Proactive, Preventative Healthcare Using Medical Digital Technology

July 10, 2021

Is it possible to move away from the current “reactive” model of healthcare? In other words, change it from waiting until the patient is sick and goes to the Emergency Department to proactively identifying an issue early in the disease state. Think along the lines of diabetes, coronary heart disease, hypertension, sleep disorders and stroke. What if we were to use existing, and new, forms of collecting data to be more engaged clinicians, able to identify underlying issues sooner and provide early or preventive care?

We are all familiar with the current wearables that can record and transmit information about the wearer to smartphones or other connected devices. This includes Fitbit and Apple Watches, Oura Ring, as well as iOS and Android phones. These devices can track your movements, sleep patterns, SpO2, heart rate, and ECG, and temperature.

What is the next wave of medical digital technology that may help detect or prevent serious diseases and medical problems before they can become major? Here is an incomplete list of devices, sensors and apps that have some application in providing preventive healthcare, some being on the market while others are still in prototype form:

• Implantable Chips – These are chips under the skin to continuously track vital signs.

• Smart Contact Lens – For the diagnosis and clinical treatment of eye diseases such as glaucoma, keratitis, and diabetes.

• Health Camera – Camera apps and systems measure vital signs, blood pressure and heart rate. These are great for aging in place as they collect data concerning amount of movement and body language, as well as if an individual is dressed, hydrating, eating, and toileting.

• Medical Hearing Aids - Capable of detecting vital signs such as heart rate, oxygenation, and blood pressure.

• Breath Device – Can detect lung cancer by analyzing molecules from your breath.

• Smart Socks – Provides information concerning external pressures recorded all around the feet for diabetic foot ulcer identification.

• Smart Clothing – Can be built into or attached to clothing. Can monitor body temperature, blood pressure, and number of steps. Acts as an Altimeter, ECG, or EMG. There is a small sensor that measures expansion and contraction of thoracic cavity for indicators of respiratory distress.

• Smart Belt – Can track number of steps and likelihood of having a fall.

• Smart Headband – Is designed for seizure detection. Will upload EEG signals to the cloud for doctor to diagnosis the patient in clinical visits.

• Digital tattoos – Made of a variety of materials. Can track ECG, EEG/EMG, monitor temperature, hydration, and blood glucose, observe sleep patterns, monitor muscle responses, and test the pH balance of sweat.

• Voice App - Detects cardiac disease, lung infections, neurologic disease such as autism and Parkinson disease, and mental health.

What if a patient used devices, sensors, and apps to monitor their health parameters? And that device, sensor or app alerted them and their physician when values were out of the normal range? Would this work in our current healthcare environment? My first thought is that it will be challenging, yet not impossible, to implement. For example, EMR’s are not able to accommodate patient-obtained digital health data as they were not designed to accept these types of external data. Therefore, some sort of device integration to connect to the EMR will need to occur. The availability of wearable technology will add to the overload of data that a physician has to sift through. Artificial Intelligence (AI) can uncover complex associations that might be hard, if not impossible, for a physician to see. It can augment and assist the physician in identifying health issues and recommending individualized treatment. I recommend that any medical practice interested in utilizing wearable technology in their clinical workflow should consider the features that are outlined in the npj Digital Medicine article, The Emerging Clinical Role of Wearables: Factors For Successful Implementation In Healthcare which can be found at https://www.nature.com/articles/s41746-021-00418-3. This article leads one to believe that organizations can achieve success in developing programs involving wearables.

So back to the original question - Is it possible to change the current reactive model of healthcare? I believe in the near future technology will provide clinicians with the ability to go beyond routine preventive health care that includes check-ups, screenings, tests, immunizations, and patient counseling to proactively monitor, detect, alert and diagnose issues and even recommend appropriate treatments.