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    Minding Your Own Medical Business


    To help you keep you to that timetable, a new kind of toothbrush will emit a tone every 30 seconds, which alerts the brusher it's time to move on to another quadrant of his mouth.

    "That way, it gets you to brush for a full two minutes and distributes brushing time throughout all the teeth," Ramsay adds.

    "These microelectronics are built into the toothbrush, so they give people feedback about their use in order for them to regulate their own behavior," says Ramsay, an associate professor at the University of Washington School of Dentistry. It works, he says, because the features are built in to the toothbrush and don't add extra steps for you to remember.

    Ramsay is working on his own smart device, one that tells patients, parents, and the orthodontist how much time a child is wearing a removable appliance -- for instance, a retainer.

    "There is greater appreciation about the role that a patient's behavior plays in determining his own health outcomes -- whether it's exercise, smoking cessation, modifying diets, following regimens like taking pills, brushing teeth, and wearing orthodontic appliances," says Ramsay.

    This has led to a growing recognition that devices, in addition to having their basic biological, physiological, or pharmacological therapeutic benefits, should also integrate the technology to help patients use them better and more faithfully.

    "They have to help the person do what we want them to do," he says.

    Don't Call These Gizmos Gadgets

    "I think I have a concern about the word 'gadget.' When you put together the words 'medical' and 'gadget,' what you don't want to have are medical toys," says Cecelia Horwitz, MBA, associate director at the Center for Future Health at the University of Rochester in New York.

    Rather, she says, think of these products as data-collecting devices intended to empower the consumer.

    "It is not a gadget, but is something that is part of your life and gathers information for you. ... It is ubiquitous, integrated into your life, and you don't have to bend for it. Smart technology recognizes changes in a person's condition, and it provides information for them to take action on own behalf."

    At the Center for Future Health, Horwitz says, scientists are working on several different products, including eyeglasses that can remind people with memory problems of the names of friends and relatives, and smart bandages that help physicians figure out which particular bacterium is causing an infection.

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