By Tracy Miller Geary
According to data from World Population Prospects, by the year 2050, one in six people in the world will be over age 65, and the number of persons aged 80 years or over is projected to triple — from 143 million in 2019 to 426 million in 2050.
“Most healthcare money goes to chronic conditions and aging,” Holly Jimison points out. She cites findings by the U.S. Centers for Disease Control and Prevention that approximately 75% of total health care spending is associated with chronic illness. Jimison, a Professor of Practice in both the Khoury College of Computer Sciences and Bouvé College of Health Sciences, also directs the Consortium on Technology for Proactive Care, an interdisciplinary research group based at Khoury and Bouvé that draws in collaborators from other universities and industry.
Jimison and her team have built NUCoach, a modular health coaching and research platform supported by mobile health technologies, and created a company, Novowell, to develop it. NUCoach allows researchers to gather vast amounts of participant data in real-world contexts in near real time. This information can be used to learn more about each participant’s behavior and provide just-in-time feedback and motivation for achieving health goals. This framework helps researchers propose or design new healthcare interventions.
Working with AlyxHealth — a local startup with a mission to improve access to healthcare and to empower nurses and clinicians with approaches to care delivery that are more proactive, timely, and scalable — Northeastern has arranged an exclusive license of NUCoach for commercialization. “A mentor in the program, Tim Simard, liked the idea of the health coaching platform so much that he decided to license it and absorb our start-up Novowell into his start-up,” Jimison explains.
She predicts that the commercialized version of NUCoach will launch in March 2020.
A one-bedroom apartment that assesses health behaviors?
Jimison’s design of NUCoach grew out of her work in the NUHome Lab, a 600-square-foot enclosed space approximating a one-bedroom apartment that is actually a behavioral assessment and intervention laboratory. Created with her husband, Misha Pavel, who also holds a joint faculty appointment in Khoury College and Bouvé College, NUHome Lab is located on Northeastern’s Boston campus on the fourth floor of Richards Hall.
Designed as a shareable research site for behavioral informatics, “it can be used for quality assurance or usability testing of new technologies or to test our algorithms, and faculty sometime use it for focus groups to help participants visualize the future,” Jimison says. With sensors on everything from the refrigerator to the microwave to the bed, the facility goes “way beyond Alexa and Google Home.” Interactive video exercise technology, passive infrared sensors, contact switches, and microphones are just some of the sensors that make accurate assessments of the participants’ behaviors.
Linked to patient-centered research approaches, the technologies at play in the NUHome Lab — including the integration of home and mobile sensing, just-in-time assessments and interventions, data fusion, and predictive algorithms — use computational methods to model and assess a patient’s state. Jimison explains, “The goal of our behavioral informatics research is to facilitate healthy, independent living for older adults, as well as people from disadvantaged populations or those with disabilities.”
This new model of care is applicable to a wide variety of people, with Jimison and her group focused on the elderly and people who have suffered neurological or traumatic brain damage. “The ultimate goal,” Jimison stresses, “is to provide continuity of care to the home where people can better improve health and maintain independence.”
A bridge between health informatics research and health interventions
“Oftentimes, the biggest stressor for older adults is loneliness,” Jimison states, emphasizing its effect on health and drawing in findings from her research. She points out that socialization is a health risk on par with smoking, yet not addressed in standard clinical visits. Robotic video conferencing and protocols for connecting people remotely with family members and other members of a group are two ways the NUHome Lab addresses isolation.
The benefits of innovations in home health include integrating both the patient and his or her family into a plan for care and extending the reach of lower cost professionals. To maintain security with the sharing of personal data, the staff of NUHome Lab uses top encryption software and plans to connect with the university’s new Cybersecurity and Privacy Institute.
Jimison notes that adult children of patients are the ones who worry more about a loss of privacy with this data collection, and not as much the patients themselves. As she points out, “in reality, we’re giving up data all the time. The patients themselves are happy to give up data when they perceive the benefit of being independent.”
Back in 2013, when Jimison and Pavel accepted offers of joint appointments from the deans of both Khoury College and Bouvé College, Jimison had been on leave from her position as Associate Professor at Oregon Health & Science University to work as a technology adviser on big data in the home with the National Institute of Health (NIH). Similarly, Misha Pavel was on rotation at NSF, creating and directing the new Smart & Connected Health Program. Their plan had been to return to Oregon Health & Science University, but Northeastern’s offer was particularly attractive because it emphasized the university’s commitment to health, aging solutions, and interdisciplinary research.
At Northeastern, Jimison has found a balance between teaching and research. “I was first part of the School of Nursing to help grow their research efforts, to help give nurses at Northeastern an opportunity to conduct research using state-of-the-art self-management health interventions without having to worry about data transfer, storage and inference algorithms,” Jimison continues.
With her emphasis on new models of care needed to emphasize prevention, self-management and social connections, Jimison and her fellow researchers are continuing to test their technology in “living laboratories” in the Boston area. New data will inform the ongoing development of NUCoach and help make “aging in place” a possibility for more older people.