The future of Health Monitoring is already here but we just use it to make animals run faster

Aidan OBrien

Unfortunately most of the monitoring applications I’ve been involved with over the last 30 years (I was using wearable sensors to monitor racing animals long before I went to medical school) remain largely confidential but I think this Irish Times insider tour of Aidan O’Brien’s world beating Tipperary stud farm and training grounds reveals interesting insights worth sharing with healthcare providers who still think remote monitoring just means they have to carry a pager.

Joseph, her eldest son and Ballydoyle’s lead jockey, strolls past. At six feet tall, he doesn’t look like a typical rider. “I was told all jockeys were tiny,” I say. He’s clearly heard this before. “Who told you that?” he says with a shake of his head. Truth is, jockeys don’t have to be small, they just have to be light. And a six footer keeping his weight under nine stone takes a whole lot more discipline than it does if they’re eight inches shorter

Building a diet app/service? Follow the world’s top jockeys on Twitter and study the discipline techniques they’re using.

Today FM’s breakfast show booms from speakers hanging from the barn walls. I ask Annemarie if the jockeys like the radio. “It’s not for them, it’s for the horses. When they hear it in the morning, they know it’s time to work. Then at around 12.30pm they’ll have lunch and the radio goes off and they’ll know it’s time to rest”

Contrast this with the healthcare industry that let’s companies with vested interests publish scientific papers trying to prove the value of music/sleep/lighting, where Hospital wards are lit with fluorescent tubes and ring with alarm bells and where insurance companies refuse to even cover the costs of hearing aids.

In silence, we watch his horses circling. “They’re really relaxed right now,” he says. “But if something small changes, even a coat being hung in a different place, that can unsettle them.”

Visit any operating room, imaging suite or Patient ward and count the completely unnecessary distractions that no one is except the Patient is bothered about enough to have applied thoughtful design.

O’Brien stands in the centre of the barn, like the conductor of an equine orchestra, staring intently at his passing charges. He’s gauging their moods, making sure everything’s okay. He’s joined by Tom Curtis, who keeps a close eye on the horses’ vital signs using heart rate monitors strapped to their chests. He’s checking heart consistency and recovery rates. He tells me a horse’s heart can reach 220 beats per minute when they’re at full tilt, falling to just 30 at rest. But the monitors don’t just tell Curtis how fast a horse’s heart is beating. They tell him what they’re thinking too.

Clearly they should be using AlivecorVet ECGs as then they won’t have the distraction of the straps (not only will these discrete devices give them more than just rate monitoring but they are so small and accurate they can be concealed within a sewn fold in a saddle cloth) but contrast this with your average Hospital ward where no one has any idea about any of the Patients heart rates (or the rates of the stressed out staff who are ticking boxes on clipboards to make it look like there are quality controls and pulling their backs lugging about bundles of paper folders containing reams of data they haven’t a hope of processing).

My face tells him what I’m thinking. Before I can verbalise my question, he answers it. Horses are so sensitive to their surroundings and Curtis so tuned in to their sensitivities that if a horse is paired with a new jockey or is having a bad day for some other reason, the subtle shift in its heart rhythms will alert him

I wonder if it might just be this incredible sensitivity that’s holding back the adoption of tech like that you see being used in Apple TV commercials from becoming adopted for use by the racing industry regulators? What chance would illegal drug users have of fixing racing results if horses were required to wear a continuous ECG monitor for the 24hrs before they were allowed to race?

Riding parallel, 10ft from to the track, we quickly reach 60km an hour. He points to the lead horse. “He’s lazy,” he says. But we’re going at a fair old clip, I say. “Ah but look at his ears. They’re straight up. If he was pushing himself they’d be flat back

Check the screen on the iPad and you’ll see his ECG also looks very different 😉

Travelling so close to racehorses as they’re put through their paces is exhilarating. They’re magnificent. As the session reaches its climax both horses – even the “lazy” fella – do their best to finish first. Their intense concentration is matched by the determination of the jockeys. O’Brien says nothing. He just drives alongside, watching every muscle and sinew move. All sessions are taped and jockeys’ thoughts recorded as they dismount. The attention to detail is extraordinary

Healthcare Journalists get breathless when a surgeon writes about using age old checklists so one wonders what it will take before it becomes standard practice for Surgeons to document their post op feelings like Ballydoyle Jockeys document their rides?

Aiden O’Brien should be lecturing at theThe Royal College of Surgeons!

O’Brien discusses horse psychology. “When you think something, they feel it. They’re remarkable. They feel everything. You can see the disappointment in their faces when they lose or when something’s not right. You’d pull a horse out of a race if his mood wasn’t right.”

Without the ability to talk it’s impossible for Veterinarians to do their work without first appreciating the personal context of their Patients but imagine if a horse could talk: in all seriousness how long do you think it would be before we interrupted them?

We pass a colt having his morning shower. “See how happy he is,” O’Brien says with a smile. “You can tell straight away if a horse is feeling down. He’s not feeling down

As we’ve seen with Olympic medal winning teams, data acquired through the use of low cost highly accurate mHealth monitoring tech you can buy in an Apple Store is giving data scientists innate reading skills close/equivalent to those of the world’s best trainers who have committed their lives to making emotional connections. These are not binary options – can you imagine the potential to improve care processes as we can increasingly mix the two skill sets?

We pass the horses and jockeys we met earlier in the barn. They’re lounging in the sun, some rolling around like puppies with their legs in the air – the horses not the jockeys, the jockeys are way too focussed on watching their charges for such merriment. “They’re relieving some stress,” O’Brien says. He points to Gleneagles. He’s the only one with his bridle removed. “He likes it taken off as soon as he’s finished his work. It was Joseph who realised that. None of the other horses want their bridle off. It’s strange but that’s the way he likes it. If we thought he liked being put in that tree over there, we’d do it – whatever they want, they get

This is also why you’ll see gorgeous little ponies flying around the world in incredibly expensive luxury suites on Jumbo Jets as companions for race horses. Compare this to how humans suffer with rigid prescribed visiting hour rules when being ‘cared’ for in our hospitals…

Annemarie takes me to the horse spa. The treadmill and swimming pool are here, as well as a cold salt water tank. There’s a sauna and a solarium with heated lamps. Recent additions include a vibrating plate to get horses’ legs warmed ahead of their go on a new underwater treadmill. “When you’re walking in water, you have to walk properly,” says Eamonn Kavanagh, who travelled from Ireland to Germany and then Kentucky on behalf of O’Brien to assess options before having a bespoke piece of kit built. “You can’t be slacking off in the water. The horses love it. And it is of great benefit, both mentally and physically. It is a great low impact, high resistance work out,” he says

Compare this to the rehab facilities in your typical hospital (which often amount to little more than an afterthought) and get in touch if you’d like to get a look at the real time biofeedback controlled aqua treadmill we helped to develop:

Alivecor on Racing Greyhound

Annemarie walks me back to the house. The family have been here for 20 years. Does she see herself here 20 years from now? “We would like to think so, but who knows? No one is indispensable. It’s like any other sport. You’re only as good as what you’re doing this minute

This is how a real data scientist approaches the future. This is precisely why I think we need to have healthcare interactions comprehensively documented (in ways similar to how the Horse Racing industry has comprehensively documented and made available all results and histories) because once we have this we can start paying attention and stop fuelling the exponential growth of bad medicine.

Next time you’re watching the races check out the transport lorries with the bubbles on the top (they’re satellites used to add data comms in remote/rural areas) and compare that to your local hospital with it’s acres of 3G/Wifi network dead spots.

Want to learn more? Click here to find out how you can get involved in the mHealth Tour we’ll be hosting to coincide with the huge WebSummit event in Dublin (which will for 2015 also feature Data Science & Sport Summits).


*** UPDATE 12 October 2017 ***

Register to attend the HorseTech Conference (produced by the author of the mHealth Insight blog- 3G Doctor’s coFounder David Doherty) being held next week at the Royal Veterinary College in Central London (accessible via a free livestream) to learn more about this exciting translational medicine opportunity.

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About David Doherty
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