Plug Me In, Nurse
Biometric integrations into car control systems offer nearfield safety enhancements long before autonomous cars are capable of saving us
While the debate rages about autonomy’s state of readiness - now or in the immediate future - there are real and present contributions pre-L3 autonomous vehicle solutions or even enhanced ADAS functionality could make to advancing the cause of road safety.
The scope for biometric integration into vehicle control systems presents relatively unexplored opportunities, perhaps because mobility technologists are not paying heed to the quantum steps being taken next door in the neighbouring medtech sector. They should meet for a coffee and have a chat.
Over the fence in medtech land, a growing cohort of DIY evangelists (of which I am a member) are specifying and creating their own treatment solutions for a variety of chronic illnesses. Frustrated by the lack of progress made by the global pharmas, who seem hidebound by FDA regulations or vested interests in maintaining the status quo, type 1 diabetics are at the vanguard of this new wave of kitchen table medtech. The #WeAreNotWaiting campaign has grown into a global movement that embraces commodity tech to build smartphone-resident algorithms that intelligently manage insulin dosing.
The #WeAreNotWaiting movement now accounts a few thousand diabetic hackers in the US and a growing number in Europe who use open source ‘looping’ algorithms built in a developer app that controls a spoofed insulin pump using a homemade Bluetooth/radio frequency bridge. The testimony from diabetics who have adopted the system are nothing short of staggering, catapulting diabetic management — and with it, the health prognosis of those that suffer from the condition — out of the dark ages from where it has been since the discovery of insulin in 1921. (Read more about looping here)
What relevance has this to cars? Well, until personal mobility is universally driverless, the liabilities associated with drivers with a spectrum of medical conditions are one of a series of externalities we seem prepared to accept when we are behind the wheel. And this in spite of the fact that the technical wherewithal to fix this is already here.
Having been a diabetic, a driver and a competition licence holder for over three decades, managing my capacity to drive with careful blood sugar control has been an over-riding priority. But prior to today’s technology that provides me with a sensor that samples my interstitial blood sugar in real-time and reporting these metrics on my wrist, on my phone, to my family members and anyone else that takes an interest, I had only time-consuming and clunky recourse to knowing the status of my blood sugars before setting off on a journey.
And before all of this new tech was mine, I suffered a profound hypoglycaemic incident at the wheel. I had been swimming and spent time in the steam room in the gym, so I had likely depleted my blood sugar levels with exercise together with the double-whammy of accelerating my metabolism in the exaggerated warmth of the steam room.
Much like the loss of mental faculty when intoxicated, by the time I was hypoglycaemic from the effects of my visit to the gym, I had completely lost the decision-making capacity to rule myself out of driving. So I climbed in the car with my young son in the passenger seat and barely conscious, tried to make my way home.
Now at this interval, I do want to make one thing clear. Anyone who suffers an aortic embolism at the wheel, endures a heart attack or an episode of tachyarrhythmia, is struck down with a stroke or finds themselves hypoglycaemic when driving is not culpable. Indeed, in many instances, people may not even be aware of underlying health conditions when a disabling emergency condition strikes. So while a diabetic in a hypoglycaemic state suffers many of the cognitive impairments of a drunk (and I might add, far less pleasant symptoms), that’s where the parallels end.
On the way home from the gym, I drove for almost seven miles before slumping unconscious behind the wheel and coming to rest in a McDonalds car park. Although my son was unhurt, the damage to his trust in his father took some while to repair, unlike the delivery-mileage E class Mercedes that went straight off to the breaker’s yard.
About a week after being discharged from hospital, a brown envelope arrived on my doormat from the DVLA advising me that my driving licence had been revoked. As a motorist, I had no greater wish to share the roads with other drivers lacking the full faculties required to navigate our highways than anyone else, so I was sanguine about the decision the licensing authorities had reached. On the other hand, six months of traversing the practicalities of living in a semi-rural area with a 40-mile daily commute tested my resolve to the full.
The safety exposure to my son, myself and other road users, as well as the resources consumed by this incident from paramedics to A&E staff, the DVLA and the significant implications of losing the right to drive could have been very easily avoided.
With full biometric integration of my Bluetooth enabled and cloud-based continuous glucose monitoring, it is straightforward engineering to safegate a car’s ignition system and deny a hypoglycaemic diabetic the capability to start a car when blood sugars are below the golden 5 mmol/l (five to drive) safe level. And existing ADAS systems that provide automated braking and lane assist could provide simple interventions if this eventuality occurred in the middle of a journey by pulling a car with a medically incapacitated driver over to the side of the road.
In more aggressive technical environments, this integration is already being used to great effect. As a competition driver who had to convince a sporting federation’s licensing authority that I was safe to race a car as a type 1 diabetic, I’m well-versed in the hurdles. But in the US, top level IndyCar driver and type 1 diabetic, Charlie Kimball, holds his own in what is widely regarded as one of the world’s most demanding and competitive racing environments. His engineers on the pitwall monitor and manage the operating parameters of his race car as well as his blood glucose through real-time telemetry. Any mid-race downward gradient in Charlie’s sugars is instantly countered with a slug of glucose fluids pumped via a catheter tube through his helmet and into his mouth.
With wearables that monitor heart rate and a variety of other HealthKit metrics, diabetes is not alone in being a condition that can be actively managed through biometric integrations into car control systems. Any such biometric integrations not only enhance safety but also can be significantly enabling in allowing cohorts of people with underlying medical conditions to safely manage pursuits that would otherwise be off-limits. Sweet.
