference Engine has stored on previous supermarket purchases, the avatar knows the sort of food that Charles favours, and it uses that information to check ingredients against a list of menus supplied by the doctor.

By cross-referencing through both lists and the contents of the internet-enabled fridge the avatar is able to produce a selection of evening meals for Charles to choose from. As the ingredients are used the fridge, using an RFID scanner, notes the fact that they have gone and adds items to a list that will be bought from the supermarket.

The supermarket itself will be monitoring Charles’ consumption habits and will offer incentives on certain items based on information it has asked the Difference Engine to supply, and on information the supermarket has culled from its loyalty card scheme.

What happens if something goes wrong in his care and treatment. Who will be held responsible?

After the meal, sensors in the house record Charles’ activity. This data will include which rooms he has visited, whether he has taken his medicine, how much alcohol he has drunk and indeed whether he is moving, or whether he is lying down, or just standing.

In winter this detailed information enables the Difference Engine to achieve significant cost savings on Charles’ fuel bills. Knowing which areas Charles habitually uses, it preheats certain rooms and reduces heating in others.

The avatar combines this knowledge with information taken from weather forecasts that allow it to achieve the most comfortable blend of heating and clothing for Charles. Information of this kind is also cross-referenced with data about other patients with a similar demographic and condition.

The avatar also sends information about Charles to his daughter, Ada, so that she knows her father is all right. Ada had in fact requested permission to ‘virtually accompany’ her father at all times but this had been declined by the Difference Engine because Charles had not wanted it. He felt it would be too intrusive.

The Difference Engine had, however, sent information to Ada and to the doctor when Charles had not taken his medicine for two days in a row, and had allowed them into the house when they called to find out why.

Meanwhile the continuous monitoring of Charles’ health data is being carried out by centralised computer systems that map small changes in his condition and alert the system to changes in Charles’ body that need to be corrected. This information is sent to the avatar to implement; the only role for the doctor now is to intervene to ensure co-operation.

Charles is happy with the system that he has helped create. But inevitably there are downsides too. One is privacy. Though Charles stopped his daughter having full access to the Difference Engine, he is worried that others in the system may be ‘snooping’ on him.

Also, as his monitoring involves a certain amount of expense, a large health company has underwritten the cost in return for access to Charles’ data. The company has good reason to do this; Charles’ condition is considered to be particularly interesting and as a result the data is potentially lucrative.

Charles is not well-off and so the offer of help to ensure his well-being is welcome. But at the same time he and his daughter Ada are concerned about the company’s use of Charles’ data. Because the data is totally specific to him they want to know whether he has copyright in it. Is the father’s data worth more than the company is paying him? So far their lawyer has simply told them this is a grey area.

Another thing that troubles Charles is what happens if something goes wrong in his care and treatment. Who will be held responsible? The makers of the Difference Engine? The health company sponsoring him? The health service? The doctor? Himself? So far neither Charles nor Ada has been able to get a clear answer from anyone on this…

This article is part of a series of articles published from the Netopia report Can We Make the Digital World Ethical? Exploring the Dark Side of the Internet of Things and Big Data, by Peter Warren, Michael Streeter and Jane Whyatt.

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