An interview with Phil Goebel on personal health monitoring technologies and physical therapy / physiotherapy

An interview with Phil Goebel on personal health monitoring technologies and physical therapy / physiotherapy

This week we spoke to Phil Goebel a recently graduated physiotherapist based in Melbourne Australia who has a particular interest in using personal health monitoring technologies (e.g. the Nike Fuel Band) and how these relate to physiotherapy practice. A general term used to describe these types of personal tracking technologies is “Quantified Self”.

Could you briefly introduce yourself

My name is Philip Goebel, I have just completed the Doctor of Physiotherapy program at the University of Melbourne (only weeks ago!). I’ve become particularly interested in technology innovation in healthcare and specifically how self-tracking behaviours and technology could be used to deliver better care for managing chronic conditions. This interest spurred on involvement in the Quantified Self community and I started the Melbourne chapter and continue to organize local meetups. I’ve also taught myself how to program through the completion of online courses over the past year and so have some amateur software development skills which enables me to better understand the technical language of engineers, follow the technology community and better understand the potential and limitations of technology in healthcare. I’m originally from Canada and now call Melbourne home and I spend my free time enjoying the great rock climbing here in Australia.

What is Quantified Self (QS) all about and why should physiotherapists be paying attention to this?

The Quantified Self is a growing community of tech enthusiasts which is exploring the potential of using data about human behaviour to better understand those behaviors and our bodies to optimize it. Although many QS discussions center around health and wellness, QS concepts are also applied to productivity, spending habits and any other areas that interest QSers. The term was coined by the editors of Wired magazine, Kevin Kelly and Gary Wolf who expressed a trend in computing where computers were getting closer and closer to our bodies (Wolf 2009). Now tiny computers with sensors can be worn on our bodies to passively collect large amounts of data about yourself. Lots of interesting things can be done with this data including: finding unintuitive insights, objectively measuring the impact of new health behaviors, exploring statistical relationships between behaviours and through finding patterns even build anticipatory systems.
The potential implications for health and wellness are huge. Although devices that are born from QS approaches are starting to go mainstream (like the Fitbit or Nike Fuelband) I don’t see the QS community as ever going mainstream. Its not a health fad rather is a community of early adopters, typically geeks like me, who get together to discuss personal QS projects and share data. I believe that QS ultimately empowers people to learn about how their own body works to figure out what works for them and what doesn’t through data.

Nike fuel band

What devices do you use, could you describe how you use them and what information do you track about yourself?

My primary tracking device is my smartphone which is great since its something I have with me all the time anyways. I have setup a google form and answer quick simple subjective questions about my training. I also have a Fitbit to monitor my general activity levels and a Fitbit wireless scale which easily monitors and tracks my weight. I aggregate this data into a spreadsheet and analyse the data about once a month to look for trends or patterns that I should be aware of.

How do you currently use this information?

I use this data to improve my climbing performance. By tracking these things I have more data to understand what is impacting my performance and then make informed changes to my training accordingly. Self-tracking is not really anything new for athletes but these types of QS style approaches are making performance tracking that only professional athletes were able to do with extensive support staff, accessible to everyone.

Can you describe an example scenario where a physiotherapist uses an individual’s QS data to diagnose and manage a patient’s condition?

Self tracking for chronic conditions is quite common. Keeping pain or migraine journals is the low tech version that’s been used for years and is useful to find potential contributing factors to the condition. Imagine how much more powerful and insightful that data from a pain journal could be if it was entered on a smartphone and location data was captured along with it. Just one extra data point is collected and a pain map could be created to find location based associations to symptom flare ups.

Do you know of any cases where this is already happening?

  1. Activity monitoring post surgery with a Fitbit has been studied by the Mayo Clinic (Cook et al 2013, a review on Mobihealthnews)
  2. And a company called Hability has built an app to track adherence to physiotherapy prescribed exercise regimes.

Generally though most health care professionals are not engaged in the QS community and this is often a point of discussion at meetups and online forums. I would like to see this changed and think health professionals should encourage patients to gather data about themselves to learn about how those behaviours impact their health to better self-manage their health. However, expecting health professionals to do this in a fee for service healthcare model is challenging.

Where do you see this going in the future?

I think that everyone will have a personal data stream of health, social and productivity data. The health data stream will be our medical record and adding data points to it will become an expected health behaviour like brushing your teeth. We’ll all do this because the benefits will be enormous. Targeted delivery of preventative care, anticipating illness, better management of population health, and more informed health professionals. I think this will impact the role of all health professions and an increasing preventative role will be played since we will start to be able to easily identify who needs that care for the first time.

I understand you have a business start-up planned, could you describe what this is?

Yes, I am building embedded sensor systems for gait aids called Footprints. My hope is to track changes to gait and build a “check engine light” for walking so that if significant deterioration is detected an alert to go see a physiotherapist for a more thorough assessment will be sent and the gathered data could be shared with the physio for assessment and outcome measures. I hope this will enable earlier and more effective care delivery for falls prevention. I will share my progress on quantifiedphysio.com

Where can people go for more information about QS?

the quantifiedself.com website is the main website for the global community. Posts often are videos of the QS style show & tell meetings that happen all around the world. If you are interested about QS the best thing to do is to try to attend a QS meetup which happens in more than 100 cities around the world. The links to those meetup groups are also on the quantifiedself.com site. If you are looking for QS tools (apps and wearables) go here: Quantified Self tools guide.

Any advice for an aspiring self tracker starting out?

Generally self-tracking is much easier if you have a general goal like improving performance or managing a chronic disease and then set more specific quantifiable goals. Often people who self-track because they like the idea and want to explore the data stop quite soon without these goals. The most powerful tracking devices are passive so once you have a goal try to find a device which is as close to a “set it and forget it” device as possible. Don’t obsess over the data either (maybe thats only a problem I have) instead review it in fixed intervals and look for interesting patterns.

For further information on self tracking devices and software please see:

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News article posted by: Tony Lowe

With a PhD in Engineering Tony is a lecturer, learning technologist, web developer and e-learning consultant. He is the Technical Director at Physiopedia and takes a keen interest in pushing the development of our profession through the appropriate use of technology.

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