Conference Vision: In October 2011, 350 academia and industrial professionals from 13 countries gathered together in San Diego to attend the Wireless Health 2011 Conference to learn and share on the subjects of wireless technology and health. Keynote speakers shared various aspects of the future of healthcare. It was interesting to note that many schools started to add new departments focusing on Wireless Health and Biomedical Engineering, among them were UCLA, Case Western, USC and the University of Virginia. The themes of Body Area Networks (BAN) and remote connections were mentioned throughout the conference.
The spirit of the conference could be summed up by keynote speaker Paul Jacob, chairman of the board and CEO of Qualcomm, who described a situation where there would be a wide range of sensors on the body to connect with the “cloud network” enabling local and remote caretakers/ clinicians to monitor the patient’s condition and take proactive actions. As an illustration, an implantable defibrillator could act as a sensor monitoring the heart’s condition as well as acting as a defibrillator when needed. In a separate video, there was an amazing scene showing a soccer player who had dropped to the ground due to a heart attack. A few minutes later, the implanted defibrillator was activated to shock the heart back to its normal beating rhythm and the person was able to get up and walk again. Jacob’s call to action was that the community had to collaborate to make these wireless devices connect seamlessly. This would facilitate the ever growing connected health market with opportunities abound.
Eric Topol, M.D., demonstrated the use of an iPhone as a tool to monitor the ECG signals of a patient. The use of an iPhone or Android as a handheld device to monitor health will continue to be a hot topic in the coming years. One of the challenges from my research is how the use of handheld devices in healthcare would be regulated. Separately, the FDA has reached out to the community to get feedback and start a dialog on this topic. (Click here for the notes of the recent townhall meeting)
Gene Frantz, principal fellow Texas Instruments, shared his vision that someday we would have a handheld device to monitor our health. (Health—don’t leave home without it). Frantz humorously started with a picture of an old computer occupying the size of a room, now becoming a handheld device. With the iPhone, Apple has combined a phone, music, video and emails in one device. In the foreseeable future, you could be holding up a smartphone that could tell you about the condition of your heart, blood sugar level, and how the other parts of your body are functioning.
Remote Sensors Reduced Costs
Bruce H. Dobkin, M.D., professor of Neurology and director of the Neurologic Rehabilitation and Research Program at the Geffen/UCLA School of Medicine, suggested that major cost savings and far better daily monitoring and outcome measurements about physical activities could be achieved by clinical trials using remotely collected, wireless technology. Trials in neurology, rehabilitation and for chronic diseases have been limited by the inability of investigators to collect data frequently from patients throughout a trial.
Bruce H. Dobkin, M.D., professor of Neurology and director of the Neurologic Rehabilitation and Research Program at the Geffen/UCLA School of Medicine
First, nearly all trials only capture data during a single test of walking, exercise and other physical activities before and at the end of a trial in the laboratory environment. Different results may be found when such data is collected daily or for weeks at a time throughout the course of a 6-12 month or more trial during real-life activities. Second, the cost of laboratory-based data collection is very high. “In a $12 million project that was recently published,” he cited, “$6 million was spent in bringing the patient back to the laboratory for training and testing.”
In an example of rehabilitation of a stroke victim, while the patient may do all the assigned exercise to regain the ability to walk in the presence of a physical therapist, they might not practice at home enough or properly to improve their skills. If remote sensors were used, clients could be monitored for compliance and receive feedback about their performance from their therapist without leaving home. Caregivers at home would be able to motivate and assist with the help of the feedback provided by the sensors. According to Dobkin, “a potential savings of 50% of the cost of a trial in which physical functioning is an important outcome measure could be achieved by using remote sensors.” To help achieve this, Drs. Dobkin, William Kaiser, Majid Serrafzadeh, Greg Pottie and others developed the UCLA Medical Daily Activities Wireless Network (MDAWN), based in the multidisciplinary UCLA Wireless Health Institute (www.wirelesshealth.ucla.edu ), to facilitate such research projects. They are carrying several clinical trials in stroke, multiple sclerosis and organ transplant participants. (Click here for more research by Dr. Dobkin)
Handheld Device to Help Diabetes
To help modify behaviors of a person, many methods were used including feedback, motivation and gaming. Today, an estimate of 63% of people with type 2 diabetes have an A1C value higher than the recommendation. A total of approximately 26 million people in the United States live with diabetes, which translates into an annual healthcare cost of $174 billion. The American Diabetes Association (ADA) uses A1C to measure the level of glucose in a person with type 2 diabetes. According to the ADA, a desirable A1C is 7% or lower. Many ways are used to manage diabetes: lifestyle management including exercises, diets and medications are among them. Dr. Anand K. Iyer, president and chief operating officer of WellDoc, Inc., cited a successful example of using technology to help people with type 2 diabetes manage their glucose levels. The WellDoc DiabetesManager, a software-based system running on data-enabled handsets, achieved an A1C reduction of 1.9% in subjects using the system plus their usual care according to an independent study. With the proper input to the device, study subjects received the needed feedback to achieve a balance of lifestyle and behavior modification to yield the optimal results. [Link- press release of Welldoc]
The Magic Glove
Physical rehabilitation requires a patient to exercise body parts such as an arm or fingers. Often patients forget to do it or lose interest. Students from UCLA, Huang and Sarrafzadeh, came up with a solution by making the exercise a game. In a demonstration they showed how a patient would wear a glove connected to a software game called “Jewel Fetching. The patient would move both the arm and the fingers in a three dimensional fashion to fetch the jewel appearing on the display monitor. Once the jewel was fetched, the game would sound with shining light. This positive feedback would encourage the patient to continue to play. A simple and yet fun demonstration had won them the “Best Demo” award. [video here]
Ultra Portable ECG
The most amazing demo was the compact ECG heart rate monitor. Together with Delta, Imec showcased a low-powered “body patch” that enabled a distant caregiver to monitor the ECG signals of a person anywhere as long as they were close to a Bluetooth hub station. This patch is a body area network (BAN) connecting to a hub using a Bluetooth radio, which allows the clinician to see the ECG signal as if the person were in the clinic or hospital. With the total power consumption about 280uA at 2.1V, the unit was able to run continuously for one month without changing the 200mAh Li-Po battery. In the demo, the display receiving the signal was able to show the change of heart rate as the person was jumping up and down
Finally, the overall best research paper and presentation award was given to Shanshan Chen, Cunninham CL, Lach J. and Bennet BC from the University of Virginia Center for Wireless Health. The title of the paper was “Enabling Longitudinal Assessment of Ankle-Foot Orthosis for Children with Cerebral Palsy.” Other academic enthusiasts with great ideas including the magic glove (UCLA and USC project) can be viewed at www.wirelesshealth2011.blogspot.com. As the conference adjourned we all left inspired. I look forward to seeing more new breakthrough research and innovations next year.
