Monitor Me Horizon

Do you know how many steps you took today?

How many calories you burned? How many people you met?

Or how many hours you slept?

If you knew these things, it might make you healthier,

or even save your life.

And finding them out is no longer very difficult.

These days, there's almost nothing we can't measure about our lives,

and we can do it with stuff that almost all of us own.

Whether it's apps on our phones or the latest gadgets...

You wear it as a headband, so like this when you're asleep.

..the promise is that our health will be transformed.

We're almost at Day Zero of a whole new world of medicine.

There are now doctors giving out apps

the way they used to prescribe pills or surgery.

That feels very Star Trek to me.

Three volunteers are going to join me

to put this medical revolution to the test.

I've really got to up my game.

These three weeks have been quite a revelation for me.

That's absolutely gobsmacking.

I'm going to find out whether simply monitoring ourselves can change us.

Can this self-monitoring revolution be the key to longer,

healthier lives?

I'm Kevin Fong.

I'm getting ready for a day on the medical frontline.

I'm going to see how fundamental the ability to monitor ourselves is

to saving lives.

So I'm here in the crew room of London's Air Ambulance.

These guys are ready to fly off to the scene of an emergency

at a moment's notice,

and all they're waiting for is for that klaxon to go.

London's air ambulance exists to get medical staff

to the scene of an emergency as fast as possible.

With a senior trauma doctor on board,

they're trained to deal with almost any situation.

The team are expected to be airborne

within four minutes of the klaxon sounding.

There's no room for a film crew aboard,

so I'm going to be on my own with this.

On board are all the tools the team needs to save lives.

They've even performed heart surgery at the roadside.

But in many ways, the most important thing of all on this helicopter

is the monitoring equipment.

If you don't know what's going on inside your patient's body,

you've got no hope of fixing them.

We've been called out to treat someone

who's suffered a severe head injury.

I think I'll just put a few stitches in that first.

As soon as possible,

the patient is hooked up to the team's monitoring equipment.

This is our monitor pack,

and this carries all the vital bits of kits, essentially,

that we use to monitor heart rate,

blood pressure, their oxygen level and the gases that they breathe out.

Essentially, this is a surrogate

for everything in the emergency department.

We can have as much surgical kit as we want,

but it really is essentially useless

if we can't tell what's happening with the patient.

So the team are dealing with quite a serious head injury there.

In addition to delivering a doctor and a paramedic very rapidly,

they're also able to bring with them some quite advanced monitoring,

the sort of thing you could get in an intensive care unit, really,

small enough and portable enough

that they're able to describe that injury in great detail

before they ever get anywhere near the hospital.

Quite simply,

this small box can make the difference between life and death.

The patient's been stabilised.

The team will go with him by ambulance to the nearest hospital.

The crisis is over, and the outlook is positive.

You know, this is much more than just a helicopter,

it's essentially a mobile accident and emergency unit.

And it's possible

only because you can take that incredible suite of monitoring

that you would normally find in a hospital,

shrink it down and stick it in the back of a vehicle like that.

But what if everybody could monitor themselves to the same degree?

What if we all had that capability?

How would that improve our health?

I'm going to start

by checking out some of the latest medical technology.

But I'm not talking about MRI scanners or surgical robots.

I'm not heading to a hospital, or a doctor's surgery.

I've come to a sports shop.

For a few years, people who are far more committed to exercise than me

have been using gadgets like these to help them keep fit.

You know, these are fundamentally impressive devices.

Take, for example, the GPS trackers,

which grab information from satellites

and define your position with unparalleled accuracy.

And then there's the heart rate monitors

which can measure the faint spread of electricity across your heart,

through the full thickness of your chest.

In a few years,

the number of us with wireless health and fitness devices

is expected to rise to almost 200 million.

When these products started to become available a few years ago,

it didn't occur to me that they would become so advanced

or deliver such a rich stream of information.

And I didn't anticipate

that self-monitoring would find its way into medicine.

But it's beginning to. And that could make a huge difference,

so much so that I've started to think

that we might be on the brink of a revolution in healthcare.

This is a revolution that takes monitoring

out of doctors' hands, out of hospitals, and it gives it to us.

And by doing that, it places us at the heart of our own healthcare,

and makes doctors of all of us.

There are few people that know this new world of medicine

better than Blaine Price.

He's pretty obsessed when it comes to the latest gadgets.

You're pretty into self-monitoring.

Yes, I get every app going.

I buy all the devices I can and try them out.

And it's great, because I get to play with all the toys

and learn lots of things about myself at the same time.

'Blaine's gathered together some of his favourite toys

'for me to have a look at.'

What have you got for me here?

First of all, we've got these, kind of a glorified pedometer

to keep track of how many steps you take, but it's a lot more than that.

They'll monitor exactly when you took your steps,

how active they were and intense they were, what time of day it was.

Sleep is one that people are often interested in.

So, er, this one, you wear it as a headband,

so like this when you're asleep,

and it measures a bit about your brain activity.

It can tell you what phase of sleep you're in,

deep sleep, light sleep, REM and so on.

And if heart information is interesting to you,

we've got a pulse oximeter here.

Oh, yeah, the sort of stuff I use in the hospital anyway.

Sure. And before, you only could get it in a hospital.

This is now very inexpensive

and what it's doing is measuring cardiac rhythm and blood sats.

Looks like I'm fairly healthy at 98 or so.

From the comfort of our own homes,

we can now measure many of our vital signs.

We can also measure a few things you might never have thought of.

There are consumer devices to check your posture...

your blood alcohol levels...

-Do a quick jump.

-How high you jump...

And even how quickly you're eating.

And much of this, we can do without even buying any new gadgets.

There are now tens of thousands of apps

available on our phones to track anything and everything about us.

In fact, there are hundreds of apps coming out probably every week

which are health-related, able to measure things, log things.

Some of the latest apps use things designed for one obvious purpose,

like a phone's camera, to do something utterly unexpected.

We even have apps that can measure your heart rate

-just by looking at you.

-That's amazing.

Give it a try. You have to keep fairly still.

OK, so I'm going to have to shut up and stay still.

And it will measure your heart rate by looking at the colour changes

in your face, and it might even get your breathing rate in there.

So there's the heart rate there coming in, about 79 or 80.

And breathing rate about 17. That's really quite incredible

because it must be, the heart rate stuff there

must be on just seeing the small differences

in the change and colour of my face?

So as the capillaries sort of swell up and fall away with every beat?

Yes, it's the resolution of the camera that does it.

The technology here has such a high resolution in smartphones

and tablets that we're looking at the same range

you would have had in medical scientific instruments 20 years ago.

I find that...just gobsmacking, really.

Blaine has set up an experiment to help me find out

whether this technology can really make us healthier.

He's roped me into taking part as well.

-I'm Kevin, hi.

-I'm Celia.

-Celia, hi.

'Celia, Cathy, and Pam work together.'

So I understand that you've volunteered to be guinea pigs

-for this particular experiment.

-Yes, we are the guinea pigs.

What have we let ourselves in for?

'They're hoping that by monitoring themselves,

'they can overcome an endless struggle and lose some weight.'

We're permanently on diets, aren't we?

We're all very conscious about we eat too much

and we drink too much, but we love it.

We all discuss what we ate last night.

"Oh, no, I had a glass of wine." "Well, Celia had three."

We've got a set of scales in the office,

and so every week, we weigh in

and we keep a chart of what our weight loss is,

and sometimes weight gain.

Until now, this, standing on a set of scales,

has been the only form of self-monitoring that most people do.

I've got to get all my jewellery off.

Moment of truth. We do this every week, don't we?

-Does it make any difference? No.

-I thought you'd been so good!

-Don't forget your watch.

-I'll take my watch off.

Get off, quick!

OK, Cathy.

-It's stayed the same.

-Oh, the same as last time.

Same as the week before.

It's the same story for so many of us.

There's too much going on in our lives

that stops us getting fit and staying healthy.

I find it really difficult to wake up in the morning

and think about doing some exercise.

There's quite a lot of ready meals going on,

which doesn't help the diet.

Any excuse.

If I had all the time in the world, I would exercise a lot more.

But, you know, there's just work, looking after the house,

picking the children up from school,

the usual domestic chores that every mum has.

So how exactly is Blaine hoping

that monitoring ourselves can make a difference to our health?

There's actually only two simple things you have to do.

One is, you've got to carry around with you a little device here.

You can stick it in your pocket.

It'll record how many steps you've taken.

The other bit of this study is,

you need to have a smartphone to measure your sleep at night.

It's going to measure, hopefully, how deeply you're sleeping,

how well you're sleeping.

It'll measure the time you go to bed and wake up.

So what you'll do is get an email every day from me

with a summary of your performance during the past day,

how it compares with the past week,

and also how you compare with the rest of the group.

The hope is

that by simply measuring the number of steps we take every day,

we can set ourselves targets and get motivated to do more.

And by keeping tabs on our sleep,

we can find out what helps us sleep better.

I'm hoping that it's going to give me a better understanding

of what you actually do have to do to kick-start a healthier life,

to burn more calories, to perhaps have a better night's sleep.

I don't have a particularly healthy lifestyle

because I don't do exercise.

I'm not aware of my health, shall we say.

I don't know what my blood pressure is.

My sleep pattern these days, as I've got older, is not good.

I'm hoping it's going to give me the enthusiasm to do some exercise

because quite honestly, I find exercise boring!

Every day for the next three weeks, each of us is going

to be bombarded with numbers - how much we've slept,

how deeply we slept, how many steps we've taken, when we took them.

The question is whether simply seeing those numbers

will be enough to make us change.

But there are people who already use self-monitoring

to alter their health and fitness in a fundamental way.

This is Twickenham, the home of rugby,

and I'm here to join the England Rugby 7s team while they train.

So if you go along it gives you

pretty much everything you could want.

'Brett Davison is the team's Head of Physical Performance.'

..zones which we would have to specify.

'His players are amongst the most

'closely monitored people in the world.'

So they've got on a little GPS unit that sits in a little

neoprene pocket on their jersey between their shoulder blades.

There we go.

And then they've got a heart-rate strap on,

those two coordinate between each other

and then the information comes straight back to us.

'Now, I'm a doctor.

'I'm used to examining people,

'and looking for the subtle signs of illness and injury.

'And as far as I'm concerned this international rugby team

'looks more than match ready.

'But Brett sees a lot more than I can without even

'glancing at the players.

'He does it simply by looking at a screen full of numbers.'

Run me through what you've got here.

OK, there's obviously speed -

your current, your average and you maximum.

Heart rate, exactly the same.

Distance, so that's for the whole training session.

Dynamic stress load, number of accelerations, decelerations.

High speed running is the number of metres they've run,

maximum speed.

'All those numbers help Brett

'detect problems well before any doctor could.'

You can see the injuries in terms of their speed

or their lack of, usually.

Um, and certainly their running intensity will be off

what we know it could be for that particular individual.

This is Geoff's trace and at the moment

he's at 18-odd kilometres per hour,

which is not very fast for these guys.

So you can certainly start to see where somebody's struggling.

'And the information Brett gathers turns out to be an incredibly

'sensitive indicator of injury.'

It picks up their step balance, their left-right step balance,

uh, through the, accelerometer.

So, we can tell how badly somebody's limping,

or how much they might be favouring a leg.

And this lad got hit on the knee.

And the difference between his left and his right is about

one and a half per cent.

So, although it's a really subtle change, one and a half per cent

off his top speed, because he's limping a little bit,

could be the difference between a try or no try.

'Since he started monitoring his players this intensely,

'Brett has found that their soft-tissue injuries have fallen

'by a stunning 80%.

'He's stopping injuries before they arise.

'To Brett, it's become something of a crystal ball,

'allowing him to see into the players' futures.'

If they've had a bad night's sleep, their heart rate will show it.

If they're getting ill and they don't know they're getting ill yet,

usually their heart rate will show it for us as well.

So from that point of view,

sometimes we know things about them that they don't know yet.

So you can tell that someone's ill

before they themselves are conscious of the fact that they're ill?

It hasn't failed us yet, where we've seen data

and we haven't reacted to it, and literally the player has

woken up the next day and said, "I'm crook, I can't train."

And we've been a bit upset that we haven't acted on it.

But we generally pick up illness

24 hours before they might start to feel ill.

You must have found that remarkable when you first realised.

Yeah. For a while we literally were looking at it, going, "That can't be right. That can't be right."

And we looked at it for a long time, and then started acting on it.

And then, the results started proving it, you know.

Your body's not going to lie. You might, but your body's not.

'Imagine if we could all see what lay ahead.

'Imagine if we all knew what was coming before it arrived.'

It's remarkable, to see illness and injury

before the players themselves were conscience of it.

Because that in medicine is essentially what we strive for.

To be able to see the storm before it's arrived,

in the hope that we might navigate safely through it.

Or perhaps even avoid it altogether.

Here we go, then. See if this works.

Our volunteers are a few days into

seeing what self-monitoring might do for them.

We'd better give this gadget a go, then.

When it comes to counting steps,

the recommended daily goal in order to keep fit and healthy is 10,000.

All the way up, all the way down!

But as the numbers start coming in there's a bit of a surprise.

I've been looking, just to see how many steps I'm doing,

and I'm really shocked, cos I really don't even break 5,000 sometimes,

and I'm supposed to be doing at least 10,000.

It's really hard.

So today I've been to boot camp and I've really got to up my game.

The step logging's come as a bit of a surprise really.

I thought I was quite active and thought I moved round a lot,

but it's quite a bit lower than I expected it to be,

and I'm going to have to rely on dancing to boost that count.

It's been difficult to find enough time to fit in the extra exercise.

Jess, this way.

'Mainly through walking,

'but anyway we'll see how we get on.'

And, despite the fact that I've come to sunny California,

I'm not finding it any easier.

This is harder than I remember it being. I haven't done it in a while.

I've never really felt the need to pull on a pair of trainers

and jog up and down a beach.

But it's different when you're confronted with

cold, hard numbers telling you exactly how lazy you're being.

So I've had this now for about a week,

and I didn't really think it was going to change the way

I looked at what I did and didn't do, but it really has.

It does make you more competitive, even if that's only with yourself.

I know that I've done 3,000 steps today,

I know that this beach is worth another 500, and I know that

the difference between exercise and no exercise is a pile of numbers

that will appear on my computer tonight

and tell me how hard I've worked.

So I guess it's probably time I got a bit more

serious about all of this.

Because the fact is, at the moment, I'm not working nearly hard enough.

'I'm not here just to run in the sunshine.

'I've got an appointment to see the doctor.'

-Hello.

-Good morning.

-I'm here to see Dr Topol.

-Go ahead and have a seat, he'll be with you shortly.

-Thank you very much.

-You're welcome.

'Californians are famously obsessed with looking and feeling great.

'So it's a natural home for some of the pioneers of the self-monitoring movement.'

I've seen a lot of waiting rooms,

and this one is pretty typical, pretty average, but the doctor

I'm about to see, his approach to medicine is anything but.

-Kevin Fong, Dr Topol will see you now.

-Thank you.

'Normally, you expect a visit to the doctor to end with

'a prescription for pills.

'But the doctor I'm going to see is much more interested

'in fixing his patients by getting them to monitor themselves.

'Dr Topol is a cardiologist.'

-So let me go ahead and start off, we'll do a cardiogram, OK?

-OK.

I've got my phone here.

'I've never seen any doctor check for the signs of a heart attack

'with little more than their phone.'

Put your fingers on that, and then just make a circuit with your heart.

So we'll look at this together, OK, and that's your cardiogram.

I find it incredible that you can do that degree of monitoring.

Normally when I'm doing that in a hospital I wheel this sort of

R2D2-looking thing into the side of the bed and it takes about

10 minutes to hook up to someone.

That feels very Star Trek to me. I mean, I...

You're easily impressed, this is nothing.

'Whatever's wrong with you, Dr Topol will try and find

'a gadget to help, so that you can look after yourself at home.

'He even uses some of them himself.'

Here's a sensor.

'He's wearing a sensor like this, with a hair-thin micro-needle that

'implants under the skin, giving constant blood-glucose readings.'

I have this on and I can monitor my glucose every minute.

So right now my glucose is 91, OK, and I can see what it's been doing

in the last several hours, and every minute it will update.

For the huge number of people who suffer with diabetes, this is...

revelatory, because until now they've had to prick their fingers.

Oh, no, the finger stick could be history.

When you have this on...

The average person looks at their phone 150 times a day.

So now you got your phone, and you're looking at it, you say,

"Am I going to eat that cookie, am I going to eat that piece of cake?

"Cos if I eat that my glucose is going to shoot up to 160, 180."

And you start to realise exactly how your body is responding to food,

to portions, to exercise.

It really changes your lifestyle, it did me at least.

So you're prescribing...apps?

You name the condition, er, heart rhythm problem,

we get the condition, the apps to match up with your phone,

and that's how you monitor yourself.

Medicine is truly unplugged now,

and it's going to change everything we do in healthcare.

Because now all the information is going directly to the patient,

not to the doctor.

And it's more information than we ever had before.

'After visiting the doctor in the future,

'rather than leaving with pills, we'll leave with something

'far more important - information that's impossible to hide from.'

The whole opportunity to know everything about the medical essence

of each person is pretty remarkable.

To me at least, a student of medicine for three decades,

this is the biggest shake-up in the history of medicine by far.

'With all this information, Eric hopes we'll be able to spot

'even the most serious problems before it's too late.'

To be able to prevent a heart attack with this type of, er,

information, that to me is the most exciting thing.

And I do believe that they will be, if not fully preventable,

awfully darn close.

We could stamp out something like asthma attacks.

You can pick up, er, pollen count, air quality

and how the chest is moving long before the person feels

a wheeze or is having difficulty breathing.

What do you think is going to turn up in the next ten years or so

that people will think,

"I never would've imagined that medicine would look like this"?

For the person who really has a significant illness or risk of one,

putting in a tiniest implant, smaller than a grain of sand, that

essentially carries no risk, will be commonplace. Er, little microchips.

We have 'em in our pets to keep track of where they are.

Why don't we have 'em in our people to prevent illness?

You know, it's startling to hear the way that Eric talks,

to see the things that he's doing.

He pretty much prescribes apps

the way my colleagues would prescribe drugs.

And that right there is an example of how

we're leaving behind what he would call the old medicine,

how we're finally dragging the field of medicine into the digital age.

And if it works the way that he says it will,

then it has the potential to change everything,

it has the potential to be truly, truly transformative.

These days, we can monitor one of the most fundamental

but usually unseen aspects of our lives - something that affects

our physical and mental wellbeing, and even how long we might live.

Our pattern of sleep.

First night in the United States

and I'm going to give Blaine's sleep app a go.

Apparently all I have to do is press that button,

stick it on the end of my bed

and it's going to tell me how I slept, so let's give it a go.

Every twist or turn is monitored

by a finely calibrated sensor in the phone

which measures tiny ripples in the mattress as I move.

It should allow me to see if anything affects my sleep.

Across the Atlantic,

Celia is carrying out her own sleep experiment.

Tonight I have had too much to drink, um, more than

I've had to drink for quite a while...

..and, yes, I am feeling...worse for wear.

So I'm going to record my sleep tonight to see what happens.

Every night, each of us will produce a graph detailing our sleep.

RADIO: John Tamm in the morning on San Diego's number one

for new country, KSON.

It's another sunny day here in San Diego.

HE TURNS RADIO OFF

Well, let's see what the phone's going to tell me about last night.

So there's the graph of my sleep, light sleep right up

there at the top, it says deep sleep at the bottom.

These mountainous looking peaks here are where I was wriggling around.

And overall it says that I slept for 8 hours,

and about 64% of that was deep sleep.

Who ever thought that phones were going to tell us

about how well we were sleeping?

After three weeks of monitoring our sleep, we should all be able to find

out what affects it - and change our lifestyles to help us get a better night's sleep.

But self-monitoring might do much more than just change our habits and behaviour.

We've all worried at some point about what nasty surprises

might be lurking inside our bodies, what might be going wrong,

without us even knowing.

By monitoring ourselves, we can find out,

and potentially do something about it.

This is the house of probably the most monitored man in the world.

He monitors himself - he monitors everything about himself.

And I really do mean everything.

But by monitoring himself so much,

he discovered a potentially fatal condition.

DOORBELL RINGS

-Larry, I'm Kevin Fong, nice to meet you.

-Good to meet you. Come on in.

Larry Smarr is one of the most influential computer scientists in the United States.

He was instrumental in developing networked computers -

the predecessors of the internet.

Today, he's putting all his talent into monitoring himself.

Larry just give me a shopping list of what you monitor about yourself?

Well, I monitor my weight.

I monitor my steps and caloric burn with my Fitbit.

I monitor my sleep every night.

Urine, saliva, blood, I monitor stool, actually...

You even go so far as to monitor your own stools?

Yes. I mean that's by far the most important part of what I've done.

There is such a thing as too much information, surely?

No. There is never too much information.

It is a challenge to...

to turn that information into understanding,

and that's what science is about.

-Am I missing out?

-You are.

We produce stool every day, everybody on Earth does,

and it has this incredible information about the state

of your health and we just flush it away.

It's relatively challenging things to do, to monitor,

you know, that element of your life - I mean how do you do that?

Let me just show you.

The point is you have to freeze it.

And I do it every two weeks so I'm going a very fine timescale.

And so it's just sitting here in the freezer.

So each of these is labelled.

That one's February 23rd,

this one is, this one here is January 26th.

This is just in the freezer in your kitchen,

it's not even a separate freezer?

Well, it's getting to the point now that I've got enough of them

that I'll take them to the medical school.

You just Fedex them, and it's overnight delivery,

and then 2 weeks later I get back all this data.

I sort of had it in my mind that you'd have

some special freezer in your garage or something.

Well, my wife probably thinks I should but she's very understanding.

At his laboratory, Larry has put all his information together.

So I was wondering how on earth you were represent

all of the data that you collect about yourself.

'Over the years, he's gathered billions of different measurements about his body.'

From his enzymes to his proteins, his minerals

to his microbes, nothing goes undetected.

And this display shows just a tiny fraction of them.

-These are 150 different variables over either 5 or 10 years.

-On you?

Just on me. Here's my cholesterol variables, my magnesium.

Phosphorous, sodium, thallium, stuff I've never heard of.

You're measuring stuff that I've I don't even know how to pronounce.

Yup, all of the things that your doctor tells you to measure

and a lot of others.

'With this information, Larry has a warning system in place,'

'in case anything goes wrong inside his body.'

The colour coding is that if they're in the green they're healthy,

but if they're in the orange,

that means you're 1-10 times above the upper limit for healthy.

I look at this and I say, "Look at all that green I must be pretty healthy."

But a few years ago, he noticed something was wrong.

I said, "What's this thing up here that is red"

"that is spiking up to 30 times the upper limit? And this one down here

that's purple, that's 125 times the healthy limit."

Some of the measures of information in Larry's bloodstream

had shot to worryingly high levels.

Lactoferrin is supposed to be less than 7,

and this is 899, 125 times the upper limit.

So far off scale that you don't have to be a doctor to know that

something's going wrong.

Terribly wrong.

So you look up Google

and within an hour you can find 5 or 6 peer reviewed papers that say

if you have a value of this variable at these numbers,

say 750 to 1,000, you have a chronic incurable disease.

He'd discovered that he had Crohn's disease - a serious disorder of the intestine.

You must've been terrified by this surely?

I'm a scientist,

so the way you fight that feeling is get more knowledge.

With the knowledge he'd gathered, Larry was able to

diagnose his disease at the earliest possible opportunity.

He believes that soon,

we'll all be able to monitor ourselves like he does.

In a world in which you can see what you're doing to yourself

as you go along, the hope is that people will take more personal

responsibility for themselves, in keeping themselves healthy.

So it's like we're almost at Day Zero of a whole new

world of medicine.

And what will come out the other end,

is a far healthier society that's focused on wellness,

rather than trying to fix sickness when it's way too late.

Larry's providing a new self-awareness that would

lead to a new kind of preventative medicine, one that doesn't depend

on vaccination, or programmes of public health, but instead on data.

And in that, I think he really might be onto something.

We're one week into Blaine's experiment.

When we started, I think we were all a bit surprised at how hard

it was to reach the recommended daily level of 10,000 steps.

So how's everyone doing now?

Who's that there? That red bar is Celia.

Upping her game.

Getting over 15,000 steps on a couple of days

which is pretty impressive.

It does kind of give it all that competitive edge.

'Our little experiment seems to have got rather serious.'

-PHONE RINGS

-Well, it's ringing.

-Hello!

-ALL: Hello!

How's it all going?

Well, we're a bit concerned about how well you did.

Last Monday, you seemed to put on a good spurt.

I did do a bit of running that day, I have to say.

But I see, Celia, you did a couple of days over 15,000 steps.

I have, yes, and I'm definitely making sure that

I walk places that I wouldn't normally do

and it's been going really well.

Celia is winning. She's beating all of us.

Yeah, what are you going to do about that, Cathy?

I've been going to boot camp,

but my step count is a bit disappointing, I'm afraid.

So I'm having to do a run after boot camp,

but, having said that,

my steps are still nowhere near as much as yours and Celia,

I'm very upset.

-How's it been going with you, Pam?

-I've been doing a lot more walking,

and, er...

going the long way round to make the tea and the coffee.

I'm a little bit concerned, because I didn't think

we'd be taking this quite as seriously as we are.

'Maybe this monitoring really is changing our behaviour.

'We'll find out in a couple of weeks

'just how much difference it can make.'

-See you later, lovely to see you.

-ALL: See you! Bye!

I'm out running...again.

It's hard not to when every single day

you know exactly how many steps you're clocking up.

But, really, what I'm doing here is one of the more obvious ways

of monitoring your health.

When we think about the way that we monitor health,

we talk about heart rates and blood pressures, or the amount

of exercise we're doing, or the calories that we've burnt.

But it turns out you can gain a surprisingly profound

insight into the state of your health by tracking apparently

trivial bits of information about your life -

stuff that until now, we've completely ignored.

So I'm here to find out how that's done.

'I've come to the Massachusetts Institute of Technology.

'I'm here to see how experts can monitor our everyday behaviour and

'peer into corners of our lives that I never would've thought possible.'

-So, please have a seat here.

-Thank you.

'Professor Sandy Pentland believes he can tell not just

'what's going on in our bodies, but in our minds too.'

'And he can do it with something that most of us already own -

'a smartphone.'

Phones know a lot about your social life, who you call, who you

communicate with, a lot about your daily activities, where you go.

And so if you put the two together, you can do things like assess

mental health, and you can actually get a picture of how you're

doing constantly, 24/7.

Sandy was asked to develop an app to help spot signs of depression

and post-traumatic stress in soldiers returning from war.

I am curious because I've had your app on my phone for a few

days now and I'm not entirely sure what it's doing,

so I'm hoping you can explain.

OK, well, it kept track of things like your socialisation,

your focus and your activity levels

and these are key things for assessing mental health.

Tell me what you've found out about me.

Well, let's look at it here

and see what you've been doing and then what it's been doing.

So, first of all, we can see your activity level - are you

curled in a ball some place and you never get out of your bed, or

are you out and around, or are you sort of manic and you're everywhere?

So you see a five over on the left-hand side,

that's how active you've been, and on the right is

the average, so you're just exactly average when it comes to activity.

A drop in physical activity often goes hand in hand with depression.

But Sandy can track much more.

By monitoring my phone use,

he can also tell how I'm interacting socially.

Do you call your friends?

Do you call workmates, things like that?

Phones can also sense when there's other people around

because they have these little short range radios called Bluetooth.

And so my phone can see your phone, and they can shake hands.

And if we go over here, to Social,

you'll see that you're quite a bit more social than other people.

So you're good to go here, this is good.

And then if we go down here, this is Focus and you can see that

you're a little bit more focused than the average person.

But how does it know about my focus? What do you mean by that?

We all know what happens when you're not focused.

One of the things that people do is that they fuss with their phone,

they look at their messages, they read news, they...you know,

so you can get a sense of whether you're focused

or whether you're distracted all the time.

Though it seems astonishing that the way you use your phone

could give an insight into your state of mind, trials of Sandy's app

have demonstrated its success when compared with a doctor.

Sandy's convinced that mobile phones might have a huge role

to play in keeping us healthy.

In fact, he believes they might even be able to prevent

the spread of diseases that affect millions.

It turns out that when people get the flu they behave differently.

They begin to retract a little bit, they don't feel so good,

they call different people, they tend to call their friends

more than their workmates, things like that.

And it's actually a signature that you can detect

with about 80% accuracy.

So I could see when you look like you're getting the flu

and I can see that somebody else is not getting the flu...

..and then I can see that the two of you spent some time together...

..and they began to get

flu behaviour, which tells me that you infected them at that meeting.

And, of course, normal flu is not that bad

but every once in a while we get these pandemics that kill

literally hundreds of millions of people

and we're defenceless against it.

This is a startling thing - the idea that you might track the

spread of a pandemic by something other than taking blood tests from

people or saliva samples, or them going and seeing their physician.

It's a rather amazing thing that you could actually watch

the progress of the disease...

..because then you could actually do something about it.

You could say, "OK, people in this neighbourhood

"don't go to work today."

Or, "Don't go to this cafeteria."

Or whatever sort of intervention you want.

But you could actually begin stopping it.

But to bring about this game-changing shift in health care,

we'll need to give up our most personal information

to people who can mine it and spot the patterns within.

And, understandably, not everyone will be comfortable with that.

The world is now full of people with their mobile phones

and their mobile devices streaming terabytes of information

about their habits and their daily lives. And I completely

understand the unease that people feel about giving

that information up to others.

But, in medicine, that's all we've ever done.

We've gone to doctors, strangers, and we've told them

those intimate details in the hope that they might bring us help.

And in a sense, that's what Sandy Pentland and people like him

are trying to do, just taking that model and dragging it into

the 21st century in the hope that will change the face of medicine.

Over the last couple of weeks, I've become increasingly

obsessed about monitoring myself.

But I'm starting to realise that there's much more to this

than just doing more exercise.

By monitoring ourselves and pooling that information,

we could unearth knowledge

that would revolutionise the way we practise medicine.

We could share our data and begin to look for patterns that unlock

the secrets of human health.

I've come to a small town in Florida

to meet someone who's looking for those patterns,

and who's moving forwards at a pace that seems barely believable.

So far, we've had a hint of the shape of things to come

for the future of medicine.

But the girl I'm about to talk to IS the future of medicine,

and, incredibly, she doesn't have a medical degree.

In fact, she doesn't have a degree at all

and that's because she's still at school.

I mean, I think it's exciting that as a teenager I've been

able to find something

I'm so passionate about that I want to spend my weekends working.

'What sets Brittany Wenger apart are her computer-coding skills.'

There is a community of us out there who are really interested

in science and through the different kind of science competitions...

'She recently won the prestigious Google Science Fair

'for a computer program she's written.'

I think I'd always had a pretty keen interest in computers but then

in seventh grade I was taking this course on futuristic thinking.

In seventh grade... How old were you in seventh grade?

-So that would be about 11 or 12.

-Right.

And I came across a concept that computers could actually be

programmed to transcend human knowledge and to detect

really complicated patterns that humans have no idea how to detect.

So I was enthralled and I went home, I started buying coding books

and I decided to teach myself how to code.

'What happened next was a family tragedy that inspired

'Brittany to do something remarkable.'

I was 15, my cousin was actually diagnosed with breast cancer

and I saw first-hand the kind of impact this disease

has on a woman and her family.

So I got really inspired to get involved and make a difference

and I started researching breast cancer.

And so that's when I really wanted to connect my two passions

and try to create a better breast cancer diagnostic system.

'And she's written this program in her spare time.'

'Looking at a biopsy of human tissue to determine

'whether it's cancerous or not is a notoriously difficult thing to do.'

'Brittany's program is designed to help doctors

'to analyse what they're seeing.'

So, for example, see these nucleoli, they're the small dots.

The small dots, right.

They're really prominent and there are multiple ones per cell.

And that could mean that the mass is cancerous.

But that is actually benign.

And this is just an example of why they are

so difficult to diagnose, because even this benign mass is

exhibiting some cancerous attributes.

I have horrible nightmares of spending hours staring at these

slides at medical school, trying to decide whether it was cancer or not.

And it just seemed nearly impossible to me.

I mean, this is a tough task.

'It's an incredibly difficult task,

'for which Brittany has found a solution.'

So what I did is I created an artificial neural network

which is this really cool type of program that can

model a brain's neurons and their interconnections, so it can actually

learn how to detect patterns that humans have no idea how to detect.

And in the end it learns how to detect

whether these masses are cancerous or not.

So your computer knows how to do this?

Yes. It actually diagnoses over 99% of cancer patients correctly,

which is huge.

Yes, so 99% of the time it will pick it up?

Yes, which... It's exciting when you think about it.

Er, it's more than exciting.

'Brittany's program effectively turns a doctor's hunch about

'whether a biopsy is cancerous into something far more scientific.'

So what this does is provides a set of nine pretty objective

questions about what they're seeing on the screen in front of them,

and then feeds that quite complicated set of information

to your program which then instantly decides cancer or not cancer?

Yeah, exactly.

It's able to detect patterns in this scoring system that are too

subtle for humans to detect.

So doctors enter these different values,

and then they would click send, and in under a second,

the service is able to respond

as to whether it thinks it's cancerous or not,

and so this particular mass would be cancerous.

Wow! That's gobsmacking. I mean, absolutely gobsmacking!

I feel like I've had a glimpse of the future -

a sense of the great prizes we might

find in the huge volumes of data

that monitoring our bodies can give us.

I've come back to the UK...

..and to the information that could change our lives today.

'Three weeks ago, I began an experiment in self-monitoring.'

-Hello!

-Hi, Kevin.

-Hi!

'Celia, Cathy, Pam, and I wanted to see if anyone could get healthier,

'lose weight, or find out how to sleep better.

'Now it's time to see if anything has changed.'

And what have you found out about us then?

Well, quite a few interesting things.

I know when everyone goes to bed, when everyone wakes up,

where they go every day, erm...

how much sleep they get, how much deep sleep -

pretty much everything.

And, in fact, Kevin, you had the lowest average sleep of everyone.

I think it must be medical training that did that.

So, my average sleep was what sort of hours?

About 6.7 hours a night.

It's well below what people generally believe is normal.

And, Cathy, you were the most consistent of all because,

as you can see, you were just under eight hours.

You're about 7.8 every night.

And Pam had the highest average. You have over eight hours a night,

and that is fairly consistent.

I think I'm sleeping better than I used to.

My sleep pattern was really, really bad.

And I do think I have slept better with the extra exercise.

The peaks on Pam's sleep graphs tell us

when she was awake or sleeping lightly.

The troughs show when she was sleeping deeply.

With graphs from every night,

there's the potential to find out how to sleep better.

It was saying that I was having about an hour of deep sleep

and I found that slightly concerning because I'm wondering

whether I need more deep sleep than just that short amount.

You may only need an hour of deep sleep to feel good.

You've got to know what's normal for you, and what affects your sleep.

So did you find anything affected your sleep?

Well, there was two nights this week when I had one glass of red wine.

Now, I try not to drink during the week, but up until that point,

I'd been having round about the hour of deep sleep in a night.

On those two nights, my deep sleep went down to 36 minutes

on one night, and 34 minutes on another.

Perhaps red wine and me don't mix for my deep sleep.

I realised that even if I have a decaf coffee,

which I used to have about 9ish, I have a bad sleep,

so I've knocked that on the head completely now.

That's one of the incredible benefits of self-monitoring -

it allows us to learn things about ourselves

and change our behaviour for the better.

So did it make a difference to our fitness or even our weight?

So we've got the daily step count total.

Everyone started coalescing, actually,

around a 10,000 step average per day,

which is what the general guideline is to keep active,

especially for people in sedentary jobs like us.

This three weeks has been quite a revelation for me.

Cos I went out consciously most days to do extra steps.

You sort of get in this you can't stop

until you've reached that magic 10,000.

In a way it's a bit crazy.

And, Celia, did you ever get to the point of madness with any of this stuff?

I had got to the point where I would set myself a goal for the day

and, if I hadn't met it, then I did end up running on the spot

as I was watching television, or just trying to get those steps up.

Do you think you've seen improvements in your health

other than just doing a whole bunch of steps?

We've all lost weight doing the challenge so that's a good thing.

I lost about four pounds.

I lost four and a half, so...

I lost two and a half so the extra exercise does pay off.

I did very little before.

I'd sit at my desk all day in front of a computer,

I didn't walk the dog that often.

Now I go home from work and I'm out there walking the dog.

Same as Pam. We're going out for walks, I'm going out for walks in the evening.

So I am... I have changed and I will continue.

It's interesting that Cathy, Celia

and Pam all in their own way managed to change their behaviour.

They all increased the amount of activity they did.

And that's more than a bit of fun, that's important

because, in medicine, if you could prescribe one thing

that would improve everybody's health,

then that thing would be exercise.

Exercise improves your physiology in ways that doctors

and pills alone never could.

And so that's what even those simple devices have managed to achieve -

they've managed to help people change their behaviour in ways

that were otherwise impossible before.

Today we all have the capacity to monitor our health.

The devices we carry already do it without us even noticing.

And in the data that we gather lies great opportunity.

But ultimately, it's what we choose to do with that information

that will make all the difference.

We stand early in the 21st century,

looking for the things that will transform medicine in the same way

that antibiotics and vaccinations did at the start of the 20th.

But I've become convinced over the last few weeks,

through everything I've seen,

that this digital revolution really might achieve that.

By giving us access to information that we never before had,

by helping us understand our bodies

and the consequences of the things we do in our lives,

I really do think that this might be the key to longer, healthier lives.

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