CHI2013 Review

May 13, ’13 3:51 PM

It’s been about a week since I got back from Paris after attending CHI. This was the most productive CHI for me personally, which I attribute in large part to the Personal Informatics workshop I attended.

PIW-CHI2013

The workshop, which took place on Saturday and Sunday before the conference began, was an opportunity to spend time and exchange ideas with a great group of folks. Thanks to Ian Li, Jon Froehlich, Jakob Eg Larsen, Catherine Grevet and Ernesto Ramirez for putting it together. It required lots of work to organize it, since it was set-up as a two-day hackathon. All the effort paid off nicely in my opinion. The interesting question now is how to make the Personal Informatics community within CHI grow, since it has outgrown the workshop format.

Now on to the main conference. With 10+ tracks, it is always a challenge to navigate CHI. Here’s a timelapse of my day 1 at the conference:

I was able to attend some good/interesting presentations, such as:

Validating a Mobile Phone Application for the Everyday, Unobtrusive, Objective Measurement of Sleep, Lawson et al.

Designing Mobile Health Technology for Bipolar Disorder: A Field Trial of the MONARCA System, Bardram et al.

Footprint Tracker: Supporting Diary Studies with Lifelogging, Gouveia and Karapanos.

Mind the Theoretical Gap: Interpreting, Using, and Developing Behavioral Theory in HCI Research, Hekler et al.

NailDisplay: Bringing an Always Available Visual Display to Fingertips, 
Chao-Huai Su, Liwei Chan, Chien-Ting Weng, Rong-Hao Liang,
Kai-Yin Cheng, Bing-Yu Chen

Food Practices as Situated Action: Exploring and designing for everyday food practices with households. Rob Comber, Jettie Hoonhout, Aart T van Halteren, Paula Moynihan, Patrick Olivier

Not surprisingly I was particularly drawn to the health-focused talks, but there were some intriguing and inspiring topics of interest in many other sessions.

Thanks for the inspiration Paris. Next year, Toronto.

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ICWSM-13 and Health

Apr 21, ’13 11:43 PM

The 7th International Conference on Weblogs and Social Media (ICWSM) is happening in Boston this year (July 8th-11th). I am not attending but I know that there is a large number of social media researchers who have been exploring the domain of health recently. In light of this, I like to check the program of ICWSM every year. Here are some of the papers that I will make sure to take a look at in July:

Predicting Depression via Social Media
Munmun De Choudhury, Michael Gamon, Scott Counts, Eric Horvitz

Perception Differences between the Depressed and Non-Depressed Users in Twitter
Minsu Park, David W. McDonald, Meeyoung Cha

Fitter with Twitter: Understanding Personal Health and Fitness Activity in Social Media
Rannie Teodoro, Mor Naaman

Characterizing Geographic Variation in Well-Being Using Tweets
H Andrew Schwartz, Johannes C. Eichstaedt, Margaret L Kern, ukasz Dziurzyski, Megha Agrawal, Gregory J. Park, Shrinidhi K Lakshmikanth, Shneha Jha, Martin E. P. Seligman, Lyle Ungar, Richard Lucas

I have to say I am very curious about the last paper on this list.

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Lively Revisiting Home Monitoring

Apr 16, ’13 12:05 PM

One of the reasons why activity recognition in the home is interesting to me is because it has the potential to enable so many important health applications, such as remote monitoring. There are many people, especially older adults, who would much rather stay at home while battling chronic diseases than move into an assisted living facility or hospital. But without a range of supportive services, which are often prohibitively expensive, it becomes virtually impossible to properly care for someone in their own home.

There is a wide range of commercial products centered on supporting independent living, from fall detection to medication compliance systems. One piece of the puzzle that is missing is a communication channel that offers caregivers a holistic view of an individual’s patterns of daily living at home. This would enable caregivers to observe everyday behaviors on a regular basis and hopefully anticipate problems.

Today I read about the Lively system, a sensor network and base station designed for eldercare remote monitoring. It combines a number of wireless sensors that could be attached to objects:

One type of sensor goes on pill boxes, while another measures whether people are eating and drinking on a regular schedule by indicating when refrigerator or pantry doors are opened, both using accelerometers. A third variety is a key fob with a Bluetooth Low Energy transmitter than lets the server know when the user is out of range, typically 125 meters (about 410 feet). This measure acts as a proxy for indicating when the person has left home.

Researchers have attempted to use sensor networks this way, with moderate success. For example, Tapia took the idea of sensors in the environment and showed how one could learn more about an individual’s high-level activities from low-level sensors. Rantz and Skubic demonstrated how a sensor network could be used as an early-warning system for conditions such as urinary tract infection in older adults. The only limitation of these system has been the large number of sensors required, sometimes in the order of 50-80 sensors per home. That is too many.

It’s clear that there is room for sensor networks in health monitoring at home, and Lively is betting that a few strategically located wireless sensors can tell us most of what we need to know about someone’s well-being. I do agree with this direction, and I am now curious to see how the company does in the future, including whether it raises significant funds through Kickstarter, which is a good indicator of how demand exists for a product like this.

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Mobile Notifications Increase (Food) Logging Behavior

Mar 28, ’13 12:20 PM

It is almost time for our community’s annual CHI pilgrimage. I am very much looking forward to it, as CHI offers a wonderful and unique opportunity to see old friends and make new ones. I’ll be there starting on April 27th for the Personal Informatics workshop.

As part of my CHI preparation activities, I’ve begun taking a closer look at papers that will be presented at the conference. I will go over some of them here, as time permits. One note that caught my attention was “The Power of Mobile Notifications to Increase Wellbeing Logging Behavior”, available here. I have been exploring the domain of food logging lately and one of the challenges has to do with the amount of work people have to do to log their every eating activity.

In this paper, Bentley and Tollmar discuss results from a study where “passive mobile notifications increase logging of wellbeing data, particularly food intake, in a mobile health service. Adding notifications increased the frequency of logging from 12% in a one-month, ten-user pilot study without reminders to 63% in the full 60-user study with reminders included”.

First of all, it is great to see studies with such a large number of participants. This is something I am trying to aim for in my own research. It looks like the second study discussed in the paper lasted for 3 months (summer of 2012), which is also a nice time frame for a study of this nature. In terms of the findings, I am surprised by how much the addition of a small notification icon in the UI and the ability to customize the notification improved logging. It is also interesting to note that even after a 5x improvement in logging frequency, users averaged only 9 days of logging for both food and weight.

Yes, we have a long way to go before food logging can be done as easily as with other forms of activity logging. Based on my recent research, I suspect the sweet spot will involve a combination of manual and automatic logging, but more validating work needs to be done, without a doubt.

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The Case for Human-Health Interfaces

Feb 25, ’13 11:44 PM

A couple of weeks ago I finally made some time to read Larry Smarr’s perspective paper titled “Quantifying your body: A how-to guide from a systems biology perspective“. Smarr is a leading figure in the Quantified-Self movement and someone who has been engaged in multiple levels of body monitoring for several years. The paper describes his own extensive self-quantification experience that eventually led to the discovery that he has Crohn’s Disease (CD). If you don’t have time to check the paper, you can find a short summary of the story (and a video) here. But I do recommend the paper, it is a quick, easy read.

At its core, Smarr’s story is about personalized preventive medicine, the type of health care that many of us envision and hope that becomes commonplace in the not-too-distant feature. However, what becomes apparent in the paper, as Smarr describes the various levels of body monitoring, starting with nutrition and delving into system biology and genetics, is how much complexity must be exposed and understood before one can bring all the pieces together and make sense of what is truly happening with the human body. Which brings me to the title of this post. Beyond the diagnosis and collection of health data, which generates much of the excitement nowadays, to realize the vision of personalized preventive medicine for the average person, one of the crucial steps will be to design interfaces that help people navigate the avalanche of health information that can and will become available to them.

I am particularly fond of the concept of health as a “fuel”, a “resource for living”, which was put forth by the World Health Organization many years ago. To my mind, it most closely matches the way most people think of health – as a means to an end. Therefore, if I am correct, it is highly unlikely that most people will invest heavily in the details and intricacies of enzymes, hormones and biomarkers, no matter their predictive power and how important they prove to be for people’s health and well-being. The opportunity that lies ahead, and that must be addressed, is to design and build an interface platform for personal health data at all levels of monitoring that leads to insights, is perceived as valuable, and that can be used by anyone. A tall order for sure. Back in the mid-nineties, we thought that the web was the common platform that would unite us all. And we were excited about the possibilities then as we are now about the future of health care. But today we know that it took a highly simplified, standardized, and shrink-wrapped version of the web (i.e. Facebook) to bring us to billion-level scale in terms of adoption.

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Tracking for Health Pew Report

Jan 29, ’13 10:42 AM

Two days ago we got a report from the Pew Research Center’s Internet & American Life Project on health tracking. Ernesto Ramirez had a chat with Susannah Fox, an Associate Director at the Center, and published some data and their conversation at the Quantified-Self web site.

One of the interesting findings to me was the percentage of people in the study who track health data informally, “in their heads”. I wrote a comment in the QS site about this, and I partially reproduce it here:

From the point of view of health literacy, we might be making more progress than we think. It could be that these people are just really inefficient at being healthier, but the motivation is there. This is analogous to the 10:00 min/mile runner who wants to get faster. There’s tons of low hanging fruit – a tempo or interval run here and there will probably bring the time down significantly. Compare that to the 6:00 min/mile runner who has to work a lot harder to shave off those extra seconds. So, overall I think this is good news.

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The Long-Term Effect of Activity Tracking and Health

Jan 24, ’13 10:13 AM

Yesterday I had a chance to read a story that discusses an important aspect of activity tracking; these devices might encourage us to exercise and walk more, but we don’t know yet what their long-term impact might be. The article claims that various institutions (hospitals, universities, healthcare organizations) are conducting trials to determine how digital data trackers affect activity levels, obesity and dietary intake in various populations. I am really looking forward to reading more about these studies.

As it’s quite obvious from my previous posts, I’ve been thinking quite a bit about the large number of activity tracking devices that have been released in the last few months. Literally, it seems like a week doesn’t go by without the release of a new wristband, or watch, or mobile app that claims to track our activities and help us get healthier. But the truth is, we have a lot to learn. This is one of those cases where products are being developed because we have the technology to build them, and people seem interested in buying them.

There are two ways of looking at this. One one hand, we don’t have a solid scientific foundation in place to support this trend quite yet, at least not in the traditional sense. At the same time, as many self-quantifiers would say, the rules of the game are changing, and n=1 is what counts.

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Custom vs. Commodity Hardware in Ubicomp

Dec 12, ’12 1:07 PM

Mark Abel, a colleague and principal investigator at the Intel Science and Technology Center for Pervasive Computing, sent out an email with a link to an article about add-ons and accessories for smartphones. The author of the article makes one point that I think is particularly relevant:

There’s no need to duplicate what a smartphone already does in a new CE device under development. In some cases, there’s no need to develop hardware at all. A smartphone already exists as a hardware platform, on which you can design — in software — whatever functions you want it to perform.

I have been thinking about this point in the context of ubiquitous computing research for some time. Many believe, rightly so, that we are in the middle of a hardware renaissance of sorts. Over the last decade, a number of factors have greatly reduced the time and cost that goes into designing and prototyping a custom hardware device. At the same time, we see certain devices, particularly smartphones, that are becoming universal hardware platforms. Why build a new item from scratch if you can simply build an add-on to the smartphone people already own and (hopefully) love?

The answer, of course, depends on the exact type of research that one is pursuing. Today, there is a large group of researchers actively developing and experimenting with custom hardware (e.g. the UIST community). At the same time, I do see an upward trend towards leveraging existing platforms. For example, highly respected researchers in the community such as Tanzeem Choudhury, Andrew Campbell, and Deborah Estrin, have recently centered their work much more around existing mobile platforms and apps than custom implementations and sensor networks. Computer vision researchers like Dieter Fox have been actively exploring the XBox Kinect depth camera in a variety of ways. It is worth noting that there is an obvious level of opportunism at play here – if the hardware is available and interesting, why not use it? – but I believe my point stands.

There is tremendous value in the “imagine and realize” mentality of custom hardware. Innovation is what one usually associates with this process, as in “build new things”. But there is another angle on custom devices that I find particularly promising – it has to do with access. When the overall cost of building hardware goes down, it is possible to build not only a better device over time, but also take an existing device that costs $100, such as the Fitbit activity tracker, and reinvent it for $10. Why? To turn it into an almost “disposable” device that you can make available to lots of people. This results in the ability to scale studies and experiments.

On the other hand, there is an enormous amount of low-hanging fruit around existing and upcoming platforms – we are just scratching the surface of what can be done, even with mobile phones. Hello wearables. It would be unwise to ignore the benefits that these platforms provide, not to mention the aspect of studying how people use and appropriate existing devices and infrastructure.

No matter how you look at it, whether you break new ground with new hardware implementations, or gather data from commodity hardware provided to hundreds of people, one thing is for sure: this is a great time to be a ubicomp researcher.

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Activity Tracking News Roundup

Nov 28, ’12 10:50 PM

The last few weeks have been quite eventful in my “offline” world, thus the lack of posts here. With the end of the semester coming to a close, and a little bit more breathing room, I felt that this was a good time to return to blogging after another small hiatus. And if the posts are back on, why not talk about activity trackers? I’m sure I’ve written about this new category of wearable devices before, but there has been a flurry of activity as of late, so it makes sense to go back and see what is new in the space.

There are three announcements that I find deserving of a mention here. The first one has to do with Weigh Watchers. The company’s calorie-counting program has been very successful at helping people lose weight over the years, and I know people who have been very grateful for it. But up until a couple of months ago, all that the Weight Watchers’ program could account for was food and calorie intake, in a fairly static sense. Obviously, that’s just part of the story. A person who has a very active lifestyle and wants to lose weight will likely need to eat more than someone who doesn’t exercise regularly and also wants to lose a few pounds. Now, thanks to a partnership with Philips, Weight Watchers will let members track their own activity with ActiveLink, “a small, simple accelerometer-equipped device”, and swap “activity points” for “food points”. The truth is, activity tracking devices fit a program like Weight Watchers’ like a glove. In retrospect, it’s surprising that a partnership like this is only materializing now.

The second piece of news is the release of yet another activity tracking device, the Misfit Shine. All the details about it can be found in its fund-raising page, so I won’t go into the details here. It’s very nice looking, seemingly sturdy, and apparently uploads data to a smartphone using a unique protocol sans Bluetooth, pairing or wires. Intriguing to say the least. I will need to explore this further. The bad news is that after losing a Fitbit or two, I’ve been hoping that a form factor will emerge for these devices that makes them a bit more difficult to disappear. The wristband is interesting and might work for me but I haven’t tried it yet. Lately, I’ve been thinking that what would work well for me is an activity tracker in the form factor of a credit card, that I can simply leave in my wallet. I would be unlikely to lose it, and if I did, I would probably have bigger problems to worry about.

Finally, to wrap-up this news round-up post, the Jawbone Up activity tracker wristband has been redesigned and is back after a disastrous product launch that forced to company to stop selling the device and go back to the drawing board. I don’t have any other info on how well the Up works now and what has changed exactly.

Perhaps the most interesting aspect of activity tracking devices to me is not that they exist, but how many companies are betting heavily in this category of health and wellness. On one hand, in my circle of friends, I do see a FitBit here and a Nike FuelBand there. I would expect that, since my colleagues are very tuned in to consumer health devices, like I am. On the other hand, I don’t see a lot of mainstream demand for these products, at least not yet. I am very curious to see how this unfolds. It will be certainly great to see this bet pay off, since it will mean more people becoming healthier and more aware of their activities.

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The Privacy of Smartphone Health Sensing

Oct 10, ’12 2:33 PM

It seems like every other day a new story in the media reports on the rise of the smartphone as the uber-sensor for medical applications. Yesterday I had the chance to read the New York Times story “Apps Alert the Doctor When Trouble Looms“, which highlights apps that monitor patterns in device usage (e.g. phone calls made, text messages received) and link pattern deviations to a variety of possible medical conditions.

The notion of extracting behavior features from smartphone usage is an idea I am fond of. I am following Ginger.io, the company that brought this idea to market, very closely. So, naturally, I read the story with interest. Surprisingly, the most remarkable aspect of the story was not the story itself, but the comments from readers.

As of now, 8 out of 10 comments note that the notion of using a smartphone as a diagnostic tool or to alert a doctor is preposterous. The majority of these negative comments were “upvoted” using the “Recommend” link that the New York Times publishing platform provides. Many comments touched on the privacy issue:

This is insane Big Brotherism

No way around it, such is a Violation of Privacy!

An interesting perspective came from someone battling chronic conditions:

As someone dealing with several chronic conditions I feel qualified to state that this is the worst idea I have ever read. The possibilities for the app to go wrong are endless.

A doctor also chimed in:

You want to know the first thing i thought about as a doctor? Picturing me getting sued by a patient or their family and the lawyer saying: this app shows that you received this information, yet there is no record that you acted on it. im literally supposed to act on it, pull the chart, and then note what the app said and what i did, and why i did it, and why i didnt do something else. tort reform before i use this app.

Two observations.

First of all, the variety of viewpoints on an important topic from many of the represented parties constitute, in my opinion, one of the best practical examples of Social Construction of Technology theory (SCOT) at play I have ever witnessed. In a few words, human action shapes technology and technology is interpreted differently by different social groups.

Secondly, as we move forward developing technologies that assess an individual’s health condition from everyday behavior, do we need to pay more attention to these loud voices asking us to stop? Or should we remember that just 10 years ago, the idea of sharing what we share today on social networks was equally ludicrous and ended up going mainstream anyway? As a technologist, I am not surprised to find myself leaning towards the latter. But I do believe it’s time for more effort to be put into thinking deeply about the privacy implications of this work.

What do you think?

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