Horizon (1964–…): Season 50, Episode 2 - Monitor Me - full transcript

Do you know how many steps
you took today?

How many calories you burned?
How many people you met?

Or how many hours you slept?

If you knew these things,
it might make you healthier,

or even save your life.

And finding them out
is already at your fingertips.

These days, there's almost nothing
we can't measure about our lives,

and we can do it with stuff
that almost all of us own.

Whether it's apps on our phones
or the latest gadgets...

You wear it as a headband,
so like this when you're asleep.

..the promise is
that our health will be transformed.



We're almost at Day Zero
of a whole new world of medicine.

There are now doctors
giving out apps

the way they used to prescribe
drugs.

That feels very Star Trek to me.

So, can this
medical revolution

really help us all?

I've really got to up my game.

These three weeks have been quite
a revelation for me.

That's absolutely gobsmacking.

I want to find out whether simply
monitoring ourselves every day

and gathering new information
about our bodies,

could be the key
to a longer, healthier live.

I'm Kevin Fong.

I'm getting ready for a day
on the medical frontline.



I'm going to see how fundamental
the ability to monitor ourselves is

to saving lives.

So I'm here in the crew room
of London's Air Ambulance.

These guys are ready to
fly off to the scene of an emergency

at a moment's notice,

and all they're waiting for
is for that klaxon to go.

London's air ambulance exists
to get medical staff

to the scene of an emergency
as fast as possible.

With a senior doctor on board,

they're trained to deal
with almost any situation.

The team are expected
to be airborne

within four minutes of the klaxon
sounding.

There's no room for a film crew
aboard,

so I'm going to be on my own
with this.

On board are all the tools
the team needs to save lives.

They've even performed heart surgery
at the roadside.

But to me, perhaps the most important
thing of all on this helicopter

is the monitoring equipment.

You've got to know what's
going on inside your patient's body,

if you're to have any chance
of fixing them.

We've been called out
to treat someone

who's suffered
a severe head injury.

I think I'll just put
a few stitches in that first.

As soon as possible,

the patient is hooked up
to the team's monitoring equipment.

This is our monitor pack,

and this carries all the vital bits
of kit, essentially,

that we use to monitor heart rate,

blood pressure, their oxygen level
and the gases that they breathe out.

Essentially, this is a surrogate

for everything
in the emergency department.

We can have as much surgical
kit as we want,

but it really is essentially useless

if we can't tell what's happening
with the patient.

So the team are dealing with quite
a serious head injury there.

In addition to delivering a doctor
and a paramedic very rapidly,

they're also able to bring with them
some quite advanced monitoring,

the sort of thing you could get
in an intensive care unit, really,

small enough and portable enough

that they're able to describe that
injury in great detail

before they ever get anywhere near
the hospital.

Quite simply,

this small box can make the
difference between life and death.

The patient's been stabilised.

The team will go with him by
ambulance to the nearest hospital.

The immediate crisis is over,
and the outlook is positive.

You know, this is much more
than just a helicopter,

it's essentially a mobile
accident and emergency unit.

And it's possible

only because you can take that
incredible suite of monitoring

that you would normally find
in a hospital,

shrink it down and stick it
in the back of a vehicle like that.

But what if everybody could monitor
themselves to the same degree?

What if we all had that capability?

How would that improve our health?

I'm going to start

by checking out some
of the latest medical technology.

But I'm not talking about MRI
scanners or surgical robots.

I'm not heading to a hospital,
or a doctor's surgery.

I've come to a sports shop.

For a few years, people who are far
more committed to exercise than me

have been using gadgets like these
to help them keep fit.

You know, these are fundamentally
impressive devices.

Take, for example, the GPS trackers,

which grab information
from satellites

and define your position
with unparalleled accuracy.

And then there's
the heart rate monitors

which can measure the faint spread
of electricity across your heart,

through the full thickness
of your chest.

In a few years,

the number of wireless
health and fitness devices in use

is expected to rise
to almost 200 million.

When these products started
to become available a few years ago,

it didn't occur to me that they
would become so advanced

or deliver such a rich stream
of information.

And I didn't anticipate

that self-monitoring
would find its way into medicine.

But it's beginning to. And that
could make a huge difference,

so much so
that I've started to think

that we might be on the brink
of a revolution in healthcare.

This is a revolution
that takes monitoring

out of doctors' hands, out of
hospitals, and gives it to us.

And by doing that, it places us
at the heart of our own healthcare,

and makes doctors of all of us.

There are few people who know
this new world of medicine

better than Blaine Price.

He's pretty obsessed
when it comes to the latest gadgets.

You're pretty into self-monitoring.

Yes, I get every app going.

I buy all the devices I can
and try them out.

And it's great, because I get
to play with all the toys

and learn lots of things
about myself at the same time.

'Blaine's gathered together
some of his favourite toys

'for me to have a look at.'

What have you got for me here?

First of all, we've got these,
kind of a glorified pedometer

to keep track of how many steps you
take, but it's a lot more than that.

They'll monitor exactly
when you took your steps,

how active they were and intense
they were, what time of day it was.

Sleep is one that people
are often interested in.

So, er, this one, you wear it
as a headband,

so like this when you're asleep,

and it measures a bit about your
brain activity.

It can tell you what
phase of sleep you're in,

deep sleep, light sleep, REM
and so on.

And if heart information is
interesting to you,

we've got a pulse oximeter here.

Oh, yeah, the sort of stuff
I use in the hospital anyway.

Sure. And before,
you only could get it in a hospital.

This is now very inexpensive

and what it's doing is measuring
cardiac rhythm and blood sats.

Looks like I'm fairly healthy
at 98 or so.

From the comfort of our own homes,

we can now measure
many of our vital signs.

We can also measure a few things
you might never have thought of.

There are consumer devices
to check your posture...

your blood alcohol levels...

Do a quick jump.
How high you jump...

And even how quickly
you're eating.

And much of this, we can do
without even buying any new gadgets.

There are now tens of thousands
of apps

available on our phones to track
anything and everything about us.

In fact, there are hundreds of apps
coming out probably every week

which are health-related,
able to measure things, log things.

Some of the latest apps use things
designed for one obvious purpose,

like a phone's camera,
to do something utterly unexpected.

We even have apps that can
measure your heart rate

just by looking at you.
That's amazing.

Give it a try.
You have to keep fairly still.

OK, so I'm going to have to shut up
and stay still.

And it will measure your heart rate
by looking at the colour changes

in your face, and it might even
get your breathing rate in there.

So there's the heart rate there
coming in, about 79 or 80.

And breathing rate about 17.
That's really quite incredible

because it must be,
the heart rate stuff there

must be on just seeing
the small differences

in the change and colour
of my face?

So as the capillaries sort of swell
up and fall away with every beat?

Yes, it's the resolution
of the camera that does it.

The technology here has such
a high resolution in smartphones

and tablets that we're looking
at the same range

you would have had in medical
scientific instruments 20 years ago.

I find that...just gobsmacking,
really.

Blaine has set up an experiment
to help me find out

whether this technology
can really make us healthier.

He's roped me
into taking part as well.

I'm Kevin, hi. I'm Celia. Celia, hi.

'Celia, Cathy, and Pam
work together.'

So I understand that you've
volunteered to be guinea pigs

for this particular experiment.
Yes, we are the guinea pigs.

What have we let ourselves in for?

'They're hoping that by monitoring
themselves,

'they can overcome an endless
struggle and lose some weight.'

We're permanently on diets,
aren't we?

We're all very conscious
about we eat too much

and we drink too much,
but we love it.

We all discuss what we ate
last night.

"Oh, no, I had a glass of wine."
"Well, Celia had three."

We've got
a set of scales in the office,

and so every week, we weigh in

and we keep a chart
of what our weight loss is,

and sometimes weight gain.

Until now, this,
standing on a set of scales,

has been the only form of
self-monitoring that most people do.

I've got to get
all my jewellery off.

Moment of truth.
We do this every week, don't we?

Does it make any difference? No.
I thought you'd been so good!

Don't forget your watch.
I'll take my watch off.

Get off, quick!

OK, Cathy.

It's stayed the same.
Oh, the same as last time.

Same as the week before.

It's the same story
for so many of us.

There's too much going on
in our lives

that stops us getting fit
and staying healthy.

I find it really difficult
to wake up in the morning

and think about doing some exercise.

There's quite a lot of ready meals
going on,

which doesn't help the diet.

Any excuse.

If I had all the time in the world,
I would exercise a lot more.

But, you know, there's just work,
looking after the house,

picking the children up from school,

the usual domestic chores
that every mum has.

So how exactly is Blaine hoping

that monitoring ourselves can make
a difference to our health?

There's actually only two
simple things you have to do.

One is, you've got to carry around
with you a little device here.

You can stick it in your pocket.

It'll record how many steps you've
taken.

The other bit of this study is,

you need to have a smartphone
to measure your sleep at night.

It's going to measure, hopefully,
how deeply you're sleeping,

how well you're sleeping.

It'll measure the time
you go to bed and wake up.

So what you'll do is
get an email every day from me

with a summary of your performance
during the past day,

how it compares with the past week,

and also how you compare
with the rest of the group.

The hope is

that by simply measuring our activity
through the number of steps we take every day,

we can set ourselves targets
and get motivated to do more.

And by keeping tabs on our sleep,

we can find out how to get
a decent night's rest.

I'm hoping that it's gonna
give me a better understanding

of what you actually do have to do
to kick-start a healthier life,

to burn more calories, to
perhaps have a better night's sleep.

I don't have a particularly
healthy lifestyle

because I don't do exercise.

I'm not aware of my health,
shall we say.

I don't know what
my blood pressure is.

My sleep pattern these days,
as I've got older, is not good.

I'm hoping it's going to give me
the enthusiasm to do some exercise

because quite honestly,
I find exercise boring!

Every day for the next three weeks,
each of us is going

to be bombarded with numbers -
how much we've slept,

how deeply we slept, how many steps
we've taken, and when we took them.

The question is whether
simply seeing those numbers

will be enough to make us change.

But there are people who already
use self-monitoring

to alter their health
and fitness in a fundamental way.

This is Twickenham,
the home of rugby,

and I'm here to join the England
Rugby 7s team while they train.

So if you go along it gives you

pretty much everything you could
want.

'Brett Davison is the team's
Head of Physical Performance.'

..zones which we would have to
specify.

'His players are amongst the most

'closely monitored
people in the world.'

So they've got on a little GPS unit
that sits in a little

neoprene pocket on their jersey
between their shoulder blades.

There we go.

And then they've got a heart-rate
strap on,

those two coordinate
between each other

and then the information comes
straight back to us.

'Now, I'm a doctor.

'I'm used to examining people,

'and looking for the subtle
signs of illness and injury.

'And as far as I'm concerned this
international rugby team

'looks more than match ready.

'But Brett sees a lot more than
I can without even

'glancing at the players.

'He does it simply by looking at a
screen full of numbers.'

Run me through what you've got here.

OK, there's obviously speed -

your current, your average and
you maximum.

Heart rate, exactly the same.

Distance, so that's for the whole
training session.

Dynamic stress load, number of
accelerations, decelerations.

High speed running is
the number of metres they've run,

maximum speed.

'All those numbers help Brett

'detect problems well before
any doctor could.'

You can see
the injuries in terms of their speed

or their lack of, usually.

Um, and certainly their running
intensity will be off

what we know it could be for that
particular individual.

This is Geoff's trace
and at the moment

he's cruising at 18-odd kilometres per hour,

which is not very fast for
these guys.

So you can certainly start to see
where somebody's struggling.

'And the information Brett gathers
turns out to be an incredibly

'sensitive indicator of injury.'

It picks up their step balance,
their left-right step balance,

uh, through the, accelerometer.

So, we can tell how badly
somebody's limping,

or how much they might be
favouring a leg.

And this lad got hit on the knee.

And the difference between his left
and his right is about

one and a half per cent.

So, although it's a really subtle
change, one and a half per cent

off his top speed, because he's
limping a little bit,

could be the
difference between a try or no try.

'Since he started monitoring
his players this intensely,

'Brett has found that their
soft-tissue injuries have fallen

'by a stunning 80%.

'He's stopping injuries
before they arise.

'To Brett, it's become
something of a crystal ball,

'allowing him to see
into the players' futures.'

If they've had a bad night's sleep,
their heart rate will show it.

If they're getting ill and they
don't know they're getting ill yet,

usually their heart rate will
show it for us as well.

So from that point of view,

sometimes we know things about them
that they don't know yet.

So you can tell that someone's ill

before they themselves are conscious
of the fact that they're ill?

It hasn't failed us yet,
where we've seen data

and we haven't reacted to it,
and literally the player has

woken up the next day and said,
"I'm crook, I can't train."

And we've been a bit upset
that we haven't acted on it.

But we generally pick up illness

24 hours before they might
start to feel ill.

You must have found that
remarkable when you first realised.

Yeah. For a while we literally were
looking at it, going, "That can't be
right. That can't be right."

And we looked at it for a long time,
and then started acting on it.

And then, the results started
proving it, you know.

Your body's not going to lie.
You might, but your body's not.

'Imagine if we could all see
what lay ahead.

'Imagine if we all knew what was
coming before it arrived.'

It's remarkable, to see
illness and injury

before the players themselves were
conscience of it.

Because that in medicine is
essentially what we strive for.

To be able to see the storm
before it's arrived,

in the hope that we might navigate
safely through it.

Or perhaps even avoid it altogether.

Here goes, then. See if this works.

Our volunteers are a few days into

seeing what self-monitoring
might do for them.

We'd better give this gadget a go,
then.

When it comes to counting steps,

the recommended daily goal in order
to keep fit and healthy is 10,000.

All the way up, all the way down!

But as the numbers start coming in
there's a bit of a surprise.

I've been looking, just to see how
many steps I'm doing,

and I'm really shocked, cos I really
don't even break 5,000 sometimes,

and I'm supposed to be
doing at least 10,000.

It's really hard.

So today I've been to boot camp
and I've really gotta up my game.

The step logging's
come as a bit of a surprise really.

I thought I was quite active
and thought I moved round a lot,

but it's quite a bit lower than
I expected it to be,

and I'm going to have to
rely on dancing to boost that count.

It's been difficult to find enough
time to fit in the extra exercise.

Jess, this way.

'Mainly through walking,

'but anyway we'll see
how we get on.'

And, despite the fact that
I've come to sunny California,

I'm not finding it any easier.

This is harder than I remember it
being. I haven't done it in a while.

I've never really felt the need to
pull on a pair of trainers

and jog up and down a beach.

But it's different
when you're confronted with

cold, hard numbers telling you
exactly how lazy you're being.

So I've had this now
for about a week,

and I didn't really think it was
going to change the way

I looked at what I did
and didn't do, but it really has.

It does make you more competitive,
even if that's only with yourself.

I know that I've
done 3,000 steps today,

I know that this beach is worth
another 500, and I know that

the difference between exercise and
no exercise is a pile of numbers

that will appear on my computer
tonight

and tell me how hard I've worked.

So I guess it's probably time
I got a bit more

serious about all of this.

Because the fact is, at the moment,
I'm not working nearly hard enough.

'I'm not here just to
run in the sunshine.

'I've got an appointment to see
the doctor.'

Hello. Good morning.
I'm here to see Dr Topol.

Go ahead and have a seat,
he'll be with you shortly. Thank you
very much. You're welcome.

'Californians are famously obsessed
with looking and feeling great.

'So it's a natural home for
some of the pioneers of the
self-monitoring movement.'

I've seen a lot of waiting rooms,

and this one is pretty typical,
pretty average, but the doctor

I'm about to see, his approach to
medicine is anything but.

Kevin Fong, Dr Topol will
see you now. Thank you.

'Normally, you expect
a visit to the doctor to end with

'a prescription for pills.

'But the doctor I'm going to see
is much more interested

'in fixing his patients by
getting them to monitor themselves.

'Dr Topol is a cardiologist.'

So let me go ahead and start off,
we'll do a cardiogram, OK? OK.

I've got my phone here.

'I've never seen any doctor check
for the signs of a heart attack

'with little more than their phone.'

Put your fingers on that, and then
just make a circuit with your heart.

So we'll look at this together, OK,
and that's your cardiogram.

I find it incredible that you can do
that degree of monitoring.

Normally when I'm doing that
in a hospital I wheel this sort of

R2D2-looking thing into the
side of the bed and it takes about

10 minutes to hook up to someone.

That feels very Star Trek to me.
I mean, I...

You're easily impressed,
this is nothing.

'Whatever's wrong with you,
Dr Topol will try and find

'a gadget to help, so that you can
look after yourself at home.

'He even uses some of them himself.'

Here's a sensor.

'He's wearing a sensor like this,
with a hair-thin micro-needle that

'implants under the skin, giving
constant blood-glucose readings.'

I have this on and I can
monitor my glucose every minute.

So right now my glucose is 91, OK,
and I can see what it's been doing

in the last several hours,
and every minute it will update.

For the huge number of people who
suffer with diabetes, this is...

revelatory, because until now
they've had to prick their fingers.

Oh, no,
the finger stick could be history.

When you have this on...

The average person looks
at their phone 150 times a day.

So now you got your phone,
and you're looking at it, you say,

"Am I going to eat that cookie, am
I going to eat that piece of cake?

"Cos if I eat that my glucose is
going to shoot up to 160, 180."

And you start to realise exactly
how your body is responding to food,

to portions, to exercise.

It really changes your lifestyle,
it did me at least.

So you're prescribing...apps?

You name the condition,
er, heart rhythm problem,

we get the condition, the apps to
match up with your phone,

and that's how you monitor yourself.

Medicine is truly unplugged now,

and it's going to change everything
we do in healthcare.

Because now all the information
is going directly to the patient,

not to the doctor.

And it's more information than
we ever had before.

'After visiting
the doctor in the future,

'rather than leaving with pills,
we'll leave with something

'far more important - information
that's impossible to hide from.'

The whole opportunity to know
everything about the medical essence

of each person is
pretty remarkable.

To me at least, a student
of medicine for three decades,

this is the biggest shake-up
in the history of medicine by far.

'With all this information,
Eric hopes we'll be able to spot

'even the most serious problems
before it's too late.'

To be able to prevent a heart attack
with this type of, er,

information, that to me
is the most exciting thing.

And I do believe that they will be,
if not fully preventable,

awfully darn close.

We could stamp out
something like asthma attacks.

You can pick up,
er, pollen count, air quality

and how the chest is moving
long before the person feels

a wheeze or is having
difficulty breathing.

What do you think is going to
turn up in the next ten years or so

that people will think,

"I never would've imagined that
medicine would look like this"?

For the person who really has a
significant illness or risk of one,

putting in a tiniest implant,
smaller than a grain of sand, that

essentially carries no risk, will be
commonplace. Er, little microchips.

We have 'em in our pets to keep
track of where they are.

Why don't we have 'em
in our people to prevent illness?

You know, it's startling to hear
the way that Eric talks,

to see the things that he's doing.

He pretty much prescribes apps

the way my colleagues would
prescribe drugs.

And that right there is
an example of how

we're leaving behind what
he would call the old medicine,

how we're finally dragging the field
of medicine into the digital age.

And if it works
the way that he says it will,

then it has the potential to
change everything,

it has the potential to be truly,
truly transformative.

These days, we can monitor
one of the most fundamental

but usually unseen aspects of our
lives - something that affects

our physical and mental wellbeing,
and even how long we might live.

Our pattern of sleep.

First night in the United States

and I'm going to give
Blaine's sleep app a go.

Apparently all I have to do is press
that button,

stick it on the end of my bed

and it's going to tell me
how I slept, so let's give it a go.

Every twist
or turn is monitored

by a finely calibrated
sensor in the phone

which measures tiny ripples
in the mattress as I move.

It should allow me to see if
anything affects my sleep.

Across the Atlantic,

Celia is carrying out her own sleep
experiment.

Tonight I have had too
much to drink, um, more than

I've had to drink for quite a
while...

..and, yes,
I am feeling...worse for wear.

So I'm going to record my sleep
tonight to see what happens.

Every night, each of us will produce
a graph detailing our sleep.

John Tamm in the morning
on San Diego's number one

for new country, KSON.

It's another sunny day
here in San Diego.

Well, let's see what the phone's
going to tell me about last night.

So there's the graph of my sleep,
light sleep right up

there at the top,
it says deep sleep at the bottom.

These mountainous looking peaks here
are where I was wriggling around.

And overall it says that
I slept for 8 hours,

and about 64% of that was
deep sleep.

Who ever thought that phones were
going to tell us

about how well we were sleeping?

After three weeks of monitoring our
sleep, we should all be able to find

out what affects it - and change our
lifestyles to help us get a better
night's sleep.

But self-monitoring might do
much more than just change
our habits and behaviour.

We've all worried at some
point about what nasty surprises

might be lurking inside our bodies,
what might be going wrong,

without us even knowing.

By monitoring ourselves,
we can find out,

and potentially do
something about it.

This is the house of probably
the most monitored man in the world.

He monitors himself - he monitors
everything about himself.

And I really do mean everything.

But by monitoring himself so much,

he discovered a
potentially fatal condition.

Larry, I'm Kevin Fong,
nice to meet you.
Good to meet you. Come on in.

Larry Smarr is one of the most
influential computer
scientists in the United States.

He was instrumental in developing
networked computers -

the predecessors of the internet.

Today, he's putting all his talent
into monitoring himself.

Larry just give me a shopping list
of what you monitor about yourself?

Well, I monitor my weight.

I monitor my steps
and caloric burn with my Fitbit.

I monitor my sleep
every night.

Urine, saliva, blood,
I monitor stool, actually...

You even go so far as to
monitor your own stools?

Yes. I mean that's by far the most
important part of what I've done.

There is such a thing as too much
information, surely?

No. There is
never too much information.

It is a challenge to...

to turn that information
into understanding,

and that's what science is about.

Am I missing out? You are.

We produce stool every day,
everybody on Earth does,

and it has this incredible
information about the state

of your health
and we just flush it away.

It's relatively challenging
things to do, to monitor,

you know, that element of your life
- I mean how do you do that?

Let me just show you.

The point is you have to freeze it.

And I do it every two weeks
so I'm going a very fine timescale.

And so it's just sitting
here in the freezer.

So each of these is labelled.

That one's February 23rd,

this one is, this one here
is January 26th.

This is just in the freezer
in your kitchen,

it's not even a separate freezer?

Well, it's getting to the point
now that I've got enough of them

that I'll take them to the
medical school.

You just Fedex them,
and it's overnight delivery,

and then 2 weeks later
I get back all this data.

I sort of had it in my mind
that you'd have

some special freezer in your garage
or something.

Well, my wife probably thinks I
should but she's very understanding.

At his laboratory, Larry has put
all his information together.

So I was wondering how on earth you
were represent

all of the data that you
collect about yourself.

'Over the years, he's gathered
billions of different measurements
about his body.'

From his enzymes
to his proteins, his minerals

to his microbes,
nothing goes undetected.

And this display shows just
a tiny fraction of them.

These are 150 different variables
over either 5 or 10 years. On you?

Just on me. Here's my cholesterol
variables, my magnesium.

Phosphorous, sodium, thallium,
stuff I've never heard of.

You're measuring stuff that I've I
don't even know how to pronounce.

Yup, all of the things that
your doctor tells you to measure

and a lot of others.

'With this information, Larry has an
early warning system in place,'

'in case anything goes
wrong inside his body.'

The colour coding is that if they're
in the green they're healthy,

but if they're in the orange,

that means you're 1-10 times
above the upper limit for healthy.

I look at this and I say,
"Look at all that green I
must be pretty healthy."

But a few years ago, he noticed
something was wrong.

I said, "What's this thing up
here that is red"

"that is spiking up to 30 times the
upper limit? And this one down here

that's purple,
that's 125 times the healthy limit."

Some of the measures of information
in Larry's bloodstream

had shot to
worryingly high levels.

Lactoferrin is supposed to
be less than 7,

and this is 899,
125 times the upper limit.

So far off scale that you don't have
to be a doctor to know that

something's going wrong.

Terribly wrong.

So you look up Google

and within an hour you can find 5
or 6 peer reviewed papers that say

if you have a value of this
variable at these numbers,

say 750 to 1,000, you have a chronic
incurable disease.

He'd discovered that he had
Crohn's disease - a serious
disorder of the intestine.

You must've been
terrified by this surely?

I'm a scientist,

so the way you fight that feeling
is get more knowledge.

With the knowledge he'd gathered,
Larry was able to

diagnose his disease at the earliest
possible opportunity.

He believes that soon,

we'll all be able to monitor
ourselves like he does.

In a world in which you can see what
you're doing to yourself

as you go along, the hope is that
people will take more personal

responsibility for themselves,
in keeping themselves healthy.

So it's like we're
almost at Day Zero of a whole new

world of medicine.

And what will come out
the other end,

is a far healthier society that's
focused on wellness,

rather than trying to fix sickness
when it's way too late.

Larry is providing a new
self-awareness that would

lead to a new kind of preventative
medicine, one that doesn't depend

on vaccination, or programmes of
public health, but instead on data.

And in that, I think
he really might be onto something.

We're one week into Blaine's
experiment.

When we started, I think we were all
a bit surprised at how hard

it was to reach the recommended
daily level of 10,000 steps.

So how's everyone doing now?

Who's that there?
That red bar is Celia.

Upping her game.

Getting over 15,000 steps
on a couple of days

which is pretty impressive.

It does kind of give it
all that competitive edge.

'Our little experiment seems to have
got rather serious.'

Well, it's ringing.

Hello!
Hello!

How's it all going?

Well, we're a bit concerned
about how well you did.

Last Monday,
you seemed to put on a good spurt.

I did do a bit of running that day,
I have to say.

But I see, Celia, you did
a couple of days over 15,000 steps.

I have, yes,
and I'm definitely making sure that

I walk places that
I wouldn't normally do

and it's been going really well.

Celia is winning.
She's beating all of us.

Yeah, what are you going to do
about that, Cathy?

I've been going to boot camp,

but my step count is a bit
disappointing, I'm afraid.

So I'm having to do a run
after boot camp,

but, having said that,

my steps are still nowhere near
as much as yours and Celia,

I'm very upset.

How's it been going with you, Pam?
I've been doing a lot more walking,

and, er...

going the long way round
to make the tea and the coffee.

I'm a little bit concerned,
because I didn't think

we'd be taking this
quite as seriously as we are.

'Maybe this monitoring
really is changing our behaviour.

'We'll find out in a couple of weeks

'just how much difference
it can make.'

See you later, lovely to see you.
See you! Bye!

I'm out running...again.

It's hard not to
when every single day

you know exactly how many steps
you're clocking up.

But, really, what I'm doing here
is one of the more obvious ways

of monitoring your health.

When we think about the way
that we monitor health,

we talk about heart rates
and blood pressures, or the amount

of exercise we're doing,
or the calories that we've burnt.

But it turns out you can gain
a surprisingly profound

insight into the state of
your health by tracking apparently

trivial bits of information
about your life -

stuff that until now,
we've completely ignored.

So I'm here to find out
how that's done.

'I've come to the Massachusetts
Institute of Technology.

'I'm here to see how experts can
monitor our everyday behaviour and

'peer into corners of our lives that
I never would've thought possible.'

So, please have a seat here.
Thank you.

'Professor Sandy Pentland
believes he can tell not just

'what's going on in our bodies,
but in our minds too.'

'And he can do it with something
that most of us already own -

'a smartphone.'

Phones know a lot about your social
life, who you call, who you

communicate with, a lot about your
daily activities, where you go.

And so if you put the two together,
you can do things like assess

mental health, and you can actually
get a picture of how you're

doing constantly, 24/7.

Sandy was asked to develop an app
to help spot signs of depression

and post-traumatic stress
in soldiers returning from war.

I am curious because I've had
your app on my phone for a few

days now and I'm not entirely
sure what it's doing,

so I'm hoping you can explain.

OK, well, it kept track of things
like your socialisation,

your focus and your activity levels

and these are key things
for assessing mental health.

Tell me
what you've found out about me.

Well, let's look at it here

and see what you've been doing
and then what it's been doing.

So, first of all, we can
see your activity level - are you

curled in a ball some place and you
never get out of your bed, or

are you out and around, or are you
sort of manic and you're everywhere?

So you see a five over
on the left-hand side,

that's how active you've been,
and on the right is

the average, so you're just exactly
average when it comes to activity.

A drop in physical activity often
goes hand in hand with depression.

But Sandy can track much more.

By monitoring my phone use,

he can also tell
how I'm interacting socially.

Do you call your friends?

Do you call workmates,
things like that?

Phones can also sense
when there's other people around

because they have these little short
range radios called Bluetooth.

And so my phone can see your phone,
and they can shake hands.

And if we go over here, to Social,

you'll see that you're quite a bit
more social than other people.

So you're good to go here,
this is good.

And then if we go down here,
this is Focus and you can see that

you're a little bit more focused
than the average person.

But how does it know about my
focus? What do you mean by that?

We all know what happens
when you're not focused.

One of the things that people do
is that they fuss with their phone,

they look at their messages,
they read news, they...you know,

so you can get a sense of
whether you're focused

or whether you're distracted
all the time.

Though it seems astonishing that
the way you use your phone

could give an insight into your
state of mind, trials of Sandy's app

have demonstrated its success
when compared with a doctor.

Sandy's convinced that mobile
phones might have a huge role

to play in keeping us healthy.

In fact, he believes
they might even be able to prevent

the spread of diseases
that affect millions.

It turns out that when people get
the flu they behave differently.

They begin to retract a little bit,
they don't feel so good,

they call different people,
they tend to call their friends

more than their workmates,
things like that.

And it's actually a signature
that you can detect

with about 80% accuracy.

So I could see when you
look like you're getting the flu

and I can see that somebody else
is not getting the flu...

..and then I can see that the two
of you spent some time together...

..and they began to get

flu behaviour, which tells me that
you infected them at that meeting.

And, of course, normal flu
is not that bad

but every once in a while we get
these pandemics that kill

literally hundreds
of millions of people

and we're defenceless against it.

This is a startling thing -
the idea that you might track the

spread of a pandemic by something
other than taking blood tests from

people or saliva samples, or them
going and seeing their physician.

It's a rather amazing thing
that you could actually watch

the progress of the disease...

..because then you could actually
do something about it.

You could say, "OK, people in this
neighbourhood

"don't go to work today."

Or, "Don't go to this cafeteria."

Or whatever sort of
intervention you want.

But you could actually begin
stopping it.

But to bring about this
game-changing shift in health care,

we'll need to give up
our most personal information

to people who can mine it
and spot the patterns within.

And, understandably, not everyone
will be comfortable with that.

The world is now full of people
with their mobile phones

and their mobile devices streaming
terabytes of information

about their habits and their daily
lives. And I completely

understand the unease that people
feel about giving

that information up to others.

But, in medicine,
that's all we've ever done.

We've gone to doctors, strangers,
and we've told them

those intimate details in the hope
that they might bring us help.

And in a sense, that's what
Sandy Pentland and people like him

are trying to do, just taking that
model and dragging it into

the 21st century in the hope that
will change the face of medicine.

Over the last couple of weeks,
I've become increasingly

obsessed about monitoring myself.

But I'm starting to realise that
there's much more to this

than just doing more exercise.

By monitoring ourselves
and pooling that information,

we could unearth knowledge

that would revolutionise
the way we practise medicine.

We could share our data and begin
to look for patterns that unlock

the secrets of human health.

I've come to a small town
in Florida

to meet someone
who's looking for those patterns,

and who's moving forwards at a pace
that seems barely believable.

So far, we've had a hint
of the shape of things to come

for the future of medicine.

But the girl I'm about to talk to
is the future of medicine,

and, incredibly, she doesn't have
a medical degree.

In fact, she doesn't have
a degree at all

and that's because
she's still at school.

I mean, I think it's exciting
that as a teenager I've been

able to find something

I'm so passionate about that
I want to spend my weekends working.

'What sets Brittany Wenger apart
are her computer-coding skills.'

There is a community of us out there
who are really interested

in science and through the different
kind of science competitions...

'She recently won the
prestigious Google Science Fair

'for a computer program
she's written.'

I think I'd always had a pretty keen
interest in computers but then

in seventh grade I was taking this
course on futuristic thinking.

In seventh grade...
How old were you in seventh grade?

So that would be about 11 or 12.
Right.

And I came across a concept
that computers could actually be

programmed to transcend human
knowledge and to detect

really complicated patterns that
humans have no idea how to detect.

So I was enthralled and I went home,
I started buying coding books

and I decided to teach myself
how to code.

'What happened next was a family
tragedy that inspired

'Brittany to do something
remarkable.'

I was 15, my cousin was actually
diagnosed with breast cancer

and I saw first-hand
the kind of impact this disease

has on a woman and her family.

So I got really inspired to get
involved and make a difference

and I started researching
breast cancer.

And so that's when I really wanted
to connect my two passions

and try to create a better
breast cancer diagnostic system.

'And she's written this program
in her spare time.'

'Looking at a biopsy of human tissue
to determine

'whether it's cancerous or not
is a notoriously difficult thing
to do.'

'Brittany's program is designed
to help doctors

'to analyse what they're seeing.'

So, for example, see these nucleoli,
they're the small dots.

The small dots, right.

They're really prominent and there
are multiple ones per cell.

And that could mean
that the mass is cancerous.

But that is actually benign.

And this is just an example
of why they are

so difficult to diagnose,
because even this benign mass is

exhibiting some
cancerous attributes.

I have horrible nightmares
of spending hours staring at these

slides at medical school, trying to
decide whether it was cancer or not.

And it just seemed nearly
impossible to me.

I mean, this is a tough task.

'It's an incredibly difficult task,

'for which Brittany
has found a solution.'

So what I did is I created
an artificial neural network

which is this really cool type of
program that can

model a brain's neurons and their
interconnections, so it can actually

learn how to detect patterns that
humans have no idea how to detect.

And in the end
it learns how to detect

whether these masses are cancerous
or not.

So your computer
knows how to do this?

Yes. It actually diagnoses over
99% of cancer patients correctly,

which is huge.

Yes, so 99% of the time it
will pick it up?

Yes, which... It's exciting
when you think about it.

Er, it's more than exciting.

'Brittany's program effectively
turns a doctor's hunch about

'whether a biopsy is cancerous
into something far more scientific.'

So what this does is provides
a set of nine pretty objective

questions about what they're seeing
on the screen in front of them,

and then feeds that quite
complicated set of information

to your program which then instantly
decides cancer or not cancer?

Yeah, exactly.

It's able to detect patterns
in this scoring system that are too

subtle for humans to detect.

So doctors enter these
different values,

and then they would click send,
and in under a second,

the service is able to respond

as to whether it thinks
it's cancerous or not,

and so this particular mass
would be cancerous.

Wow! That's gobsmacking.
I mean, absolutely gobsmacking!

I feel like I've had a glimpse
of the future -

a sense of the great prizes we might

find in the huge volumes of data

that monitoring our bodies
can give us.

I've come back to the UK...

..and to the information that could
change our lives today.

'Three weeks ago, I began
an experiment in self-monitoring.'

Hello! Hi, Kevin. Hi!

'Celia, Cathy, Pam, and I wanted to
see if anyone could get healthier,

'lose weight, or find out how
to sleep better.

'Now it's time to see
if anything has changed.'

And what have you found out
about us then?

Well, quite a few interesting
things.

I know when everyone goes to bed,
when everyone wakes up,

where they go every day, erm...

how much sleep they get,
how much deep sleep -

pretty much everything.

And, in fact, Kevin, you had the
lowest average sleep of everyone.

I think it must be medical training
that did that.

So, my average sleep was
what sort of hours?

About 6.7 hours a night.

It's well below what people
generally believe is normal.

And, Cathy, you were the most
consistent of all because,

as you can see, you were just under
eight hours.

You're about 7.8 every night.

And Pam had the highest average.
You have over eight hours a night,

and that is fairly consistent.

I think I'm sleeping better
than I used to.

My sleep pattern was really,
really bad.

And I do think I have slept better
with the extra exercise.

The peaks on Pam's sleep graphs
tell us

when she was awake
or sleeping lightly.

The troughs show
when she was sleeping deeply.

With graphs from every night,

there's the potential to find out
how to sleep better.

It was saying that I was having
about an hour of deep sleep

and I found that slightly concerning
because I'm wondering

whether I need more deep sleep
than just that short amount.

You may only need an hour of deep
sleep to feel good.

You've got to know what's normal for
you, and what affects your sleep.

So did you find anything
affected your sleep?

Well, there was two nights this week
when I had one glass of red wine.

Now, I try not to drink during
the week, but up until that point,

I'd been having round about
the hour of deep sleep in a night.

On those two nights, my deep sleep
went down to 36 minutes

on one night,
and 34 minutes on another.

Perhaps red wine and me don't mix
for my deep sleep.

I realised that
even if I have a decaf coffee,

which I used to have about 9ish,
I have a bad sleep,

so I've knocked that on the head
completely now.

That's one of the incredible
benefits of self-monitoring -

it allows us to learn things
about ourselves

and change our behaviour
for the better.

So did it make a difference
to our fitness or even our weight?

So we've got
the daily step count total.

Everyone started coalescing,
actually,

around a 10,000 step average per day,

which is what the general guideline
is to keep active,

especially for people
in sedentary jobs like us.

This three weeks has been quite
a revelation for me.

Cos I went out consciously
most days to do extra steps.

You sort of get in this
you can't stop

until you've reached
that magic 10,000.

In a way it's a bit crazy.

And, Celia, did you ever get
to the point of madness
with any of this stuff?

I had got to the point where I would
set myself a goal for the day

and, if I hadn't met it, then
I did end up running on the spot

as I was watching television, or
just trying to get those steps up.

Do you think you've seen
improvements in your health

other than just doing
a whole bunch of steps?

We've all lost weight doing the
challenge so that's a good thing.

I lost about four pounds.

I lost four and a half, so...

I lost two and a half
so the extra exercise does pay off.

I did very little before.

I'd sit at my desk all day
in front of a computer,

I didn't walk the dog that often.

Now I go home from work
and I'm out there walking the dog.

Same as Pam. We're going out
for walks, I'm going out for walks
in the evening.

So I am... I have changed
and I will continue.

It's interesting that Cathy, Celia

and Pam all in their own way managed
to change their behaviour.

They all increased the amount
of activity they did.

And that's more than a bit of fun,
that's important

because, in medicine, if you could
prescribe one thing

that would improve
everybody's health,

then that thing would be exercise.

Exercise improves your physiology
in ways that doctors

and pills alone never could.

And so that's what even those simple
devices have managed to achieve -

they've managed to help people
change their behaviour in ways

that were otherwise
impossible before.

Today we all have the capacity
to monitor our health.

The devices we carry already do it
without us even noticing.

And in the data that we gather
lies great opportunity.

But ultimately, it's what we choose
to do with that information

that will make all the difference.

We stand early
in the 21st century,

looking for the things that will
transform medicine in the same way

that antibiotics and vaccinations
did at the start of the 20th.

But I've become convinced
over the last few weeks,

through everything I've seen,

that this digital revolution
really might achieve that.

By giving us access to information
that we never before had,

by helping us understand our bodies

and the consequences of the things
we do in our lives,

I really do think that this might be
the key to longer, healthier lives.

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