Sal McKeown looks at how people are increasingly using smartphones and wearable technology to keep track of their health and vital signs…
Prevention is better than the cure, or so the saying goes. For the NHS and private providers alike, however, the need to keep patient numbers down is very real. Technology is playing an important role in achieving this, enabling an ever increasing number of people with medical conditions such as heart disease, dementia and diabetes to be monitored remotely.
Being diagnosed with a long-term health condition will have a major impact on a person’s life. It’s often not just a question of dealing with the symptoms, but also trying to manage a serious loss of confidence. With the right solution in place, however, it’s possible to monitor someone’s health in ways that can alleviate their worries, restore their independence and improve their quality of life.
Sensium Healthcare’s SensiumVitals system, for example, sees hospital patients given a lightweight patch for them to wear while up and about. The patch contains a wireless sensor that monitors their heart rate, respiration and temperature every two minutes; the resulting data is sent direct to clinicians via the hospital’s IT system, with the system issuing instant audio alerts if and when the sensors detect something wrong. The batteries inside the patches last five days, after which the patches are disposed of and replaced so as to minimise the risk of cross infection.
So far, the SensiumVitals system has been trialled at Spire Health’s Montefiore Hospital in Brighton, with NHS England subsequently noting how, “For the patient, it offers reassurance, mobility, and better outcomes.” Further trials are now scheduled to take place at a number of other NHS hospitals, including Queen Elizabeth Hospital Birmingham.
Advocates of the system claim that at £35 each, SensiumVitals patches could potentially save hundreds of lives a year and the NHS millions – though critics have expressed concerns that widespread adoption could spell an effective end to bedside nursing.
Putting people in charge
Ultimately, however, the main objective is not to change current hospital practice, but to support more people at home and work, putting them in charge of their own healthcare in a way that hasn’t been possible until now.
The conceopt of providing people with healthcare support from a distance isn’t new, of course – telecare solutions, in the form of alarms and monitors, have been around for many years. What is new is how advances in wireless communications and mobile devices – not least the ubiquity these days of smartphones – are set to revolutionise how we can capture, process and analyse individuals’ bio-signals.
Right now, we have wearable fitness devices that can track individuals’ physical activity, sleep patterns, calorie intake and even, according to some companies – your mood. They typically come in the form of wristbands, watches and earphones, and there are many in the NHS who see both wearable technologies and smartphone apps as a good way of motivating people to adopt a healthier lifestyle.
According to Laura St Quinton, who leads the NHS’ web and mobile apps development, “Apps can help enormously with behaviour change and good habit forming. Research tells us that it takes at least 21 days to form a new habit, and having an app in your pocket that provides regular nudges along the way is a huge help.”
Apple’s Health app, for example, came included in last year’s release of iOS version 8, the software that powers all of the company’s mobile devices. Once opened, the Health app displays three graphs showing the number of walking steps you normally take each day and the total distances you have covered when running and walking. The recorded data can then be displayed as a daily, weekly, monthly or annual graph, allowing you to monitor your exercise patterns over time. The Health app can also be used to keep track of your cholesterol and blood sugar levels and heart rate, and even share that data with medical professionals.
The Google Fit app for Android smartphones, meanwhile, lets you track your steps, distances and pace. It can distinguish between running, walking, and cycling, gives users the option to set themselves specific time or distances goals and can be used with other Android fitness apps and third party devices (such as smartwatches), so that all your biometric data can be displayed in one place.
Beyond smartphones there’s the new generation of fitness technology of represented by the Apple Watch. As well the GPS location tracking and accelerometer movement monitoring found in most smartphones, it also includes a built-in heart rate monitor and works well with apps designed to measure calories burned and overall fitness.
In the coming years, we can expect to see a growing number of mobile health apps that make use of wearable accessories. The incoming SecuraFone Health app for iOS and Android, for instance, uses a water-resistant Bluetooth wireless sensor that’s worn on the chest or back like an adhesive bandage. As well as tracking a person’s steps and calories burned, it can also detect potentially dangerous changes in heart rate, respiration and skin temperature and use your smartphone to automatically alert up to 200 people via text message or email.
There’s also now an experimental app for people with Parkinson’s – a condition that affects around 127,000 people in the UK. Developed by Dr. Max Little, a mathematical researcher from Aston University, the app can sense tiny changes in an individual’s voice, gait, movements and manual dexterity and is currently being tested among of 2500 people at the University of Oxford.
Benefits and risks
Dr. Little’s app and others like it highlight perhaps the key advantage of wearable fitness apps and devices – that they can give health professionals access to more detailed biometric information than ever before. If enough people start using them, we could start to see health information collected and transmitted on an extremely large scale. Medical professionals will then hopefully be able to use that data to identify trends and patterns and use their findings to develop new treatments and strategies for people living with conditions such Alzheimer’s and heart rhythm disorders.
Some have voiced concerns about the security of such information, however, since it’s often unclear who owns the data recorded by wearable devices and how it might be shared. Presently, a number of health apps will allow – and occasionlly require – users to consent to sharing data with third parties.
Apple states that its HealthKit service, for example, will store users’ data securely, but many people may not know enough about how it works to give informed consent. Given how often financial data is shared with insurance companies, credit agencies and even market research companies, it isn’t far-fetched to suggest that our health information may one day be made available to life insurance companies or HR professionals. And while the data recorded by wearable devices can assist with new scientific developments, it can also be exploited by the makers of freely downloadable apps with built-in advertising that only exist to generate revenue. Apart from anything else, it’s important to remember that any company bringing a health app to market will have done so with the aim of somehow generating a profit.
Putting healthcare into the hands of individuals throws up exciting possibilities for medical research, but we must be mindful of the other risks involved – not least to our peace of mind. When it’s possible for us to monitor our bodies’ performance at all hours of the day, there’s a chance that the ‘worried well’ will become obsessive. A small change in blood pressure or sleep patterns, or perhaps a headache or hangover, is all it might take for us to imagine the worst…
Case Study: Staying in Control
Bart Kakoschke has tachycardia and atrial fibrillation, with occasional bouts of supraventricular tachycardia
A Fitbit monitors my heart rate, steps taken and sleep. It gives an instant readout of my current heart rate (except when I have arrhythmia) and keeps a 24-hour-a-day record. The device connects wirelessly to a smartphone app – as long as the phone is on and within range, the updates are automatic.
I find it’s good for my peace of mind to know whether my heart really is running fast, or if it’s just my imagination. It’s also useful for my cardiologist to see in graphical form what my heart rate has been.
The AliveCor is a slim electronic device that connects adhesively to a smart phone and is basically a single channel ECG. I only use this device when my heart is playing up, as it’s great for recording anomalous heart rhythms. It’s used simply by running the app and holding your fingers steadily on two metal contacts for 30 seconds or so. The phone app automatically detects signs of atrial fibrillation, provided your pulse is less than 100bpm. The company also provides an analysis service by a doctor or technician for a modest fee, or you can email the recording yourself to your own doctor.
These devices make me feel more secure, independent and in control, as opposed to relying solely on doctors’ visits.