Smartwatches Track Our Health. Smart Toilets, Too.
Commodes that measure your health and might even diagnose Covid-19 are in the works.
4 min
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.”
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As tariffs bite, Sydney’s MAISON de SABRÉ is pushing deeper into the US, holding firm on pricing and proving that resilience in luxury means more than survival.
Early indications from several big regional real-estate boards suggest March was overall another down month.
Can its real-estate market continue to rise amid stock-market turmoil?
7 min
MANALAPAN, FLA.— The Deal-Closer. That’s what real-estate agent Jack Elkins jokingly calls the Hinckley picnic boat he docks on the Intracoastal Waterway in the Florida community of Manalapan.
From the road, many of Manalapan’s mansions are shrouded by plantings and foliage, but they are clearly visible from the water, Elkins explained. A boat ride is often the best way to show properties to the wealthy buyers now flocking to the tiny town.
On a recent afternoon, Elkins cruised down the Intracoastal in the The Deal-Closer, passing mansion after mansion, most with their own docks. “When I was a little kid, almost all of this was jungle,” said Elkins, 46, who spent much of his childhood in the area. “There were foxes and parrots and all these wild animals.”
Manalapan, a roughly 2.4-square-mile town with a population of about 400, is just south of glitzier Palm Beach.
While Manalapan has long drawn moneyed residents such as the singer Billy Joel, it has historically lacked the prestige—and price tags—of Palm Beach. That has changed dramatically over the past five years, however, thanks to a series of major home sales.
In 2022, for example, Oracle billionaire Larry Ellison paid $173 million for a historic Manalapan estate. And David MacNeil, the founder of the automotive-accessories manufacturer WeatherTech, has spent a combined $94 million over the past year on a pair of neighboring sites, with plans to build a megamansion there.
“People like Larry Ellison and David MacNeil, these individuals can afford to buy real estate anywhere in the world,” said local real-estate agent Nick Malinosky of Douglas Elliman . “Manalapan is not a second choice for them. It’s their first choice.”
On South Ocean Boulevard, Manalapan’s most affluent corridor, about 21 homes have traded for more than $20 million each since 2020. At least six have sold for $40 million or more, up from only one in that price range during the previous five years.
In 2021, eBay billionaire Jeffrey Skoll bought an ocean-to-Intracoastal estate for $89.93 million, while Joel’s longtime home sold last year for $42.6 million.
Now, however, it is unclear whether Manalapan’s hot streak can continue. Like luxury markets across the country, the town is contending with stock-market turmoil and the fallout from President Trump’s tariffs.
Like many Manalapan residents, local developer Stewart Satter, who is listing a yet-to-be-built spec home for $285 million, is a Trump supporter. During the 2024 election, Satter flew a giant Trump flag above the site.
But tariffs have “created a tremendous amount of uncertainty at the minimum, and that is not good for business,” Satter said. “It’s not good for real estate. People say, ‘Let’s wait. We’re not going to buy a house, we’re not going to build a house.’”
Hitting the big time
Elkins’ cuddly Native American Indian Dog, Bear, lounged on The Deal-Closer’s blue-and-white-striped seats as the boat zipped along the Intracoastal, passing glassy modern mansions and traditional Mediterranean estates.
To catch a glimpse of Ellison’s roughly 16-acre oceanfront estate, Elkins guided the Hinckley through the Boynton Inlet into the choppy Atlantic, where the sandy beach in front of Ellison’s property was visible.
Known as Gemini, the gargantuan mansion was once owned by the late publishing magnate William B. Ziff Jr., who brought in large plantings and trees from South America for the landscaping.
“When I was a little kid, barges were going by our house with these huge trees,” Elkins recalled.
Ellison has approved plans to add more homes to the estate. He also paid about $277 million last year for Manalapan’s Eau Palm Beach Resort & Spa, home to the members-only La Coquille Club, and talk is rife about how Ellison might upgrade the property. Ellison didn’t respond to requests for comment.
It’s a strange feeling, Elkins said, to see Manalapan hit the big time.
Before Covid, the town was often confused with its namesake: Manalapan, N.J. Tiny compared with Palm Beach, Manalapan developed much more slowly than its famous neighbour. It lacks the commercial infrastructure of Palm Beach, and its low-density zoning has kept it largely free of major condos or resorts.
When Satter, the developer, bought four empty lots in Manalapan in 2005, parts of the town looked like “just a mess of woods,” said his wife, Susan Satter. “I said, ‘Is this really how we want to invest our money?’”
Over the next decade, her husband built spec homes on three of the lots and sold them for a significant profit. He kept one, building a mansion there for himself and his wife.
“I thought I’d discovered a really special place,” said Stewart, who tested products for Walmart before turning to spec-home development. “If I had known what was going to happen, obviously, in the rear view mirror, I would have bought the whole town.”
The buyers of Satter’s projects include Ron and Cindy McMackin, who paid roughly $39 million in 2020 for a roughly 15,500-square-foot waterfront house with six bedrooms, then expanded it.
The couple, founders of the mechanical subcontracting company Pan-Pacific Mechanical, had relocated from Hawaii to South Florida during COVID.
“We knew nothing about Manalapan when we moved here,” said Ron, 78. He and Cindy were in the process of moving into a Palm Beach property they owned when their real-estate agent, Lawrence Moens , called. The actor Sylvester Stallone was searching for a home amid the Covid-induced real-estate frenzy, and wanted to see their house.
Before they knew it, they had agreed to sell to the “Rocky” star for $35.375 million, 33% more than the $26.65 million they had paid two years earlier.
This left them without a house. It was slim pickings in Palm Beach, and with five children, they needed plenty of space. Moens suggested Manalapan. At the time, the less-flashy choice was surprising to some of their Palm Beach friends. “I did hear a couple of times from people after that, ‘Why would Lawrence take the McMackins to Manalapan?’” said Ron.
But the McMackins love that it is quieter than Palm Beach, with less traffic. The couple have Sunday dinners with their neighbours, and Cindy has a small group of girlfriends who call themselves the “Manalapan mafia.” The McMackins like it so much that they are building a new, larger home along the same stretch.
Food-service entrepreneur Bob Carlucci and his wife, Aileen Carlucci, paid $11.63 million in 2020 for a roughly 13,000-square-foot Manalapan mansion on the Intracoastal, with a small beach house on the ocean. They are happy to have “discovered Manalapan early, ” Bob said.
Many buyers are tearing down older homes to build new mansions, Malinosky said. Before COVID, Manalapan was seen as more of a vacation destination, so buyers weren’t as choosy. Now that many are seeking full-time homes, however, “they want to make sure that it has the spa, it’s got the 12-car garage, it’s got the fitness centre, it’s got the wellness centre.”
Another prized amenity is a tunnel that runs underneath Highway A1A. Portions of the town are on a barrier island, and some homes sit on the ocean, requiring residents to cross the busy road to reach their docks on the Intracoastal.
Other estates are on the Intracoastal but have small beachhouses on the ocean. A tunnel allows residents to easily go from one side to the other.
Construction of these tunnels has become a rare point of contention between residents. In January, one couple asked the town commission to stop their neighbors from digging under the highway during the tourist season, claiming it was causing traffic to back up.
Building on the coast comes with challenges. Florida building code now requires roofs, windows and doors in high-risk areas to withstand winds of up to 170 miles an hour, according to builder Robert Burrage, who is building MacNeil’s home and four others in Manalapan.
Satter said the property insurance on his personal residence in Manalapan doesn’t include coverage for hurricane damage because it was too expensive. In addition to the annual premium, which was about $150,000 a year, he would have faced a deductible on hurricane damage of about 10% of the assessed value of the house.
He isn’t concerned with rising sea-levels, however. “When I bought my first oceanfront lot, my late father-in-law said, ‘What the hell are you doing? Don’t you know about global warming?’” Satter said. “I sold it at a huge number [in 2016] and made a lot of money. It’s been sold again and again and again—and the water hasn’t done anything.”
Stock market slide
Manalapan’s proximity to Mar-a-Lago has added to its popularity since Trump’s election to a second term, Malinosky said. Many residents support Trump. In the McMackins’ home, a bedazzled MAGA purse hangs in Cindy’s closet and a photo book in the living room shows her attending a Trump event at Mar-a-Lago, where they are members.
But the trade war and stock-market volatility have injected uncertainty into the real-estate market.
Until recently, Hamptons home builder Joe Farrell was considering paying more than $30 million for a building site in Manalapan, he said. He has decided to hold off on any acquisitions for now, however, because of the tariffs and resulting stock-market fallout.
“The market seems to still be pretty good, but people are maybe a little more cautious about parting ways with liquidity,” Farrell said. “I want to see things stabilize before I commit to that kind of capital outlay.”
Elkins said one of his clients considered backing out of a $10 million deal over the last few weeks on Point Manalapan, but decided to move ahead to avoid forfeiting the deposit.
Malinosky said he still sees significant demand for big-ticket properties in Manalapan, especially since many wealthy people are taking money out of the stock market. He said he has closed more than $150 million in deals in the greater Palm Beach area over the past two weeks.
Even with the uncertainty, “there is no shortage of buyers that will spend $100 million right now in Manalapan,” he said.
Shelly Newman, an agent with the Corcoran Group, said she recently sold a piece of land to a spec-home developer for $25 million. And the McMackins are moving ahead with plans to complete their new house, though tariffs have been “the talk of the town,” Ron said.
“I do have a stock portfolio and it is down,” he said. “But I don’t let that affect what I’m doing. We’re very fortunate with resources.”
While Satter agrees with efforts to bring manufacturing back to the U.S., he said he has been blindsided by the extent of the trade war. “I’m not sure about how they’re rolling it out,” he said.
A handful of potential buyers have expressed interest in his $285 million listing, he said, but he realizes the prospective buyer pool is tiny. “There are going to be three or four people who ultimately show real interest and have the capacity to pull the trigger,” he said.
Ultimately, he said he isn’t too worried about the prospects for sale, since he can afford to sit on the property long-term.
Still, real-estate agents said Satter’s property and others may be priced too aggressively, even without tariffs.
British hedge-fund billionaire Chris Rokos is listing his 3-acre Manalapan estate for $150 million, more than triple what he paid for it in 2017. And real-estate investor Vivian Dimond recently cut the price of a Manalapan home by $14.5 million, to $64.5 million. It’s been on the market since September 2024.
For some Manalapan residents, home values are beside the point. Bob and Aileen Carlucci, for example, have no intention of moving.
“We look at each other and we say. ‘This is it,’” Bob said. “You can’t get anything better, we don’t believe—in this country, at least.”
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