Smart Health in 2030
by Ejede Okogbo, Diego Dias, and Anik Mathur
April 20, 2030
Chicago police officer Del Spooner wakes up for his morning workout. Iris, his Sleep Number 930 Smart Bed, programmed to communicate with him in a French accent, informs him that his sleep quality indicator (SQI) was five points below his target goal of 85. Iris updates his health profile, a medical record uploaded every month to the United Health Blockchain (UHB), the largest health blockchain on the globe. UHB records encompass 30% of all Americans, including all of California and Illinois. Del’s sleep data is complex — with over 10,000 embedded sensors, Iris can sense his movements, body temperature, and muscle tension. Iris both records and responds — she can adjust firmness and temperature to best support his body, and coordinate with other devices in his bedroom, such as Del’s curtains, thermostat, and audio system, to create an optimized sleep environment for Del.
The push that began in 2010 to connect things, as well as people, has enabled almost everything Del interacts with to send data to the cloud using barely detectable sensors each the size of a grain of sand. In the early 2020s, when organizations were drowning in data from myriad sources, Apple built and launched the iPen, a mobile hub to connect and interpret all device data, and digital assistant to help interact with them. Gone are the days of “Alexa” and “Siri,” company-created personas people were forced to interact with. Instead, Del chooses the name and personality of each device and can speak or send a message to them via his iPen (or directly if the device has a microphone and speaker). Del chooses his devices’ voices from thousands of available tones, intonations, languages, and accents, all combinations that Del can customize. “Timmy” is his health assistant (he added the voice of Morgan Freeman and has observed that he finds it comforting for health information), and “Rambo” is his personal trainer with a thick Soviet accent.
Del ordinarily would never have a pet, but his ability to customize his digital assistants makes him feel like he always has companionship. Recorded anonymized conversations between owners of AI devices who opt into the global AI Speech Advancement Project, run by UC-Berkeley, to make AI increasingly more human in its communication.
Del bought Iris last year, and now he’s more energetic, focused, and less reliant on stimulants. Over the past year, his health profile has improved and helped lower his health tax rate. In 2025, Illinois led the wave to address ever increasing healthcare costs by implementing a health tax that replaced the old “health insurance”. While still early, the results have been promising. California put it on the ballot in this year’s elections. Being a part of the UHB is independent of the health state tax.
After using the restroom, Del listens to “Timmy”, his digital health advisory, who gives him updated urinalysis (conducted by his smart toilet) and health recommendations for the day. Last night before bed, Timmy informed Del that he needs to drink an additional 17oz of water and boost his intake of certain vitamins, and updated his recommended meals to reflect this change. Even though yesterday he had eaten unhealthy and overexerted himself during exercise, Del drank the water last night and took some vitamins, letting him rebuild his daily health score to end the day only only 5 points below his target. Del’s meals, vitamins, medicine, and supplements are personalized and delivered by Amazon Whole Life (AWL) to his home or office. Depending on the day, sometimes he chooses to pick them up at one of AWL’s 10,000+ retail locations. The Whole Foods acquisition in 2017 had been prescient for Amazon — in 2019 they rebranded to Amazon Whole Life and used the brick and mortar retail locations to rapidly expand into pharmacy and wellness consulting.
While enjoying a pre-workout shake in his driverless Uber to his Equinox gym, Del reviews what his digital personal trainer, Rambo, has prepared for him today. Del prefers to “Uber Solo” to the gym over “Uber Company,” because he likes his morning pep talks with Rambo, and he generally prefers privacy. Rambo collects data points from all the connected machines at his gym through his login with his iPen, and correlates those with his public and private health information, previous workouts, goals, and preferences to customize his exercise program. During workouts, Del’s Polar smart compression shirts and pants track his every movement so that Rambo can provide feedback in real time on his performance and even give him a little motivation when he begins to fatigue. Rambo can also compare Del’s data with his peer group and help him visualize what his body could look like, how his health and quality of life might improve, and how much he can save on his health tax if he stays on track to achieve his goals. Smart compression clothing are a recent innovation, so developers are actively working on how to better simultaneously connect smart compression clothing to IoT gym equipment and to digital personal trainers. The belief is that this capability will further improve workout recommendations and prevent injuries, especially when people go analog and opt in for free-weights or non-connected gym equipment.
Del’s workout today includes a physical test required by the Chicago Police Department (CPD). In addition to evaluating each employee’s health profile on the UHB, CPD regularly conducts physical tests, to ensure that its staff is in top physical condition to meet the demands of the job and maintain a lower employer health tax rate. This is a preventative measure to keep employees from attempting to cheat the system. Some complain about the multi-level taxation of requiring both individuals and organizations to pay health taxes, but proponents argue that this setup helps promote a greater sense of accountability for community health among members of the organization and society in general. Del is proud that CPD is one of the highest ranked police departments in the country by health index and other measures and wants to excel in his physical to keep things that way. To prevent cheating, individuals and organizations must participate in a health audit every tax day. Intuit has a solution in which participants perform a full-body scan through their iPen camera and enter select key datapoints into TurboTax. This information connects to the the top three healthcare blockchains to determine the expectation of their current health status based on their demographic data and health status throughout the year. The promise of this verifying technology is what prompted California to put the health tax on their ballot.
Inspired by Rambo’s pep talk prior to the CPD test, Del is motivated to push himself especially hard, the way he has been doing in recent days. Del’s iPen broadcasts Rambo’s voice to come with his music at full volume. The sound quality of his earbud headphone are simultaneously crisp and deep, which puts him in a trance-like state during exercise. After 17 minutes of intense cardio following 40 minutes of free weights, without proper stretching, Del feels a sharp pain in his lower back that radiates into his buttocks and down the back of his leg while riding the stationary bicycle. His compression clothes sense what could be an impairment to his sciatic nerves and send a message to Rambo to warn Del to slow down. Immediately, Rambo notifies Del, “Your new Adidas Samsung Compression shorts M34 wants you to slow down.” Yikes — this is the first moment Del has considered naming his compression clothes.
Del is able to finish and pass the test, but he can barely walk. The information is automatically sent to Iris, and she immediately triggers a change to Del’s schedule to include relaxation thermotherapy this evening when he returns home. As he stretches, Del asks Timmy to look for potential causes of his symptoms given his individual, family, and UHB health data. Given the pain he’s in, he also asks Timmy look for a medical specialist with availability within the next two hours near his home or office.
In 2021, medical technology companies were granted access to millions of anonymized medical records by national governments around the world led by a renewed European Union after the reversal of Brexit and the “Russian Scare” of 2020. While the US as a whole didn’t contribute, proponents marketed to individual citizens and medical record owners to share health data. With this unprecedented amount of historical and real-time data, scientists were able to study risk factors and health correlations that they would have never even considered in the past such as correlations between soft drinks and cancer or Del’s favorite, beets and a lack of hair loss. Increased volumes of data led to better insights into risk factors for diseases. Understanding risk factors better coupled with real time data from sensors about what people are actually doing helped to more interventions to prevent disease. The ability to prevent disease before it happens presented an opportunity to change incentive models around health. Illinois proposed a new incentive model — a responsive tax rate, based on an individual’s actions toward improving their health. The Illinois state tax covers healthcare costs to cover citizen’s medical expenses, including pharmacy and healthcare. Because medicine and pharmacy are still profit driven industries, the system relies on a collective incentive to keep people healthy and have less visits to practitioners. To keep with that tax, a way was need to securely capture medical information (both pre-intervention and at intervention) in a way that felt fair and transparent. Blockchains and the creation of the UHB was the solution to that. While Illinois was the only state with the health tax model in 2028, California and Utah also joined UHB.
Thanks to the UHB, Blockchain for American Health (BAH), and several other health bureaus, Illinois citizens can now contribute directly to maintaining and improving the healthcare system through a tax that’s based on each individual’s health profile. Medically unexplained sickness is covered by the state. Similar to cryptocurrencies, healthcare blockchains have made healthcare information cross organizational and national silos. Unlike cryptocurrencies, however, healthcare blockchains have had better adoption rates, even though Bitcoin is now 21 years old due to the value being more apparent than cryptocurrencies. Although, Del did make a lot of money from his Ethereum investment in 2017.
In 7 seconds, Timmy reports back that his analysis indicates a 76% probability of a lumbar herniated disk and that he found a doctor available in one hour just five miles from his house. Timmy sends a message to Dr. Penny Claw’s AI digital assistant, “Coral,” an assistant designed with nuanced medical knowledge.
As Del limps back to the locker room, Timmy tells him, “Coral, Dr. Claw’s medical assistant, thinks you should come in. She can even call you an Uber Luxury with thermotherapy and a healthy lunch consisting of beet juice, trout, asparagus, and quinoa as part of your introductory offer to her as a client.”
Given her medical background and the fee Dr. Claw pays for customer targeting data, Coral understands Del is the type of customer who might respond to this suggestion. Del is accustomed to recommendations catered to his needs, and says yes. In less than an hour from his injury Del is en route in a massage chair, eating a delicious meal as he wears a pair of augmented reality glasses re-experiencing his friends’ recent Instagram stories on 4/20 with a legal edible as a gift from Coral.
