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Could Wearable Medical Devices Track Vitals, Diagnose Disease?

By Vera Gruessner

- The mobile health industry is really making a major impact on patient care throughout the country, as more consumers continue utilizing mHealth apps, remote monitoring tools, and telemedicine services. In particular, wearable medical devices have the potential to revolutionize the diagnosis, health monitoring, and treatment outcomes of patients throughout the healthcare continuum.

Mobile Health Industry

To learn more about the potential benefits of the mobile health space and the opportunities afforded by wearable medical devices, spoke with Dr. John Patrick, author and mobile health expert.

Which mobile health devices are making headway in potentially diagnosing disease in the near future?

Dr. John Patrick: “I think in the short-term, what we’re seeing is very rapid growth in devices like the Fitbit and many other similar devices that count our steps. That’s an elementary thing, but it is important because it does allow people to get used to the idea of gathering data about their activities.”

“Studies going way back find that people who track their health and activity are healthier. It may be obvious in a way, but nevertheless that correlation has real merit. The simplest thing is how many steps you took – devices that measure your activity.”

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“The future is going to be much more significant in terms of the breadth of things that could be measured. It’s not just steps – it could be cholesterol, the presence of an infection, your heart rate, or many different tests from bodily fluids that could be indicators for the actions within one’s body.”

“For example, human sweat carries a huge amount of data that could be predictive and could explain many things about what’s going with our bodies. I’m not aware of devices that measure that, but I have no doubt that there will be such devices.”

“What I attribute to this growth and significance are the smartphones. These are just incredibly powerful. I relate in my book the story about the supercomputer back from 1976. It was a very much in-demand supercomputer – the largest, most powerful computer ever built [by that date]. It weighed five tons and cost $5 million. It used the electricity of 20 h0mes. It was not even 1 percent the power of an iPhone 6.”

“So we have these supercomputers in our pockets and wallets. We’re going to be able to do amazing levels of analysis of various medical conditions [with the smartphone.]”

Are wearable medical devices capable of tracking patients’ health and vital signs?

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Dr. John Patrick: “They absolutely are. This is in the early stages compared to Fitbit, which has been around for a long time. The capabilities are vast.”

“A good example of where this is going is what Cedar Sinai Hospital in Los Angeles has done. They have enabled electronic health records of 80,000 patients to be connected to the Apple Health App, which is an iPhone app. The Apple Watch gathers data about our cardiac activity, and that data continuously monitored by the Apple Watch flows directly into the Health App.”

“That App is linked into electronic health records. We have a really profound situation now where cardiologists can look at data of one of their patients and see not how today’s heart rate compares to 30 days ago when they last visited, but to actually see all the activity of the heart over the past 30 days. By applying some computing power to that data – such as IBM’s Watson or other techniques – cardiologists can see any irregularities that might occur, the mean daily heart rate, the standard deviation of these averages, and see arrhythmia.”

“Other than the smartwatch, Ralph Lauren now has a shirt that measures heart rate, posture, and activity – seven or eight things that it measures. It transfers that information to either a smartphone or a smartwatch and allows a consumer to gather a lot of data about their body’s performance.”

Could remote monitoring improve the outcomes of patients with chronic conditions?

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Dr. John Patrick: “I did my doctoral dissertation on the subject of home monitoring for the reduction of hospital readmissions among congestive heart failure patients. Readmissions are a very big problem for hospitals as well as patients and their families.”

“After a patient is discharged, 25 to 50 percent of CHF patients within a month are right back in the hospital with the same symptoms again. If there’s a way to monitor their symptoms, if the patients themselves can monitor these symptoms, this can provide an early warning and offer the opportunity for an intervention to prevent a readmission.”

“For example, measuring the weight of a patient is one typical standard that is used. When a congestive heart failure patient gains three pounds in a day, it’s not from chocolate cake – it’s from fluid buildup.”

“The fluid buildup causing the ankles to swell is the result of a heart that’s not as effective as it needs to be. If that measurement can be done in the home, an indication can emerge that suggests that in the next few days, this will result in an episode that will result in somebody dialing 911.”

“Rather than dialing 911, a paramedic could be dispatched by the hospital to that patient to administer a change in the diuretic. It could move from taking a pill to an injection that is much more effective at reducing that fluid buildup.”

“The cost of dispatching the paramedic in that scenario is not trivial, but it is trivial if compared to the cost of calling 911, having an ambulance come, moved to the emergency department, and be admitted into the cardiac floor and be treated for two or three days. This is tremendously expensive. This could be avoided through more effective home monitoring.”

Are mobile health apps growing in popularity among physicians? Which apps are the most widely used?

Dr. John Patrick: “There was just a report out that suggests the market for these devices is now half a billion dollars. The most popular apps are the fitness apps, but that’s going to change. It’s similar to the Internet in the early days. It was mostly file transfers and email. There was no World Wide Web, but once we had the World Wide Web, it grew very rapidly and became the predominant use for the Internet.”

“A similar thing is happening with these devices. It will initially be simpler things like the Fitbit and the Apple Watch, but as people learn about the capability to measure their own blood for cholesterol. To be able to use a device like the Live Core device for the iPhone, which does a 30-second EKG.”

“People will realize that they can test themselves as often as they want. Nobody will have to drive across town, make an appointment, and go back 30 days later. Consumers will be able to take a test as often as they want.”

“As people realize this, we will see a rapid growth in these devices. Another indicator of this is that the FDA has embraced the idea of mHealth. They see it as a way to make people healthier and they’ve approved more than 150 devices so far.”

Could telehealth technology and mobile health apps make healthcare more convenient for the everyday patient?

Dr. John Patrick: “The word convenient is definitely the key word. Today, if I need a test, I have to get in the car, drive 12 miles, and wait in line for a simple test that I could have done at home with an iPhone and a proper mHealth attachment.”

“These attachments are not readily available yet, but the technology has been proven to work and we’re at the very early stage of that. Over the next few years, we’re going to see a huge growth and consumers are going to jump on these devices for exactly the word mentioned – convenience.”


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