Health Monitoring Technology

Smartphones, online platforms, wearables, and other health technology applications have in many ways radicalized the way that physicians access health information and communicate patient well-being. Antiquated medical devices are getting updated to include digital features that extend the utility of preexisting equipment. For instance, many health devices now communicate with other health devices and systems, connecting, organizing, and integrating previously disparate pieces of information.

Health technology's potential continues to progress year after year, and many companies, institutions, practices, and hospitals are investing and working on its evolution. New devices are even being tailored to serve those with specific health conditions. The data that gets collected from such health devices is not necessarily appropriate or applicable to every specific health situation. Hence, there has been a push to launch reliable, condition-focused devices that can serve health care providers who specialize in specific problems.

Progress in Telemedicine

Telemedicine and telehealth remove some of the existing barriers of traditional care and bring health care into the home. In the past, there were some concerns regarding the limitations of not seeing a physician face-to-face, especially when elements of specific health conditions are considered. However, with continued advancement of wearables, virtual doctor visits are becoming more and more comprehensive and can transcend a simple video chat.

New digital devices and home tests are allowing a more thorough patient examination remotely, which addresses some of the previous setbacks of telemedicine.

Remote diagnostic tools such as Tyto, Scanadu and MedWand are expanding the perception of telemedicine. Heartbeat and respiration rate can now be checked remotely. The same is true for blood pressure, blood glucose, body temperature, and oxygen levels (depending on the specifications of the device being used in the telemedicine session). Some devices feature a high-definition camera that can be used to look down the throat and/or into the ear canal. Cameras can also provide high-resolution images of skin, so skin lesions and suspicious skin changes can be examined. Home urine-testing kits are being developed, which are designed to check for several health conditions almost instantaneously. All the collected data can then be shared in real time or stored for later consultation.

Most medical devices require necessary testing and need to receive United States Food and Drug Administration (FDA) clearance. It is essential that medical devices are first recognized as accurate, so they can be accepted and used without hesitation.

Treating the Physician Condition: Burnout

These days, health care professional are often overwhelmed with work and different types of work demands. Some spend more time at their computer documenting and writing notes than they do with their patients. Health technology is now being developed to assist them and support doctor-patient interactions. This growing and expanding digital health market specializes in actual devices aimed at health professionals and their work efficiency.

One invention in the direction of more time-efficient health care is Augmedix—headwear that can help doctors record and recall information. Purportedly, it saves a physician up to 15 hours a week. This wearable device automatically completes the patient’s notes and is compatible with some electronic health record systems (EHR). It offers hands-free charting by using voice and Google Glass. It also helps retrieve information about a specific patient, including their medication, lab results, and allergies.

Although novel devices like Augmendix are inanimate pieces of technology, they are helping to rehumanize the health care experience.

They have the potential to increase patient satisfaction as well as health professionals’ focus on seeing patients (rather than paperwork).

Ensuring Quality and Safety

The FDA regulates all technologies, devices, and applications that are considered medical devices. The Center for Devices and Radiological Health (CDRH) is a branch of the FDA and is responsible for approval of all medical devices as well as various other safety regulations. Since mobile health technology is a growing field and the industry has often expressed the need for more guidance, the CDRH established the Digital Health Program. The Program's mission is to advance digital health as well as develop policies and regulations around health technology.

Not all technologies that are used by health professionals have been classified as medical devices. For example, some health-related apps are not considered medical devices (e.g. those used as educational tools, generic aids that are not intended for diagnosis and those that allow communication between patient and health care providers).

Also, if an app poses a very low risk to the public, the Federal Food, Drug, and Cosmetic Act (FD&C) generally does not get enforced. As a result, the open market for health apps and devices is really buyer beware.

As a general rule, the FDA is most concerned with technologies and mobile medical apps that could pose a risk to general safety if the device was not to function as intended. The information about FDA-approved medical technology is accessible to the public in the form of a database, and the agency offers the option to subscribe to updates about recently approved medical devices.

From Generic Wearables to Condition-Specific Smart Devices

There has been a gradual move from technologies that monitor common human functions and activities to devices that can monitor and/or detect specific health conditions. While generic wearables have started to show market fatigue, condition-specific devices have emerged as the next big opportunity. Scientists and digital technology experts are working on various wearables for specific chronic conditions, such as diabetes, epilepsy, pain management, Parkinson’s disease, cardiovascular disease, sleep disorders, and obesity—to name just a few. The benefits of these devices are many, but at their core they provide doctors with non-invasive options that can be integrated into patients' day-to-day lives. Because digital health is generally not pharmaceutical or invasive by nature, these devices minimize the possibility of side effects when compared to many other health treatment modalities.

Health equipment that used to be confined to medical rooms because of cost and/or size can now be packed into a miniature wearable device, making some procedures more convenient and accessible. One example is ZetrOZ, which specializes in acoustic medicine and is producing wearable ultrasound devices that can be used for pain management.

Another common condition that has been receiving a lot of attention in health technology circles is diabetes. Big players such as Google, Apple, and Samsung as well as smaller startups have all been investing and researching new technologies for diabetes. Soon, the management of this condition is expected to drastically change. For instance, glucose monitoring will no longer depend on finger pricking. Options including smart contact lenses (measuring glucose levels in tears), electronic skin patches (detecting glucose levels in sweat and administering drugs) and smart footwear (preventing the onset of diabetes-related foot ulcers) are all being explored. In addition, numerous health applications are being developed that can assist with education and adherence to medication and lifestyle changes. Implanted technology might become another option too. For example, skin implants that automate drug delivery and bio-artificial pancreas for those with type 1 diabetes are already in development.

Sources:

Barkai U, Ludwig B, Bornstein S, Zimermann B, Gendler Z, Rotem A. Bio artificial pancreas - the immune barrier and oxygen deficiency. Xenotransplantation. March 2014; 21(2):190-203.

Longworth L, Yang Y, Brazier J, et al. Use of generic and condition-specific measures of health-related quality of life in NICE decision-making: a systematic review, statistical modelling and survey. Health Technol Assess. 2014;18(9):1-224.

U.S. Food and Drug Administration. Mobile Medical Applications. Guidance for Industry and Food and Drug Administration Staff. Issued on September 25, 2013. http://www.fda.gov/downloads/MedicalDevices/.../UCM263366.pdf

Zhang J, Hodge W, Hutnick C, Wang X. Noninvasive Diagnostic Devices for Diabetes through Measuring Tear Glucose. J Diabetes Sci Technol. 2011; 5(1):166-172.

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