Harnessing the power of feedback loops

I enjoyed Thomas Goetz's article in the June issue of Wired about companies who are designing technologies that incorporate feedback loops to change human behavior. The two most interesting companies that Thomas wrote about are Vitality and GreenGoose.

Vitality makes a cap for prescription pill bottles called the GlowCap:

The device is simple. When a patient is prescribed a medication, a physician or pharmacy provides a GlowCap to go on top of the pill bottle, replacing the standard childproof cap. The GlowCap, which comes with a plug-in unit that Rose calls a night-light, connects to a database that knows the patient’s particular dosage directions—say, two pills twice a day, at 8 am and 8 pm. When 8 am rolls around, the GlowCap and the night-light start to pulse with a gentle orange light. A few minutes later, if the pill bottle isn’t opened, the light pulses a little more urgently. A few minutes more and the device begins to play a melody—not an annoying buzz or alarm. Finally, if more time elapses (the intervals are adjustable), the patient receives a text message or a recorded phone call reminding them to pop the GlowCap. The overall effect is a persistent feedback loop urging patients to take their meds.

These nudges have proven to be remarkably effective. In 2010, Partners HealthCare and Harvard Medical School conducted a study that gave GlowCaps to 140 patients on hypertension medications; a control group received nonactivated GlowCap bottles. After three months, adherence in the control group had declined to less than 50 percent, the same dismal rate observed in countless other studies. But patients using GlowCaps did remarkably better: More than 80 percent of them took their pills, a rate that lasted for the duration of the six-month study.

GreenGoose is making sensors that turn boring daily chores into a game:

The GreenGoose concept starts with a sheet of stickers, each containing an accelerometer labeled with a cartoon icon of a familiar household object—a refrigerator handle, a water bottle, a toothbrush, a yard rake. But the secret to GreenGoose isn’t the accelerometer; that’s a less-than-a-dollar commodity. The key is the algorithm that Krejcarek’s team has coded into the chip next to the accelerometer that recognizes a particular pattern of movement. For a toothbrush, it’s a rapid back-and-forth that indicates somebody is brushing their teeth. For a water bottle, it’s a simple up-and-down that correlates with somebody taking a sip. And so on. In essence, GreenGoose uses sensors to spray feedback loops like atomized perfume throughout our daily life—in our homes, our vehicles, our backyards. “Sensors are these little eyes and ears on whatever we do and how we do it,” Krejcarek says. “If a behavior has a pattern, if we can calculate a desired duration and intensity, we can create a system that rewards that behavior and encourages more of it.” Thus the first component of a feedback loop: data gathering.

Then comes the second step: relevance. GreenGoose converts the data into points, with a certain amount of action translating into a certain number of points, say 30 seconds of teeth brushing for two points. And here Krejcarek gets noticeably excited. “The points can be used in games on our website,” he says. “Think FarmVille but with live data.”

A fascinating read. I hope Thomas writes a book about feedback loops.

Harnessing the Power of Feedback Loops

• [Thylacinthine]

  I don’t want something monitoring how often I drink from my water bottle (or stupid points, either! what is this, sticker charts for grown ups?), and I really don’t want it nagging me, either. I like my inanimate objects quiet, and servile. I’m looking at you, microwave. Stop telling me to enjoy my food!

• [Anonymous]

  The full article is thoroughly satisfying. The behavioral approach is so well established it’s fun to think of it in shades of new technologies.

• [Jerril]

  The last couple of years make me feel like I’m watching the first baby steps towards practical, real-world applications of smart packaging and augmented reality.

• [Anonymous]

  “Think FarmVille but with live data.”

  Wait, that’s supposed to be a positive side of this tech? Yikes.

• [hideousmonster]

  I would like to see how the general health of the participants was affected in the study. It showed how the glowcaps affected the participants likelihood of taking their medication, but pharmaceudical drugs have side effects. I want to see if the health of the participants without active glowcaps improved more or less than ththe health of those with activve glowcaps.

• [Anonymous]

  Interesting idea, but the examples they cited in the article seem like they wouldn’t be useful for most people.

  • [Susan Oliver]

    Taking meds as prescribed isn’t useful? Toothbrushing isn’t useful?

    The fact is that many if not most of us don’t take our meds as prescribed or brush our teeth for a full 2 minutes, not to mention flossing. Even if the only positive feedback that’s given is mere recognition of my completion of the task, that’s still enough for say, millions of users on HealthMonth.

• [Anonymous]

  Made me think of this:
  http://www.smbc-comics.com/index.php?db=comics&id=2286#comic

• [Anonymous]

  Methinks I’ve seen something quite similar to this glowcap before (more like a glow bottom…but still):
  http://grouplab.cpsc.ucalgary.ca/grouplab/uploads/Publications/Publications/2004-Pillbottle.UBICOMP.pdf

• [Art Carnage]

  These are NOT examples of feedback loops. These are just one-way notifications. Authors shouldn’t use terms they don’t understand.

  Want a very simply example of an actual feedback loop? Get a yard (or meter) stick. The task is to find the middle, with your eyes closed. Stick out your index fingers of each hand, hold your arms apart, and balance the stick between your fingers. Close your eyes, and *slowly* bring your fingers together. When they meet, you will be very close, if not dead-on, to the middle of the stick. How is this a feedback loop? Both fingers are supporting the weight of the stick. If one finger gets closer to the middle than the other one, it’s supporting more weight. This increases the friction between that finger and the stick, causing it to slow down, which allows the other finger to catch up. The natural forces of friction and gravity cause a true feedback loop which continually modifies the fingers’ movements, causing them to meet in the middle. This works even if the fingers start at different distances from the ends.

• [Daemon]

  One step closer to the eventual skinner-box-ification of our entire lives!

  Seriously though, this should be very handy for those who have memory issues or the like.

• [Anonymous]

  People! This isn’t something that you will be forced to use at gunpoint. If you know you should drink more water but have had a hard time actually getting yourself to do it, here’s a gadget you can use to motivate yourself. If you always flake out on taking your meds and it is really important you do (say mental health patients with severe disorders…) there’s a gadget to help you remember. The comic someone posted assumes we are all slaves to points on a game, I think people would choose to use these to make improvements in their own behavior to be healthier, but would always have the option of using our current methods such as setting a timer on your phone to go off, tying a string around your finger, etc. So chill out, this is just another option, not a mandate. Anyone have an elderly relative who forgets to take their meds or brush their teeth? This can improve their quality of life, or they could use another method. It is a choice. Choices are good.

• [FreakCitySF]

  I usually speed up on the radar equipped speed reminders. It’s like the strongman game at the carnival.

• [Ugly Canuck]

  And how to power these networks of sensors?

  Perhaps like this:

  http://esciencenews.com/articles/2011/07/07/device.captures.ambient.electromagnetic.energy.drive.small.electronic.devices

• [Anonymous]

  Spooky, imagine stuxnet embedded in that cap, and granpa goes OD.

• [Anonymous]

  GlowCap sounds useful, but less some sort of special feedback loop, and more the mundane kind called a reminder.

• [Anonymous]

  Does no-one else find this a bit of step too far towards substituting (or excusing) our own ability to think?

  I appreciate it for medicines, where some of the users may be older, and more inclined to forget (and where the act of forgetting could have more serious consequences). But for toothbrushes?

  It all smacks of Idiocracy to me.

• [HahTse]

  Doesn’t anybody else find this scary?

  I don’t want my medicine usage to be shouted around in a wireless network, much less the internet or to a third party company (somebody has to compile these charts).
  And I don’t want my home appliances calling out to a third party so that I can get points that I can play their games with…think of how much personal data could be collected that way, data that accurately describes your every habit.

• [Gulliver]

  Cigarette: You’re killing yourself! You’re killing yourself!

  Cigarette with biometric proximity sensor: You’re killing other people! You’re killing other people!

  Cigarette with family mode: You’re killing your children! You’re killing you’re children!

• [Antinous / Moderator]

  Vicodin users rarely have the problem of forgetting a dose. (Drums fingers on desk, stares at clock.)

  But seriously, if you take meds regularly, you can take something and literally one minute later have no idea if you took it or not.

  • [HahTse]

    Yeah, I know – I have the very same problem. I don’t have anything against the thing reminding me (I have an alarm set for that atm), but everything against it sending my data over the internet.

  • [CH]

    “But seriously, if you take meds regularly, you can take something and literally one minute later have no idea if you took it or not.”
    Oh, yes… me and my memory were separated at birth, so I had to buy a pill dosette box at the ripe age of 41, because I had absolutely no idea what so ever if I had taken my meds or not. Combine that with an alarm (I call mine Husband) and I’m all good to go.

    Dunno… positive reinforcement is good, but… um… not like that. And yeah… feedback loop it is not! Yes, nerdrage, but darn it!

• [Tau’ma]

  ♫ Country Feedback ♫

• [turn_self_off]

  annoying valley girl being annoying…

• [Jack Daniel]

  I can’t wait to get an angry phone call from the mayonaise jar in the fridge thats about to expire.

  Our grandkids are gonna think we grew up with dinosaurs.