Smartwatches Track Our Health. Smart Toilets, Too.

The next frontier of at-home health tracking is flush with data: the toilet.

Researchers and companies are developing high-tech toilets that go beyond adding smart speakers or a heated seat. These smart facilities are designed to look out for signs of gastrointestinal disease, monitor blood pressure or tell you that you need to eat more fish, all from the comfort of your personal throne.

“All of the things that have come with smartwatches and phones, you can imagine that on another scale,” says Joshua Coon, a bioanalytical chemist at the University of Wisconsin-Madison and Morgridge Institute for Research, who published a 2019 study exploring the potential of continuously monitoring a person’s health by looking at molecules in their urine samples. “You could really start to understand disease risk.”

Doctors have long used fecal and urine samples for clues to people’s health, but there has been a renewed interest in recent years as scientists have begun to better understand how the microbes in our gut influence our well-being. In the Covid-19 pandemic, more communities launched wastewater surveillance initiatives, enabling health officials to hunt for early signs of the virus in cities and neighbourhoods and track its spread.

Some researchers want to harness that wealth of information on the individual level and have come up with models to peer into the toilet bowl remotely. Some smart toilets are geared toward helping doctors monitor patients with chronic conditions or heightened risk for certain diseases, whereas other companies aim to sell the toilets—with price tags in the hundreds or thousands of dollars—directly to consumers as a tool to track or improve their own health and wellness.

Researchers at Stanford School of Medicine have outfitted a toilet bowl with cameras and trained a machine-learning algorithm to analyze the waste against a diagnostic chart. The toilet can also track the flow, colour and volume of urine. It is equipped with a urine test strip similar to a pregnancy test that detects specific molecules that can provide insight into a person’s health. To tell users apart, the toilet has both a fingerprint scan when a person flushes and a scan of their anus’s characteristics, or an anal print.

The Stanford team has signed an agreement with Izen, a Korean toilet maker, to manufacture the toilet. They hope to have working prototypes that can be used in clinical trials by the end of this year, says Seung-min Park, who leads the project, which was started by Sanjiv Gambhir, the former chair of radiology at Stanford, who died in 2020.

Another prototype smart toilet developed at Duke University also deploys cameras and machine learning to analyze waste after it has been flushed. It uses other sensors to capture consistency, presence of blood and specific proteins and extracts a small vial of stool that can be shipped off to a lab for further analysis. The smart toilet, along with others in development, is designed to connect with an app on a person’s phone.

“[You could] get personalized alerts for having more fibre or avoiding certain foods to avoid flare-ups,” says Sonia Grego, founder of the Duke Smart Toilet Lab and Coprata Inc., a startup that she and two other team members launched in 2021 to commercialize the technology.

A remote smart toilet could help doctors monitor patients with chronic conditions such as irritable bowel syndrome or spot early signs of disease, says Dr. Grego. Another plus is that it could allow for frequent measurements that can be tracked over time, which could be a more effective, non-invasive way to track certain metrics and quickly identify and flag changes than sporadic readings during doctor’s visits.

“What your blood pressure is at 2 p.m. on a Tuesday doesn’t matter. To get that information with real trends behind it is super valuable,” says Austin McChord, the chief executive of Casana, a home-health monitoring startup working on a toilet seat that can measure vital signs including blood pressure, blood-oxygen levels or heart rate.

The company said in February that it had raised $14 million in Series A funding and is working toward getting clearance from the Food and Drug Administration for the seat to measure a handful of vital signs, Mr. McChord says.

Some diagnostics experts argue that the value in a smart toilet would come from being able to analyze the molecular substances in patient samples and that other devices, including smartwatches, can easily monitor blood pressure and heart rate. Mr. McChord and others working on smart-toilet technology say that advantages to using a toilet seat over another wearable device are adherence and ease-of-use.

“If you want someone to use something, it has to be incredibly simple,” says Chad Adams, president and chief executive of the company Medic.Life, which is working to get FDA clearance for its Medic.Lav smart toilet. “Everybody has to go to the bathroom.”

Medic.Life first plans to sell its toilet to assisted living facilities, where it could help track residents’ vital signs, bodyweight or even the sugar or sodium levels in their urine, among other metrics, before expanding to general consumers. A future version for assisted living facilities, pharmacies and healthcare providers would diagnose certain infections, such as urinary-tract infections or Covid-19.

Google LLC also has a patent for a toilet seat that doubles as a cardiovascular monitor, filed in 2015, although it isn’t clear whether the company is pursuing the project. Google Health declined to comment. Toilet maker Toto is designing a toilet that could analyze people’s waste and provide recommendations to improve wellness, such as drinking more water or adding something to their diets. The company anticipates launching the toilet in the next several years.

Toilet makers say that their products can provide medical-grade results for some vital signs and urine tests, but a smart toilet that can analyze the broader chemical makeup of waste is likely further off. Developers will have to work out how to prepare samples for analysis and refill the chemicals needed to run the reaction, as well as make the toilet cost-effective, biochemists and diagnostic experts say.

Another key barrier is privacy. A 300-person survey conducted by the Stanford team found that one third of respondents were uncomfortable with the concept of a smart toilet that collects health data, with many citing privacy as a chief concern. Respondents were especially uncomfortable with the camera-based approach. More than half, however, were at least somewhat comfortable with a smart toilet.

“I have now heard every toilet pun or joke you can imagine,” Casana’s Mr. McChord says. “A toilet seat is something that everyone is going to giggle about, but you have that moment to explain what it really does, and people really do see the value there.”

The marketplace has spoken and, at least for now, it’s showing preference for hybrids and plug-in hybrids (PHEVs) over battery electrics. That makes Toyota’s foot dragging on EVs (and full speed ahead on hybrids) look fairly wise, though the timeline along a bumpy road still gets us to full electrification by 2035.

Italian supercar producer Lamborghini, in business since 1963, is also proceeding, incrementally, toward battery power. In an interview, Federico Foschini , Lamborghini’s chief global marketing and sales officer, talked about the new Urus SE plug-in hybrid the company showed at its lounge in New York on Monday.

The Urus SE interior gets a larger centre screen and other updates.
Lamborghini

The Urus SE SUV will sell for US$258,000 in the U.S. (the company’s biggest market) when it goes on sale internationally in the first quarter of 2025, Foschini says.

“We’re using the contribution from the electric motor and battery to not only lower emissions but also to boost performance,” he says. “Next year, all three of our models [the others are the Revuelto, a PHEV from launch, and the continuation of the Huracán] will be available as PHEVs.”

The Euro-spec Urus SE will have a stated 37 miles of electric-only range, thanks to a 192-horsepower electric motor and a 25.9-kilowatt-hour battery, but that distance will probably be less in stricter U.S. federal testing. In electric mode, the SE can reach 81 miles per hour. With the 4-litre 620-horsepower twin-turbo V8 engine engaged, the picture is quite different. With 789 horsepower and 701 pound-feet of torque on tap, the SE—as big as it is—can reach 62 mph in 3.4 seconds and attain 193 mph. It’s marginally faster than the Urus S, but also slightly under the cutting-edge Urus Performante model. Lamborghini says the SE reduces emissions by 80% compared to a standard Urus.

Lamborghini’s Urus plans are a little complicated. The company’s order books are full through 2025, but after that it plans to ditch the S and Performante models and produce only the SE. That’s only for a year, however, because the all-electric Urus should arrive by 2029.

Lamborghini’s Federico Foschini with the Urus SE in New York.
Lamborghini

Thanks to the electric motor, the Urus SE offers all-wheel drive. The motor is situated inside the eight-speed automatic transmission, and it acts as a booster for the V8 but it can also drive the wheels on its own. The electric torque-vectoring system distributes power to the wheels that need it for improved cornering. The Urus SE has six driving modes, with variations that give a total of 11 performance options. There are carbon ceramic brakes front and rear.

To distinguish it, the Urus SE gets a new “floating” hood design and a new grille, headlights with matrix LED technology and a new lighting signature, and a redesigned bumper. There are more than 100 bodywork styling options, and 47 interior color combinations, with four embroidery types. The rear liftgate has also been restyled, with lights that connect the tail light clusters. The rear diffuser was redesigned to give 35% more downforce (compared to the Urus S) and keep the car on the road.

The Urus represents about 60% of U.S. Lamborghini sales, Foschini says, and in the early years 80% of buyers were new to the brand. Now it’s down to 70%because, as Foschini says, some happy Urus owners have upgraded to the Performante model. Lamborghini sold 3,000 cars last year in the U.S., where it has 44 dealers. Global sales were 10,112, the first time the marque went into five figures.

The average Urus buyer is 45 years old, though it’s 10 years younger in China and 10 years older in Japan. Only 10% are women, though that percentage is increasing.

“The customer base is widening, thanks to the broad appeal of the Urus—it’s a very usable car,” Foschini says. “The new buyers are successful in business, appreciate the technology, the performance, the unconventional design, and the fun-to-drive nature of the Urus.”

Maserati has two SUVs in its lineup, the Levante and the smaller Grecale. But Foschini says Lamborghini has no such plans. “A smaller SUV is not consistent with the positioning of our brand,” he says. “It’s not what we need in our portfolio now.”

It’s unclear exactly when Lamborghini will become an all-battery-electric brand. Foschini says that the Italian automaker is working with Volkswagen Group partner Porsche on e-fuel, synthetic and renewably made gasoline that could presumably extend the brand’s internal-combustion identity. But now, e-fuel is very expensive to make as it relies on wind power and captured carbon dioxide.

During Monterey Car Week in 2023, Lamborghini showed the Lanzador , a 2+2 electric concept car with high ground clearance that is headed for production. “This is the right electric vehicle for us,” Foschini says. “And the production version will look better than the concept.” The Lanzador, Lamborghini’s fourth model, should arrive in 2028.

Smartwatches Track Our Health. Smart Toilets, Too.

Commodes that measure your health and might even diagnose Covid-19 are in the works.