Smartwatches Track Our Health. Smart Toilets, Too.
Commodes that measure your health and might even diagnose Covid-19 are in the works.
Commodes that measure your health and might even diagnose Covid-19 are in the works.
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.”
Following the devastation of recent flooding, experts are urging government intervention to drive the cessation of building in areas at risk.
Private club memberships and luxury cars are some of freebies on the table.
When Ryan Wolitzer was looking to buy an apartment in Miami Beach late last year, several beachfront properties caught his eye. All were two-bedroom homes in high-end buildings with amenities aplenty and featured glass walls, high ceilings and an abundance of natural light. But only The Continuum, in the city’s South of Fifth district, came with a gift: a membership to Residence Yacht Club, a private club that offers excursions on luxury yachts ranging from a day in south Florida to a month around the Caribbean. Residents receive heavily discounted charters on upscale boats that have premier finishes and are stocked with top shelf spirits and wine. Mr. Wolitzer, 25, who works for a sports agency, was sold.
“The access to high-end yachts swayed my decision to buy at The Continuum and is an incentive that I take full advantage of,” Mr. Wolitzer said. “It’s huge, especially in my business when I am dealing with high-profile sports players, to be able to give them access to these incredible boats where they experience great service. I know that they’ll be well taken care of.”
Freebies and perks for homeowners such as a private club membership are a mainstay in the world of luxury real estate and intended to entice prospective buyers to sign on the dotted line.
According to Jonathan Miller, the president and chief executive of the real estate appraisal and consulting firm Miller Samuel, they’re primarily a domestic phenomenon.
In the U.S. residential real estate market, gifts are offered by both developers who want to move apartments in their swanky buildings and individuals selling their homes. They range from modest to over-the-top, Mr. Miller said, and are more prevalent when the market is soft.
“When sales lag, freebies increase in a bid to incentivize buyers,” he said. “These days, sales are slowing, and inventory is rising after two years of being the opposite, which suggests that we may see more of them going forward.”
Many of these extras are especially present in South Florida, Mr. Miller said, where the market is normalizing after the unprecedented boom it saw during the pandemic. “The frenzy in South Florida was intense compared with the rest of the country because it became a place where people wanted to live full time,” he said. “Now that the numbers are inching toward pre-pandemic levels, freebies could push wavering buyers over the finish line.”
Kelly Killoren Bensimon, a real estate salesperson for Douglas Elliman in Miami and New York, said that the gifts that she has encountered in her business include everything from yacht access and use of a summer house to magnums of pricey wine. “One person I know of who was selling a US$5 million house in the Hamptons even threw in a free Mercedes 280SL,” she said. “They didn’t want to lower the price but were happy to sweeten the deal.”
A car, an Aston Martin to be exact, is also a lure at Aston Martin Residences in Miami’s Biscayne Bay. Buyers who bought one of the building’s 01 line apartments—a collection of 47 ocean-facing residences ranging in size from 325 to 362sqm and US$8.3 million to US$9 million in price—had their choice of the DBX Miami Riverwalk Special Edition or the DB11 Miami Riverwalk Special Edition. The DBX is Aston Martin’s first SUV and retails for around US$200,000. It may have helped propel sales given that all the apartments are sold out.
The US$59 million triplex penthouse, meanwhile, is still up for grabs, and the buyer will receive a US$3.2 million Aston Martin Vulcan track-only sports car, one of only 24 ever made.
“We want to give homeowners the chance to live the full Aston Martin lifestyle, and owning a beautiful Aston Martin is definitely a highlight of that,” said Alejandro Aljanti, the chief marketing officer for G&G Business Developments, the building’s developer. “We wanted to include the cars as part of the package for our more exclusive units.”
The US$800,000 furniture budget for buyers of the North Tower condominiums at The Estates at Acqualina in Sunny Isles, Florida, is another recent head-turning perk. The 94 residences sold out last year, according to president of sales Michael Goldstein, and had a starting price of US$6.3 million. “You can pick the furniture ahead of time, and when buyers move in later this year, all they’ll need is a toothbrush,” he said.
Then there’s the US$2 million art collection that was included in the sale of the penthouse residence at the Four Seasons Residences in Miami’s Brickell neighbourhood. The property recently sold for $15.9 million and spans 817sqm feet. Designed by the renowned firm ODP Architects, it features contemporary paintings and sculpture pieces from notable names such as the American conceptual artist Bill Beckley and the sculptor Tom Brewitz.
But it’s hard to top the millions of dollars of extras that were attached to the asking price in 2019 of the US$85 million 1393sqm duplex at the Atelier, in Manhattan’s Hell’s Kitchen neighbourhood. The list included two Rolls-Royce Phantoms, a Lamborghini Aventador, a US$1 million yacht with five years of docking fees, a summer stay at a Hamptons mansion, weekly dinners for two at lavish French restaurant Daniel and a live-in butler and private chef for a year. And the most outrageous of all: a flight for two to space.
It turned out that the so-called duplex was actually a collection of several apartments and a listing that went unsold. It did, however, generate plenty of buzz among the press and in real estate circles and was a marketing success, according to Mr. Miller.
“A listing like this that almost seems unbelievable with all the gifts will get plenty of eyeballs but is unlikely to push sales,” he said. “Empirically, it’s not an effective tactic.”
On the other hand, Mr. Miller said that more reasonable but still generous freebies, such as the membership to a yacht club, have the potential to push undecided buyers to go for the sale. “A nice but not too lavish gift won’t be the singular thing toward their decision but can be a big factor,” he said. “It’s a feel-good incentive that buyers think they’re getting without an extra cost.”
Examples of these bonuses include a membership to the 1 Hotel South Beach private beach club that buyers receive with the purchase of a residence at Baccarat Residences Brickell, or the one-year membership to the Grand Bay Beach Club in Key Biscayne for those who spring for a home at Casa Bella Residences by B&B Italia, located in downtown Miami and a residential project from the namesake renowned Italian furniture brand. The price of a membership at the Grand Bay Beach Club is usually a US$19,500 initiation fee and US$415 in monthly dues.
Still enticing but less expensive perks include the two-hour cruise around New York on a wooden Hemmingway boat, valued at US$1,900, for buyers at Quay Tower, at Brooklyn Bridge Park in New York City. The building’s developer, Robert Levine, said that he started offering the boat trip in July to help sell the remaining units. “We’re close to 70% sold, but, of course, I want everything to go,” he said.
There’s also the US$1,635 Avalon throw blanket from Hermes for those who close on a unit at Ten30 South Beach, a 33-unit boutique condominium; in Manhattan’s Financial District, a custom piece of art from the acclaimed artist James Perkins is gifted to buyers at Jolie, a 42-story building on Greenwich Street. Perkins said the value of the piece depends on the home purchase price, but the minimum is US$4,000. “The higher end homes get a more sizable work,” he said.
When gifts are part of a total real estate package, the sale can become emotional and personal, according to Chad Carroll, a real estate agent with Compass in South Florida and the founder of The Carroll Group. “If the freebie appeals to the buyer, the transaction takes on a different dynamic,” he said. “A gift becomes the kicker that they love the idea of having.”
Speaking from his own experience, Mr. Carroll said that sellers can also have an emotional connection to the exchange. “I was selling my house in Golden Isles last year for US$5.4 million and included my jet ski and paddle boards,” he said. “The buyers were a family with young kids and absolutely loved the water toys.” Mr. Carroll could have held out for a higher bidder, he said, but decided to accept their offer. “I liked them and wanted them to create the same happy memories in the home that I did,” he said.
The family moved in a few months later.