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2 billion people will need this tech by 2050: Injured vet shares the good and bad – CNET

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Phil Swinford plays music on his phone.

Megan Wollerton/CNET

OK Google, text Pamela ICE (in case of emergency),” says retired US Army Col. Phil Swinford from his home in the Virginia suburbs, roughly an hour’s drive from Washington, DC. He’s using Google Assistant on his Android phone to talk to his wife, Pam, who’s working today at her consignment shop, the Copper Cricket, a few miles away. I’m listening in, which feels a little too invasive, but it’s OK: This text is just for demo purposes.

“Sure,” Google’s AI responds. “What’s the message?”

“Hey, babe. I love you,” Phil says clearly and deliberately into his phone.

“I got, ‘Hey, babe. I love you,”http://www.cnet.com/” it speaks back to him. “Do you wanna send it or change it?”

“Send it,” Phil says.

“OK. Message sent,” it confirms.

Demo or not, it’s sweet that this is the message he chooses to send.

I first met Phil and Pam in 2017 at the Polytrauma Rehabilitation Center at the McGuire VA Hospital in Richmond, Virginia, where they talked with me about the smart home technologies he uses everyday.

I’m here now to see all of it in action.

Phil is an incomplete quadriplegic. His injury was caused in a mountain biking accident in 2015. The “incomplete” part means he has some movement, mainly in his fingers, hands and arms, but he relies on an electric wheelchair to get around.

About 3.6 million Americans and more than 250,000 veterans use wheelchairs, according to a 2018 study. More than one billion people in the world need at least one type of assistive technology; only one in 10 people have that access, the World Health Organization (WHO) reports.

Assistive technology is a category of specialized, often costly, tech designed to help people with disabilities live more fulfilling, independent lives. The smart home industry is a mainstream extension of assistive technology. App- and voice-controllable smart locks and LED lights might be a convenience purchase for you and me, but for Phil (and so many others), it means there’s one less thing he has to ask Pam — or one of his caregivers — to do for him.

Access to smart home technology could also potentially be live-saving, a way to contact someone if he’s on his own, to let them know something’s wrong.

Together Phil and Pam make a concerted effort to keep up-to-date on all of the latest innovations. Pam searches New Mobility Magazine for the newest devices. Phil reads about research studies and university programs doing interesting work related to spinal cord injuries. He volunteers to test beta software and one-off devices from all over the world — and provides feedback on what’s working and what isn’t.

Largely because of their efforts, their house is full of smart home technology. “Even (within) the VA, you have to fight for everything,” he explains, and Pam is his strongest advocate. Phil knows he’s lucky, and that many don’t have the same access. He believes it also helps that he retired as a colonel, a high-ranking position in the US Army.

“(Part of) a senior officer’s job is to write and speak, to advocate for his unit, the Army, and if necessary, himself. A guy who gets medically retired as an E4 specialist in the Army (a comparatively low rank — read more about Army ranks) is not going to have those skills, more than likely,” he explains.

The WHO estimates that the number of individuals needing assistive tech will double to two billion people by 2050. Hopefully access will improve with this growing need, but for now, Phil might just have one of the most decked-out setups around.

I’m here to find out what technology is in his house, how he uses it, how well it works and what he’d like to see that hasn’t emerged yet.  

The tech

Control4, a professionally installed smart home system, is the brains powering Phil’s smart home. It isn’t marketed as an assistive technology, but it is commonly used for that purpose. The McGuire VA alone has requested about 26 Control4 systems for veterans in the past five years, Melissa Oliver, assistive technology program coordinator at McGuire, tells me over email.

(The Stephen Siller Tunnel to Towers Foundation, a nonprofit that builds custom homes for veterans and first responders critically injured in the line of duty, installed Control4 in the home they built for retired Marine Sergeant Rob Jones.)

Control4 consists of touchscreen control panels, an app and Amazon Alexa speakers to control various connected devices. You could install and configure various smart home devices in a similar way yourself, but Control4 unites them under the same app, which makes them more manageable. 

“Due to the vast integration and customization possibilities of Control4, our systems have been installed for many veterans and those who use technology to improve their lives. We love seeing the ways that a Control4 smart home can help, even (in) just the smallest ways,” Brad Hintze, Control4 senior director of product marketing said via email.

Phil has Amazon Echo Dot speakers, security cameras, door locks, fans, lighting and doors — all controllable via Control4. During my visit he demonstrates opening the door in his bedroom, turning lights on and off, turning on the TV and changing the channel, playing music, and even answering a Ring doorbell.

He says the tech works “nearly 95% of the time,” which seems about right. He experiences the classic voice assistant annoyances we all do: When Alexa or Google Assistant (on his phone) either doesn’t respond when you give a command or thinks you said their name when you didn’t.

There were some other issues, particularly in the specialty assistive technology Phil’s testing out.

One such software, called Open Sesame by startup Sesame Enable, was developed by Giora Livne, a retired naval officer from Israel who’s quadriplegic. Open Sesame had a successful Indiegogo campaign back in 2015, where it raised nearly $60,000.

The Open Sesame app, which costs $20 per month, uses the cameras in Phil’s phone and laptop to scan his face (note: Open Sesame is only compatible with Android and Windows at this time). He then navigates apps, responds to emails and plays games — all using head gestures, with his nose as the cursor.

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When Phil uses Open Sesame head gestures to click the Ring push notification, Open Sesame will crash.

Megan Wollerton/CNET

But Open Sesame doesn’t work perfectly — the voice command that used to work to open the app has stopped working, and the app crashes when it’s competing with a secondary video feed, like the live stream from the Ring doorbell Phil and Pam have out front.

Now he has to use a joystick or his head array (a physical device with built-in sensors that allows Phil to control things with head movements) to pull up the app, which slows things down. That’s especially frustrating when he’s trying to do something time sensitive, like answer the front door, which is compounded by the issues with the secondary video feed.

Phil likes to order pizza for Pam when she works late. He always instructs the delivery person to bring the pizza inside, but they always ring the doorbell first. (I don’t blame them, honestly. I’d probably be hesitant walking into someone else’s home too.)

When they buzz the Ring doorbell, Phil gets an alert on his phone. He uses Open Sesame to answer it, but the technology can’t continue to scan his face and simultaneously pull up the video of whoever’s out front. So instead, Open Sesame crashes, and by the time Phil gets the app open with the joystick or head array to tell them to come in, the person is long gone.

We tested out the Open Sesame/Ring doorbell issue ourselves, along with CNET video producer, Vanessa Salas, and it did indeed stop working. Vanessa waited at the door for at least a minute as Open Sesame stopped and Phil had to switch to a different technology. When it’s working, Open Sesame is his fastest option, so it’s typically his default choice. But it’s essentially a beta technology, so there are glitches.

I also messed up Open Sesame for him at least once by accidentally sticking my head in front of the phone’s camera as he tested it out, which, of course, confused the face-tracking software and caused it to crash.

I saw his frustration, navigating these technologies that don’t always work the way he needs them to. But Phil is hopeful; he has plans way beyond his current range of motion — and his current array of smart home tech. 

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Phil is training to walk again.

Megan Wollerton/CNET

His goals

Marita Allen, a licensed practical nurse (LPN) who’s one of Phil’s caregivers, grabs an iPad and shows us videos of Phil walking at the Fairfax DPI Adaptive Fitness Training Center.

In the videos, he uses a walker and electronic stimulation bands attached to his legs that send signals to his brain to help him move. While the staff keep close by in the videos, Phil is walking, the strain of determination clear on his face.

He has a specific goal in mind: his daughter’s wedding is coming up, and he wants to walk her down the aisle.

He uses electronic stimulation technology at home to continue strengthening his legs when he isn’t at physical therapy, as well as something called a mobile arm support to strengthen his arms. 

“Until I gain functional movement of an arm that would allow me to use a remote, or open the computer, or open the iPad, I pretty much have to have somebody here (to help),” he says.

Arm strength is also crucial to helping him walk again.

The mobile arm support is an arm brace that helps him extend his arm for things like eating, which, in turn, helps strengthen his arm. There are fewer than 50 of these devices in the United States, he says, because the company stopped selling them here. Pam found it in New Mobility Magazine, and they jumped at the chance to have one.

“I’ve actually regained some strength and mobility in my right arm (from using the mobile arm support),” he says. Soon, he plans to switch the mobile arm support device to his left arm to help strengthen it, too.

This goes way beyond feeding himself, though, and even beyond walking his daughter down the aisle. Phil is actively trying to keep up his strength so he’s ready for future technologies.

He’s waiting for Dr. Harkema at the University of Louisville’s Kentucky Spinal Cord Injury Research Center to further develop her embedded stem cell research, designed to help people with spinal cord injuries to walk again.

“My hope is to someday regain upper body movement from the implantation of stem (cells). I think I’m well along the way in terms of eventually being able to walk with minimal help,” he says.

He also mentioned the Miami Project, which is working on upper-body mobility for quadriplegics.

Phil is eager to participate in the research studies, but doesn’t qualify for most of them. They are often looking for complete, rather than incomplete quadriplegics — individuals with no mobility.

“I don’t think I look like a “normal” quadriplegic (Phil says “quote, unquote normal” here). I still have significant muscle mass. I mean, I can sit on a leg press and press 220 pounds,” he explains.

In addition to his hope for embedded stem cells, Phil wants an embedded device that helps him breathe. He currently uses a diaphragmatic pacing system to assist with breathing — it’s a battery-powered device that stimulates his diaphragm, allowing it to contract more naturally.

“Instead of me having to carry this Star Trek Tricorder around (the pacing system), we can embed microcontrollers in my body and then recharge it at night, the way pacemakers work,” he explains.

Phil kicks me out at exactly noon. His schedule is pretty full today, but he says I should drop in on Pam at her shop.

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Pam’s got Phil’s back (taken in 2017 at the McGuire VA Hospital).

Tyler Lizenby/CNET

The advocate

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Phil walks his daughter, Jillian, down the aisle. 

Wendy Atkinson

When I walk through the doors of Copper Cricket a little after noon, the shop is buzzing and Pam is nowhere to be found.

I eventually find her far in the back, after walking past a maze of rooms packed full of breakable tea sets, mirrors, paintings and a myriad of other collectibles. One particular embroidered wall hanging of birds looks strikingly similar to something that used to hang in my grandmother’s house.

Pam is in the middle of lifting a giant planter to bring it to a customer’s car. I ask if she needs help with it; she says no. 

The area where they live has a lot of former military and state department employees who’ve moved a lot, she tells me as we walk back to the front of the the store, so she gets items from all over the world.

She talks fast; she has a lot of customers to get to. She reiterates something I remember Phil mentioning when we first met at the VA hospital two years ago — that technology is great when it works and not so great when it doesn’t.

She clearly isn’t fazed by it, though. She and Phil will figure it out together.

I find out later that Phil did indeed walk his daughter down the aisle at her wedding. Now he’s one step closer to his goal. 

This is part of CNET’s “Tech Enabled” series about the role technology plays in helping the disability community.

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