Some Straight Talk on Digital Health Sensors in Health Care

“We’ve come to a point in time where you can take the rich functionality of microelectronics and put it in new forms, fits and functions.”

Gregory Raupp, Professor of chemical engineering and research director of the WearTech Applied Research Center
Image credit: The Medical Futurist Institute

Health monitoring devices are taking center stage as the most practical use case for consumer wearable technology. What started years ago as stand-alone home health monitoring devices like heart-rate monitors, pedometers, and glucose monitors morphed into wearable fitness trackers. Then came smartwatches, which quickly started cannibalizing health functions. Fast forward a few more years, and there are now full-fledged wearable dedicated intelligent health devices. And it’s almost sure the technology and use cases will expand further in the coming years. Here are some current projections on the wearables market:

  • 1.3 million lives saved by wearables by 2020 — Swiss firm Soreon Research
  • $200 billion saved — Estimated global health cost savings from wearable tech over the next 25 years — Deloitte
  • 50% reduction in hospital visits — Projected reduction in hospitalizations through use of home monitoring devices of chronic diseases — California Telehealth Resource Center
  • $56.8 billion market value market projection for wearable tech by 2025 — MarketsandMarkets

A few years ago, wearable tech was rarely seen outside a lab or a clinic, where doctors used the devices to gather critical patient data or help with recovery. Today, wearable technology can come as a watch, a ring, a pair of contact lenses: a patch, or even a tattoo. The most familiar wearable technology in healthcare by far, for now, are fitness sensors and smartwatches. Chronic diseases like Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Hypertension, Dementia, and various behavioral conditions mean that the relevance of wearable technology in healthcare is bound to grow.

Wearable technology is helping people stay healthy in many ways. One of its foremost uses is in the prevention, detection, and management of chronic diseases. Depending on the disease condition, wearable healthcare technology could be vital for prevention, treatment, or control. Some conditions currently benefiting from wearable technology are:

  • Diabetes – Diabetes is the seventh leading cause of death in the United States and accounts for over $327 billion in direct and indirect costs.
  • Hypertension – In the US, almost half of adults have the condition.
  • Psychological issues – Over 50 million Americans are living with psychiatric conditions. Wearable health technology can assist with screening, monitoring, and diagnosing psychiatric disorders.
  • Heart disease – Wearables can monitor for conditions like AFib and other heart rhythm issues.

What are the Benefits of Healthcare Wearables? – An exhaustive listing of the potential benefits of wearable technologies is beyond the scope of a blog post. (The image at the top of this post is an excellent listing of currently available wearable technologies compiled by Dr. Bertalan Mesko and his team at The Medical Futurist Institute.) But some of the benefits include:

  • Protect an aging population – Recent studies have focused on developing wearable devices and associated algorithms to collect and analyze gait (manner of walking) data for fall prevention.
  • Tracking fitness – Fitness trackers have evolved into a global staple for athletes, sportspeople, and anyone interested in getting and staying fit. The personalized data they collect help doctors monitor activity levels and provide customized care. The development of biosensors has accelerated the adoption of this technology by expanding the form factors that can incorporate the technology. Biosensors are now incorporated into wearable technology, such as shirts, eyewear, wristbands, rings, patches, and even tattoos.
  • Blood Pressure & ECG – Electrocardiogram (ECG/EKG) monitors are the latest addition to wearable vital sign monitoring technology devices. ECG monitoring help people monitor their heart health and can help people detect strokes before they occur. The FDA has cleared medical-grade sensors like the Kardia mobile for several heart conditions. They even have developed a six-lead ECG version that provides a more complete picture of a patient’s ECG than their single-lead version.
  • Women’s Health issues – Several wearables are designed to help you figure out when you ovulate and when your next period is likely. Monitoring menstrual cycles may also be helpful if you have certain health conditions. If, for example, you have menstrual migraine, they might help you make predictions about your attacks.
  • Sleep disorders – Wearable technologies like the Oura ring can track sleep and provide valuable feedback on various sleep disorders.
  • Brain trainingVersus brain training was designed by neuroscientists, and it helps increase impulse control, regulate your emotions, stay focused and sleep better.
Image Credit: Rock Health

What are the potential drawbacks associated with wearable technologies? – While wearable healthcare technology essentially is beneficial, there are some ethical concerns to be aware of. It is possible devices could be hacked. Rigorous encryption is vital to protect user data. Users need to make sure they understand who can access their data and for what purposes. There may be situations where having real-time feedback on one’s physical or mental state could be unhelpful. Some users might find having too much information on their state at a given instant could make it hard to change that state.

How is the digital health care sensor market currently segmented? – Today, the digital health care sensor market is generally segmented into three areas:

  • Wearables – These are those sensors that are worn on the body like fitness trackers, smartwatches, smart clothing, and even temporary tattoos. For example, LifeSignals’ remote patient monitoring system consists of a single-use wearable biosensor that measures electrocardiography, heart rate, respiration rate, skin temperature and body posture data for up to five days. The biosensor wirelessly transmits the encrypted data to a secure cloud-based server; the data can be viewed on the accompanying app or on the remote monitoring dashboard.
  • Injestibles – These are sensors that can be swallowed and transmit data to a sensor worn outside the body like the pill sensors developed by the former company Proteus Digital Health or the PillCam. PillCam is a minimally invasive tool that allows doctors a direct view of the inside of your colon. It takes two images per second, over eight hours, transmitting them to an external sensor that connects to a computer to relay the data.
  • Insideables – Insideables are technologies that are implanted within the human body. They can be both controversial and hugely beneficial. A recent example of this type of technology is a bioabsorbable, transient pacemaker developed by researchers at Northwestern and George Washington University Hospitals.
Image Credit: Medtronic, Inc.

How are organizations implementing the use of digital sensors? – I have long been an admirer of the work being done by the Ochsner Health System in digital health. One of their signature initiatives was developing their version of Apple’s Genius Bar, which they call “O-Bar.” First opened in 2015, each O Bar is staffed with a technology specialist who can answer questions and provide demonstrations. These “genius” bars are where all patients can find the right tool for them and get set up to use it. O Bars are stocked with the latest digital health devices, ranging from wireless blood pressure cuffs to activity trackers, and equipped with iPads loaded with over 100 health apps that can be browsed and demoed before downloading to a personal device. Featured apps address a wide range of topics, including nutrition, fitness, women’s health, diabetes, and smoking cessation.

Image Credit: Ochsner Health

CVS Health has created a service designed to help CVS Caremark pharmacy benefit management clients more quickly roll out and manage third-party health products. Since it’s no easy task for an organization to vet the growing number of digital health products and services streaming onto the market, the Point Solutions Management program looks to stem this burden for its PBM clients by acting as a gatekeeper and ensuring that the digital health vendors it does recommend generate measurable clinical and financial benefits. Express Scripts has developed a similar program initially focused on prevention and management tools for diabetes and cardiovascular, behavioral, and pulmonary conditions, with support for more chronic and complex conditions to come. Watch for a more comprehensive look at the development of “digital health formularies” in an upcoming post this week.

What is the future of wearable technology? – The future of wearable technology in healthcare is bright. Wearable technology is expected to reach more people and has more disease prevention, detection, remote patient monitoring, and treatment applications. The devices are expected to become smaller and more efficient and will cost less. Artificial Intelligence and machine learning algorithms will automate collecting, analyzing, and reporting real-time clinical data to the care team. Wearable sensors will undoubtedly save more costs and save more lives.

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