Health and computers. (includes related articles )
by Gregg Keizer, Peter Scisco, Robert Bixby, Jill Champion, Alan Bechtold
Is a computer your best friend and personal trainer? Or is it a potentially dangerous appliance? Can the PC help the disabled leave more normal lives? Or is it a powerful tool in the hands of medical professionals? The answers are Yes, Yes, Yes, and Yes.
A personal computer much like the machine sitting on your desk can be everything from a coach to a diagnostician. And it helps enable the disabled.
On the downside, your computer's monitor showers you with extremely low frequency (ELF) and very low frequency (VLF) radiation every minute you use it. And, unless your workspace is ergonomically designed, your keyboard may be dooming you to chronic, painful repetitive strain injury.
Your PC has its own health to worry about, too. Viruses can strike at a PC's heart and soul--its hard disk drive--and cripple the machine as effectively as a fly virus lays you low.
As they say, if you have your health, you have everything. The PC, the household tool of the 1990s, can help to ensure that you keep your health--your everything.
Eat Right, Lose Weight, Stay Fit
Your PC can't do it alone. Before it can help you get a grip on your diet, before it can tell you how healthy (or unhealthy) certain foods are, and before it can motivate you to exercise, you have to give it the right software.
Several comprehensive nutrition and diet programs let you record what you've eaten and see exactly what nutrients make up each food. They'll even note your physical activities. Most are flexible enough to let you enter new foods and play what-if games with your diet and exercise. Noteworthy software in that category ranges from the graphical DINE Windows to the more traditional Food Processor II. Some products treat your diet as the key to good health, monitoring not entirely for the sake of weight loss, but for nutritional content. Parsons Technology's Diet Analyst checks your food intake for deficiencies in vitamins and other nutrients. Diet Analyst can also help you track caloric intake, but its principal claim is health maintenance rather than weight loss. If your diet is intended to maintain weight or is a reduced-sodium, -sugar, or -cholesterol diet, Diet Wise/Energy Wise from Nutritional Data Resources not only assists you via your computer but also provides toll-free access to a registered dietitian.
Your computer can't nag you to get up in the morning for you daily run or swim, but it can motivate you by tracking your progress. A small amount of software is available to help you develop daily exercise plans, while logging your workouts. Fitness Profile, an expensive package, scores your current fitness from several tests, many of which you can do at home or at the local club. Personal Fitness Planner designs a daily activity and eating plan and then lets you record activities to show how you're doing.
Software can also turn your PC into a rudimentary self-diagnostic tool. Packages like Family Medical Adviser and Home Doctor consider symptoms, ask questions, and let you narrow down the possibilities for personal and family illnesses. They can't replace a doctor's expertise, of course (export system software isn't at that stage yet), but they can help answer questions about simple ailments.
If you go to the trouble to look for it, you can find specialized software on almost any health topic imaginable. Want information about AIDS? Understanding AIDS takes you through an interactive lesson on the disease, from its history to its symptoms and prevention. Birds 'N Bees for 7-12 Years Old explains sex and reproduction in a clear and simple fashion to youngsters, and it even lets you customize the content as well as direct it for your child's age and sex.
The Doctor Is Always In
Transform your PC into a fascinating medical- and health-information terminal with a phone line, a modem, and access to one of the online services. Connect to CompuServe, for instance, and you can peruse medical journals, order prescription drugs, and even chat with others about anything from exercise to cancer treatments.
Although other online services offer health information, none of them match CompuServe. If you call on Health Database Plus, for instance, you can retrieve complete articles from general-interest publications like American Health, Hippocrates, Runner's World, and Psychology Today. If you want to keep up with breaking medical news, you can pull down short summaries of articles from prestigious journals such as the New England Journal of Medicine, the British Medical Journal, and the American Journal of Medicine.
Want specific information about the medication your family doctor has prescribed? Then go to HealthNet, an online medical reference library. You can consult it at any hour of any day to learn about symptoms, diseases and disorders, home health care, drugs, and more. If your child's doctor prescribes Amoxil to fight an infection, for instance, you can quickly find out how it works, what it's best used for, its side effects, and even its wholesale cost.
CompuServe also includes Court Pharmacy, an online drugstore that fills prescriptions. The doctor's prescription must be mailed to the pharmacy, so it's best for maintenance medications, not drugs you need immediately. Court is an interesting and price-competitive alternative to your local pharmacy and may be especially attractive to the homebound or those living in remote rural areas.
But perhaps the most impressive way online services like CompuServe help your health is through their forums. Forums gather together people with common interests, allowing them to talk electronically about their illnesses, share their experiences, and offer support and advice.
Your PC is no replacement for an intelligent, caring medical professional, but it can certainly put a wealth of information at your fingertips.
PCs for the Pros
Personal computers do more for health care than just make out the bills and keep track of a doctor's schedule. Although they may be ever present in the office, handling the same sorts of chores as in any business, PCs may actually be making a bigger and better contribution to medicine long before an M.D. goes into practice.
At the Louisiana State University Medical Center in Shreveport, Louisiana, PCs are a prominent part of the library. Linked in networks, they connect to any number of online medical databases, including the publication listing of MedLine. Medical students can scan recent journals, pulling down abstracts of articles from the screen. Interlibrary and interregional loan programs ensure that hardcopy gets to students quickly. Teaching faculty and physicians link up from the PCs in their offices via the network or modems.
Off to the side, PCs drive an interactive videodisc lab. IBM PS/2s control laser disc players to simulate medical emergencies and put prospective doctors under pressure. A station, the videodisc shows a shotgun victim arriving at a hospital's ER. By pressing a touchscreen on the PC's monitor, users call for examinations, order medications and fluids for the patient, and review vital statistics like blood pressure, respiration, and heartbeat. Choices determine the wounded man's condition. A wrong diagnosis at the PC can kill the patient a moment of hesitation can waste what little time the victim has left.
"Hospitals are leery of letting students practice on people," says Bonnie Sellig, the library's assistant director. Instead, computer-assisted instruction lets rookie doctors try treatments and immediately see the outcome just as a student pilot uses a simulator before climbing into the cockpit. "Computer technology is the very beginning level of medical training," Sellig says.
But medicine holds even more hope for the PC. Sellig spells out a not-too-distant future in which doctors use an integrated system to pull up all the records of a patient; see the treatments, diagnosis, and medications given; and then review current literature to ensure that everything possible has been done. "Doctors are going to have to be knowledgeable about computers," Sellig asserts. "[Computers are] going to be part of their life from now on.
Linked with other commonplace technologies--the facsimile machine and the CD-ROM drive--PCs already send copies of crucial medical articles to doctors in rural areas and provide entire textbooks on disk. In the years ahead lie simpler point-and-click software and even voice-activated computers. "It's just a matter of keeping up," says Sellig. "And computers are what's doing it for us."
Talk It Up
The PC may play surrogate physician or help diagnose common illnesses, but these contributions pale nearly to insignificance in comparison with its impact on the handicapped. Computers, including heavily modified laptops, are providing the power and freedom of communication to people who can't speak.
Sitting in a wheelchair, a quadriplegic man watches the laptop's LCD screen. Using specialized software, he writes, not by pressing keys, but by almost imperceptibly moving an eyelid. A flat sensor attached to his muscles reads the movement, and as a bright cursor scans across a graphic of the keyboard, it stops momentarily to enter a letter. Tedious? Not really, since the word processor leaps to conclusions and offers a list of words it thinks should come next. A single flick of the eyelid, and the word pops up on the screen. The program can even be trained to remember the user's most-used words.
Laptop speech add-ons like DecTalk put natural-sounding voices on chips inside the PC, letting the computer speak--even sing--for those who can't. Quick-response software like Talking Screen and E-Z Keys from Words + let the disabled "talk" much faster and more normally. Drawing programs provide a creative outlet and can be manipulated on the portable computer when switches are pressed, sipped, or squeezed.
All this technology doesn't come cheap--customized laptops run $5,000 and up. But they're portable, they have legible screens, and they can carry on conversations for as long as two hours between battery changes.
Advanced technologies like voice recognition and virtual reality combime to show the future of computerized aides for the handicapped. At Pacific Gas & Electric, Bill yee, a senior programming analyst, works with a robotic assistant. Yee, a quadriplegic, talks, and the robotic arm responds, bringing reams of computer printouts to his side, turning pages on command, and tearing sheets off the printer as he programs and debugs software. It performs the functions of a human assistant but does it more economically. The robot will pay for itself in less than two years.
Virtual reality--creating artificial environments inside the PC that can be experienced like a sketchy version of the real world--also promises much for the handicapped. Connected to a powerful PC in the not-too-distant future, people bound to wheelchairs will be able to "walk" through computer-made worlds, "run" for an imaginary touchdown, or simply free themselves from the constraints of their afflictions.
Imagine how motivated you'd be to eat right and keep fit if it meant your job. Think how you'd watch what you eat if when you arrived at the office each day, you were paid by how quickly you charged through the halls or by how many chairs you could knock out of the way.
San Francisco 49er football players like everyone else in professional sports, are constantly judged on how well they perform, how often they win. It's no surprise, then, that Jerry Attaway the 49ers strength and conditioning coach, uses PCs to help players manage their diets and calculate their conditioning.
Attaway has calibrated the ergometers on the exercise bicycles and combined them with a custom PC program that tells his charges how long they've got to pump the pedals to consume a set number of calories. "It really hits home that way," Attaway says, "about how much work is involved to burn off the calories in a food."
But it's in nutrition that he excels. Using program called Nutritional Analysis, Attaway tries to get professional athletes to change their eating habits. He's really trying to change their lifestyles. "There's only one or two guys on the team with a weight problem," he says. "I'm trying to get everyone to eat for their performance. I sit down and explain some physiological principle and, with the computer, show them what they normally eat, then do what-ifs on the bottom line--the calories. They go, 'Oh, yeah, I can do that,' or 'Coach, what if I do this?' The computer gives us all sorts of options."
Calculating a nutritional plan used to take Attaway half a day, and then it wouldn't be quite correct. Now it takes only ten minutes to make them do it," he says. "They see the numbers, and it's a way of teaching them how to enhance their performance or reduce the risk of heart disease or even certain kinds of cancer."
The 49ers also use PCs to log injuries and treatments, whether that means ice on an ankle or a session in the whirlpool. Everything goes into a player's file at the end of the season--missed practices, missed games due to injuries--and is reviewed by the organization. That PC use probably makes some players nervous. "Pro football players don't like to keep records," laughs Attaway. "You can't let the paranoia take over. If you don't win, they're going to fire all of us anyway. You just do the best you can."
Warning: Computer in Use
Your PC may pose a potential threat to your health. Surprised?
Monitors are the prime suspect. They emit electromagnetic radiation at VLF and ELF levels. Although studies are far from conclusive, many researchers warn of possible health risks associated with high electromagnetic radiation levels, including miscarriages and cancer. San Francisco, the first American city to regulate working conditions at computer monitors and terminals, has even established a Video Display Terminal Advisory Committee to report on, among other things, electromagnetic fields.
You can reduce the risk simply and inexpensively. Don't crowd your screen: Radiation levels drop sharply two to four feet from the monitor. Turn off any monitor you're not using, as well as laser printers and copiers, because they also throw out large electromagnetic fields. And if you have several computers in your home office, position them so that the monitors' sides and backs don't face your work space: Radiation levels are typically weakest from the front.
More costly solutions range from antiradiation screens to low-radiation monitors. For $139 you can buy NoRad's screen, which, according to the company, stops 99 percent of the electric radiation at VLF and ELF levels. Low-radiation monitors are pricey but available from major manufacturers like NEC, Sigma, and Qume. They block electromagnetic radiation, but only at VLF levels. Or you may want to switch to an LCD monitor, like those on laptops. LCD screens emit negligible radiation. Safe Computing makes desktop-sized LCD screens, but the cost--$2,495 for a backlit VGA model--is prohibitive to all but the wealthiest home computer users.
The catalog of less threatening, but still harmful, effects includes everything from headaches and eyestrain to backaches and carpal tunnel syndrome, a persistent pain in the wrist. Tired muscles and eyes can be relieved by wrist support pads at the keyboard, an adjustable chair, and properly positioned lighting to reduce glare on the screen. Headaches can be combated by taking breaks from the computer.
Heal Your PC
Unaccountable system crashes. Extraordinarily long times to load programs. Corrupted (and crucial) files. Sound familiar? If so, your PC may be the sickest thing in your house.
A PC can succumb to illnesses, too. Some ailments come from carelessness or unforeseen events, like using out-of-date printer drivers or electrical blackouts. Others are harder to diagnose and treat, like incompatible software or a damaged hard disk drive. But nothing comes close to a computer virus for sheer terror.
Viruses, those small bits of computer code maliciously placed inside innocent software carriers, can rob you of valuable data or make your PC virtually unusable. Where you pick up a virus--from public domain software, from a program you eagerly "borrowed," or in some limited cases, even from commercial software--is almost beside the point. Once your PC has a virus, once your PC starts acting strangely and unpredictably, it may already be too late. Fortunately, several good detection programs can spot and eliminate viruses before they have a chance to lay your PC low.
One capable package is Virex-PC. This three-program combination scans your disk, checking each file for 137 different virus strains. It also constantly watches over your computer and alerts you when potential viral activity is detected. And it eradicates some (though not all) of the viruses it finds. You pay a price for this protection--Virex-PC consumes 31K of precious RAM.
Norton AntiVirus is a slightly more expensive virus-protection package. AntiVirus identifies 142 strains and uses three methods to detect viruses: It watches each disk read, scans memory for viruses, and scans disks for suspicious strings of characters that may mark a virus. Once AntiVirus spots a virus, it tries to destroy it and repair the damage done.
Actually, viruses are rare. That's why you may want to use Scan and save yourself the RAM used by programs like Virex and AntiVirus. Scan and its companion, Clean-Up, don't constantly watch for viruses. Instead, you run Scan if you suspect your PC has caught a bug and then run Clean-Up to mend any faulty files. The combination takes care of most viral infections and damage, but if you don't remember to regularly check your PC, it could become irreversibly infected before you notice.
Another option is ViruCide from Parsons Technology. It should be run regularly for file maintenance, like Scan. It removes viruses and repairs files wherever possible. As a premium, Parsons provides a book about computer viruses so you will know what you are up against.
Prevention is the key to computer health.
Only the Beginning
Crude. That's the current state of health computing. In ten years, or even in five, what you'll be able to do with your household PC will make today's possibilities seem laughable.
As the information revolution continues to hit home, you'll be able to contact your family doctor electronically to book appointments and ask simple questions. You'll be able to keep up with groundbreaking medical research by going online and reading clips your computer has collected for you from professional journals and consumer magazines. Your doctor will send prescriptions to the pharmacy via computer, and you'll file claims to your medical insurance company the same way. The PC will monitor your wellness, reminding you of immunizations for the kids and watching your blood pressue and cholesterol through the add-on diagnostic tools you'll connect to it. It will become an invaluable adjunct to your health.
Your home PC is a good health tool now. Someday it'll be great.