Shelly Fritz believes that in-home sensors and informed artificial intelligence could be the ticket to increased at-home independence and overall longevity for at-risk populations such as the elderly, injured or permanently disabled.
Fritz, a Mossyrock native, is an assistant professor of nursing at the Washington State University College of Nursing in Vancouver. For the last two years, she has been angling for federal grant funding in order to spur on the research that she and a team of WSU scientists have been pursuing together since 2012. After much persistence, that team received the good news they’d been waiting for on July 31 when they were informed that their team had been awarded a $1.77 million grant by the National Institute of Nursing Research in order to conduct further study on the use of groundbreaking “smart-home” technology.
Work on the officially funded project began post-haste on Aug. 1.
“That’s the way government works,” laughed Fritz. “They tell you today and expect you to get started tomorrow.”
Fritz is flanked on the research team by Dr. Diane Cook, chair professor in the School of Electrical Engineering and Computer Science, as well as Maureen Schmitter-Edgecombe, a professor in the Department of Psychology. She says that the process to obtain federal funding was laborious but the quality and extensive experience of her partners ultimately paved the way forward.
“Yes, it was a lot of work, however, we received the grant in-part because of their reputation as researchers. They have been doing smart home research together for about 10 years. I am one of the newer members of the Center for Advanced Studies in Adaptive Systems smart-home team. I am the only nurse on the team. I bring a clinical perspective to the work,” explained Fritz in an email. “I have always been interested in tech in the hospital and have often claimed that nurses need to be at the table with engineers when tech for health care is designed. After all, nurses are the ones who are asked to directly employ the use of high-tech equipment on patients while caring for them.”
The new model of in-home health care envisioned by the team of WSU researchers includes the assistance of in-home sensors and artificially intelligent apparatus around the house. The first five “smart-homes” being used for testing purposes have been installed at the Touchmark on South Hill Retirement Community in Spokane. The “smart-homes” are each outfitted with 15 to 20 motion sensors that are able to track the movements of an individual around the home. Those sensors then create a data log of a person’s typical behaviors and routines.
Preliminary studies have shown that the sensors can account for more than 40 everyday activities with a labeling accuracy of more than 98 percent. That information is then used to evaluate the actual behaviors of an individual at any given time based on the anticipated model. If those behaviors veer drastically from the norm, that information can be instantly evaluated by off-site health care providers, or even managed by artificial intelligence features within the home, in order to stave off more serious circumstances.
Fritz says that the presence of the in-home sensors is less about active supervision than about creating a detailed and useful chart of analytical information for health care providers to evaluate. Fritz noted that the sensors merely pick up simple information such as movement and do not come with actual video or audio recording. That information is compiled over time and used to get a sense of the normal behaviors of an individual. When those activities, like going into the kitchen around dinner time, change or stop altogether, the information can be used to determine if there is a problem.
Fritz says that the information gleaned by the “smart-home” sensors would be used to “evaluate changes in health states.”
“Those changes occur when people don’t feel good,” explained Fritz, who believes that the use of real-time “Big Data” is the next big wave in health care that will be utilized to improve patient experiences and outcomes. She believes that real-time data provided by patients is an untapped mine of sorts, full of information that can be used to ward off major health incidents in the future while simultaneously extending personal independence.
She mentioned a diabetic with a severe drop in blood sugar, or an elderly person who typically sleeps in their bed but has spent the past two nights sleeping in the living room recliner, as potential problems that could be detected and handled through preventive care. She even noted that the sensors can track how many times a person goes to the bathroom at night. Fritz knows that may seem like invasion of privacy, but noted that it is the exact type of information that a nurse would chart if a person were forced to stay in a hospital.
“If we can identify these changes in health states just like a nurse would, what we’re really talking about is the things that a nurse would look for. We know you have a diagnosis now what are your symptoms and conditions on this particular day,” said Fritz, who believes that many early deaths are related to a lack of professional oversight post-diagnosis. “What the sensors are looking for are the changes that a nurse would see that would spur a homecare provider to call and say, ‘Look, I think we need a change in medication, or, this person could benefit from this procedure and attention. That kind of thing.”
After years working in hospital settings and being forced into reactive situations prone to spiraling out of control as an emergency room nurse, Fritz says she was inspired to investigate preventative in-home health care measures as a way of taking back control of health care treatment plans for at risk individuals.
“It has the possibility to empower the patient while simultaneously providing information to the provider that can improve care and reduce costs,” said Fritz. “We’re talking about proactive interventions and hopefully being able to prevent a bigger event.”
Fritz says the technology is not only applicable to the elderly but also those who may be in rehabilitation from injury or illness, or who are otherwise disabled or vulnerable. She said that the research team is currently training part of the “smart-home” system at a test bed on the WSU campus in Pullman to take actions on behalf of residents. Fritz used the example of a person with memory loss who may forget to turn off the stove at night. She says that sensors near the stove would be able to detect the increasing heat along with the prolonged absence of motion in the nearby vicinity and could then use that data to override and shut off the stove.
“That’s something that could potentially be deployed into a home,” said Fritz. “It really relies on the idea of extending independence for older adults or for anyone else who otherwise would have to be out of the home receiving extra assistance.”
Fritz admits that she is sensitive to the inevitable fears of patients who believe they will be sacrificing their privacy in exchange for the help of new fangled robot doctors. However, she says that most patients have been quick to recognize the promise of a tradeoff that could ultimately prolong their life and extend their ability to retain some semblance of normalcy while remaining in their own home.
“Older adults in my study have told me that they are willing to accept this technology, even though there is a perception that there is a loss of privacy ... But they tell me that they don’t want a robot dressing them, bathing them or feeding them,” said Fritz.
In an email Fritz further explained, “One older adult said that they would lose privacy if they moved into an assisted living so they would rather lose privacy and stay in their home. That was an aha(!) moment for me.”
In addition to her position at Washington State University, Fritz is also on the Board of Commissioners for Morton General Hospital, representing the Mossyrock area.
According to her biography on the hospital’s website, she was born at Morton General Hospital and was a local resident until graduating from college with a bachelor’s degree in 992. After living in California and Idaho, she returned to Mossyrock in 2006 with her husband and children and settled in on the same street she grew up on. Since returning, she completed a master’s degree and Ph. D. in nursing.