Could big brother actually be your GP? Doctors may one day use monitoring cameras to check that heart failure sufferers are taking care of their condition properly. Improved self-management has been associated with reduced mortality, hospital admissions and healthcare costs, but forgetting to do crucial tasks such as taking medication on time and physical activity can be a hindrance. Scientists at Deakin University, Australia, decided to see whether a small clip-on camera on a group of 30 people with heart failure, all roughly aged in their 70s, would help patients identify areas where they are going wrong. Over a month-long period, the cameras captured an image every 30 seconds during waking hours. “The cameras bring more information to health professionals to really understand the lived experience of heart failure patients and their unique challenges,” said first author Dr Susie Cartledge, a registered nurse and dean’s postdoctoral research fellow at Deakin University. “This is a level of detail and context that will help us tailor their care.” Some 629,603 images were taken during the test, which were grouped into medication management, dietary intake, meal preparation and physical activity using a machine learning system. The process still requires some work, however, as not everything was correctly identified – diet-related photos were successful 49% of the time, while drug adherence was the least precise, with an average of only 6%. Nevertheless, sorting through the data, doctors were able to figure out areas for patients to work on, notably an increase in exercise, as well as cutting down on sedentary behaviour that was typically associated with screen time. In one case, it helped to spot that one participant needed to reduce the amount of diet fizzy drinks they consumed, beers when they played bingo, and cigarettes. “You can really just see the context of the patient’s world from chest height,” Dr Cartledge continued. “We saw their bingo scorecards, their families, their friends, but we only saw them if they stood in front of a mirror. “We felt like we had been with the patient for the day. “We can use this information to have a discussion with the patient. “Yesterday, one man’s pills sat out on his table for ages before he took them.” Despite potential privacy concerns, the majority of participants indicated that they were happy to wear the camera because they felt like “someone was watching over them” and that it encouraged them to be on “good behaviour”. “This is the first step,” Dr Cartledge said, whose findings are being presented at the ESC Congress 2019. “Patients are happy to wear it. We can see the context of the challenges they face. “The next step is to build an artificial intelligence platform to sort the images out in a quick and meaningful way so healthcare practitioners can use it. “We’re entering a new frontier.”