Almost every home in the country has one and unlike the background population they have tended to become slimmer and slimmer over recent years. The television set has managed to hold onto its place as the epicentre of home entertainment, despite the assault from the personal computer and the ubiquitous iPod, iPhone, and iPads. One of the endearing attractions of television is the high quality picture resolution and the performance of the device without the need for multiple usernames and passwords, or without being affected by the variable performance of the local broadband network. In contrast to the choice available on the internet, the acceptance of the rigid nature of programme scheduling on television remains somewhat surprising, but endearing as a template around which the week’s other activities are planned.

However the traditional “night-in-with-the-telly” will soon be unrecognisable if the recent Consumer Electronics Convention in Las Vegas is to be believed. Soon all televisions will be connected to the internet allowing viewers to not only watch their favourite programmes, but also send tweets, add photographs to their Facebook pages, and play Angry Birds at the same time if they so wish! Viewers will also be able to download “apps” to help find the relevant movie or episode from Coronation Street and all of this can be voice-activated removing the need for multiple hand-held controllers. Google TV will soon be available in Europe, but the main question is how “disruptive” will Apple TV be when it is launched?

These changes to traditional television viewing are likely to have the potential to increase the time spent in front of the box and will surely ring alarm bells in terms of further fuelling the obesity crisis. However might these types of technological innovation also offer new opportunities for public health?

Another industry, pilloried for promoting obesity, has also recognised the opportunity for increasing revenue by engaging with healthcare. Again at the Las Vegas convention, vehicle manufacturers were showing off their latest concept of “Augmented-Reality Windshields.” The idea is that holograms will appear on the side of windscreens with information about restaurants, people, and places, with menus for passengers to see, and with the ability to purchase tickets for a movie as you drive up–the ultimate satellite navigation system. Car manufacturers have also realised that people spend a great deal of time in their car offering the potential for in-car medical monitoring and out-of-hospital diagnosis, clinical assessment, and also to enhance driving safety. Here there would be wireless displays of multiple physiological systems from heart rate, blood pressure, oxygen saturations, and glucose levels. If a low glucose level is recognised, as well as warning the driver, the sat nav system will light up and show the nearest location of a food source.

Therefore given what is possible in the confines of a motor car, this must surely be reproducible on a television set? The notion of a “TV dinner” could be taken to a completely different level with a  TV app analysing the calorie content of the meal, suggesting a change in portion size and making this information available to all family members, while at the same time recording blood pressure and metabolic rate. In between the programmes there would be short positive health messages, support for people giving up cigarettes, and a rolling record of weekly alcohol consumption. A Wii-based exercise could come on during half time of a football match as an alternative to listening to the pundits.

For some all of this would be one step closer to the nightmare Orwellian world of big-brother control. However unlike the residents of Oceania, these futuristic television sets would retain a vital electronic component—the off switch!

David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes and Mylyfe.me a service for women surviving breast cancer. He also believes that social media has the potential to be of huge benefit in improving medical care and practice. He also holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.