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Advances in Connected Health Sensor Technologies Enable an Exciting Vision

January 18, 2011

Most of the time I write about the psychology of patient, consumer or provider adoption.  This is not an accident.  The psychology of adoption is the next big hurdle for connected health to overcome.  We have good evidence that connected health solutions can be engaging and sticky for patients, leading to improved self-care. Likewise, we have evidence that enriching data coming from patients to providers can lead to better care decisions and that these decisions, made and delivered in the moment of need, are the other half of the magic of connected health. Further we have a sense that those patients who are not interested in the level of engagement that connected health demands often have worse outcomes and therefore cost the system more.

But today, I want to talk about technology.  Most of the time, I write from the perspective of a technology vision that includes continuous (or near continuous) sensing of multiple physiologic signals. These signals are flawlessly transmitted to a computing environment where decision support can be applied to aid in improved communication with patients and improved decision making by providers. The state of the art today is not so elegant.  We use multiple different sensors, both wired and wireless, communicating via a large variety of aggregator devices that then transmit the sensor outputs to us via the Internet.  The environment is both user-unfriendly and error prone, which increases the technical support resources required.   We have the strong sense that some individuals drop out of programs because the technology is too challenging for them, so we miss them before we can turn them on to the benefits of a connected health experience.

The marketplace for sensors is changing in a number of exciting, dynamic ways.  First, a number of sensors are coming to market that have embedded mobile chips right in them.  They are sold in the same way as the Amazon Kindle (the wireless connectivity is bundled in the price of the device).

The Center for Connected Health is working with a number of manufacturers to evaluate a range of health devices. Examples we’ve been using, testing or looking at lately include the Bodytrace wireless weight scale, the Telcare wireless glucometer and the latest version of Vitality’s GlowCaps device.  All of these devices can find the mobile network automatically when the sensor is triggered and transmit their relevant data to the Internet with no patient intervention.

A related approach is to create the wireless home hub that finds all of the sensors within a certain radius and send their information seamlessly via the wireless Internet.  An example of such a device is the Medapps Healthpal.  I am not sure which of these competing architectures will win the day when all is said and done, but they are both such an improvement of today’s complex, hard-to-use set ups, that they seem like nirvana at this point.

The second dimension of change I find exciting is that we are able to sense more and different things than we could in the past.  A pioneer in this effort is BodyMedia, whose armband sensor uses an algorithm to calculate activity, caloric output, sleep quality, etc.  The Proteus Biomed Raisin system pairs a small, embedded wireless chip in each tablet you swallow and a disposable band aid that one wears on the chest to capture the effects of the medication as it flows through one’s system.

Perhaps the most interesting area of sensor innovation is in the non-physiologic area.  Cogito is a company whose product analyzes an individual’s voice on the phone and can predict their mood with a high degree of accuracy.  Affectiva has two technologies that analyze emotional state by facial recognition and by a simple armband sensor.  We’ve had too limited of a view of what we can collect from patients remotely and these emotional sensors add a whole new dimension to the objective data part of the connected health story.

You can tell I find it exciting to follow the success of these companies. We are busily working at the Center for Connected Health to put them all to work in real patient context in order to sort out their strengths and weaknesses in hopes of extending them into our programs as soon as we can.

I’m curious as to your thoughts.  Are the examples I chose the best ones? Are there ones out there that I should know about but weren’t mentioned?

10 Comments leave one →
  1. Sandra Peters permalink
    January 18, 2011 9:56 pm

    What about My Guardian Angel home monitoring?

    • January 19, 2011 12:18 pm

      I think of these systems as a different category entirely, but it is worth mentioning them in the mix

  2. January 24, 2011 11:36 am

    At a conference at the NIH in the mid 90s, technologies of this sort were presented. Of course that era passed wthout their adoption and these have long since been replaced by this avalanche of mHealth devices et al with a rapidity that allows no one to evaluate their true value, accuracy etc. Even ignoring the economic aspects involved how will we utilize them with any confidence?

    • January 24, 2011 1:26 pm

      I have decided that the best evaluation of actual sensor precision is to correlate its use with some clinical outcome. This assumes that they are generally all internally consistent. So if my Fitlinx ped says I walked 7000 steps and my Bodymedia armband says I walked 9000, that is ok as long as the difference is always consistent in that way. What matters is that i’m following my activity and motivated to be more active as a result. Similarly, if my Omron BP cuff measures BP that is consistently 20 mm of Hg higher than my doctor gets when she checks it, that is OK as long as we understand what the readings mean and their relevance to improving health. I don’t think we can or should demand the same rigor of accuracy of these ambulatory sensors as we do medical grade sensors used in an acute care setting.

  3. garry welch permalink
    January 27, 2011 6:25 pm

    Interesting how this field is heating up. At Baystate Medical Center we are running a new pilot remote home monitoring study in which we are tying together a wireless weight scale, wireless pedometer, and medication tracking device containing the cellular hub to provide feedback and coaching to gastric bypass patients following surgery. The medication box will track the vitamin and mineral supplements the patients need to take daily. Maybe a big piece to figure out is who get is to what data when and in what form reported,depeding on preferences (patient,care-giver, surgeon, nurse, etc. Is much written on this?

    • January 27, 2011 9:19 pm

      Its great to hear of your progress out in Springfield. The project sounds fascinating and a bit daring. If we at CCH can help in any way would love to hear more about it.

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