New Lease on LifeJune 11, 2009
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Tim Studt
Editor in Chief | The combination of smaller, more sensitive sensors with lower power requirements and rapidly expanding wireless communication capabilities has given researchers newfound powers to investigate a multitude of physical, environmental and biological entities. In the medical arena in particular, telehealth has grown over the past decade with these technological improvements. They now provide the 12% of our population who are senior citizens with greatly improved health monitoring benefits—and even non-seniors who are incapacitated, like the 10% of the general population with asthma or the 8% with diabetes. Simply, telehealth provides doctors access to real-time patient data that’s transmitted via phone or Internet from the patient’s location. The majority of this data comprises weight, body temperature, blood pressure, blood glucose and oximetry (blood oxygen). While the current model relies on mostly manual transmission modes (patients sending data), the technology is available to provide automated transmissions via cellular methodologies. The technology is not yet so sophisticated that weight, temperature, blood pressure, sugar and oxygen levels can be automatically transmitted without the patient’s assistance, but advances have been made that greatly simplify those measurements. Monitors for each of these measurements can readily be bought online for less than $65—wireless body fat scales can be bought online for less than $40. The high incidence of diabetes (22% of senior citizens) and its potentially life-threatening consequences has driven development of real-time, wireless continuous glucose monitoring (CGM) technologies where sensors are implanted under the skin and glucose measurements are sent wirelessly and continuously to a Bluetooth-enabled monitor (currently more expensive than those mentioned above). This Medtronic-developed device also has warning alarms and can incorporate an automated pump to provide insulin on demand. Data can be downloaded from the wearer’s monitor to a computer/doctor to evaluate ongoing trends. The benefit of these technologies is that a patient’s medical condition can be seen in mostly real-time situations. A secondary benefit is being able to look at the patient’s medical trends. The absolute value of body fat, for example, is not so much important as is the trend of the patient’s body fat levels. Preventative medicine is always more important and less costly than an abrupt, traumatic medical event. Even more sophisticated technologies are available that simplify the workflow for healthcare organizations performing remote monitoring of patients with chronic diseases. These triage applications allow physicians to analyze trending data, manage patient care plans, create reports and exchange data with other clinical information systems. Physicians can also now talk to patients through online video, chat or phone and review these data and have those discussions (and prescribed medications) approved through insurance providers (in limited areas currently). Office visits and costs are thereby minimized with more immediate attention and less patient trauma. A third benefit of these technologies is that the devices, software and communications systems have been ruggedized for a wide range of environments. Many are FDA-approved with all the rigors of that process. The Medtronic wireless CGM device, for example, is waterproof so diabetic athletes can use it. Even wireless technologies, with their maze of protocols, are becoming more workable with open software platforms that are capable of communicating with multiple protocols. While my discussion here focused on medical applications, the same or similar technologies can and are being applied to non-medical areas. Watch for our August 2009 cover story on Remote Sensing for even more technology case studies.
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