Just-In-Time Context-Sensitive Questioning for Preventative Health Care
STEPHEN S. INTILLE, Kent Larson, Chuck Kukla · 2002
This paper argues that there is an emerging opportunity for artificial intelligence researchers: the development of technologies that enable a new type of “proactive health care system ” that continuously monitors “healthy patients ” in their homes and motivates lifelong healthy behavior and health self-awareness. The components of the system, which would augment but not replace traditional health care, could be funded entirely by consumers without reliance on the financially-burdened health care industry. A research prototype of one com-ponent of such a system is described: a preventative monitoring system for congestive heart failure that uses “just-in-time, ” context-sensitive questioning. The sys-tem illustrates how sensors in the home used for en-tertainment and communication purposes might also be employed – at a negligible additional cost – for preven-tative health care applications. The problem The U.S. medical system and those in other countries face an impending crisis: how to pay for the care of an aging population. By 2020, the U.S. Census Bureau predicts that over 30 % of the U.S. population will be over the age of 50 (Staff 2000). This growth combined with governmental health care shortfalls and the rising cost of medical proce-dures will place an enormous strain on the U.S. health care industry in the next 10 years. In 2000 alone, U.S. health care spending rose 7%, the largest increase in more than a decade (Kowalczyk 2002). More alarming, the Congressional Bud-get Office reports that “financing problems in the near term will be dwarfed by the crisis that could occur as the baby-boom generation reaches age 65 ” (Antos 1997). The current system provides excellent acute care for disease and injury, but current models of care and payment will not effectively handle the rising number of people needing chronic care. Although there is a consensus that the present system is not fiscally sustainable, there is no agreement on how to fix it. Meanwhile, costs continue to rise for consumers 8-15% per year, and they feel increasingly frustrated by barriers to access and lack of care options. Corporations as well are strained by rapidly increasing health plan costs.