Can medical and consumer MHealth applications finally converge?
For wearable devices and consumer applications to be successful, they should address more serious health issues than just Wellness and Fitness. This was the conclusion of the recent Juniper Research report which echoed many other respectable sources. As discussed in my previous blog the approaching wave of consumer wearable devices, people are getting increasingly bored with compulsively calculating their calories, steps and BMIs and expect mobile applications to shift to more serious health indicators, in particular, related to such areas as chronic disease management, active aging or disease prevention. Physicians, for their part, do not trust data coming from consumer applications that were not clinically tested.
There is an apparent gap between consumer devices, applications they are linked to and users’ aspirations. Nevertheless, developers continue to enthusiastically yield applications nourished with data with no meaningful use. If such trend sustains, the commercial mHealth applications will rapidly face public disillusionment followed by a collapse of startups that invested their money and intelligence in developing such applications.
But there is a light at the end of a tunnel. It seems that medical professionals together with engineering companies are entering the field by designing new types of medical devices that can collect data capable of providing physicians a much deeper insight into complex health issues. These portable wirelessly connected and miniature devices can assemble vital health parameter measurements such as ECG, blood pressure or blood glucose concentration, sending data to applications accessible to physicians anytime anywhere. If these endeavors are extended to the consumer market, we may see a new wave of commercial health devices and applications with wide acceptance from both consumer and professional medical environment.
I remember visiting the Amosov National Institute of Cardiovascular Surgery, one of the largest and most recognized cardiology centers in Kiev, the capital of Ukraine. A cardio surgeon, apparently coming directly from the Operation Theater, showed me a long line of people scuffling in the corridor. They came from all over Ukraine clutching CDs with their cardio images only to be diagnosed by the Amosov Institute experts. “We really do not know if these people are fit to travel”, explained the cardiologist. “Some of them may be at risk of a heart arrest on their way to the clinic. At the same time, we often have to respond to emergency calls travelling with full ammunition only to discover that the alarm was false. Imagine if somebody might really be in need at this very moment”.
Other European countries, with a much better Healthcare system than Ukraine, encounter similar problems. Pressed by costs, workload stress and time associated with visiting patients in remote areas, physicians are considering options that will allow them more flexibility in treating their patients. Patients, from their side, are ready to embrace services enabling them to be connected to their physician from home or anywhere. Instead of being “tied” to the bulky equipment installed in the hospitals every time an individual needs an ECG or an ultrasonic test, a patient can be linked to the physician or nurse directly going through the same checkup from a comfort of their home.
There are already some good examples of wearable equipment designed by medical engineering companies.
The Austrian company MedCubes’ product RemoteCase has recently received “the State Award for Consulting and IT”, the national prestigious acknowledgement for innovation.
The solution is intended to link physicians to patients who have limited access to healthcare services. Compact and light wirelessly connected medical device “in–a-box” provides the wide range of high-quality measurements including 12-channel ECG, FastECG, stethoscope, oximetry, thermometer, blood pressure and blood sugar units, dermascope, otoscope, weight scale or selected rapid tests. The collected patient data are stored to a centrally located MedCubes private cloud system. Medical data are transmitted to PCs, tablets or smart phones accessible to physicians, depending on their role in the clinical process.
Physicians can run a remote triage based on more than 70 symptoms for each patient registered in the system. The measurements results are going directly to an application designed by MedCube. The elegant graphical interface allows doctors to easily navigate through multiple data.
When a nurse is visiting a patient, she can take the assessments from a Fast ECG, oximeter or blood pressure device and save it to the central system for doctors to examine the results. The external specialists can get a limited access to the anonymized patients’ data if the “second opinion is required”. Physician can make an audio/video-chat with their colleagues, start chatting with a nurse or directly with a patient. The emergency visits are no more an unexpected surprise: physicians know exactly what to expect when they receive a call, while patients have a feeling that their situation is under a professional control no matter if they are in or out of the hospital.
The ultimate dream of medical engineering is to design devices that would help to monitor patients 24×7 with the minimum involvement on behalf of a physician.
The U.S. Food and Drug Administration has recently approved CardioMEMS Hearth Failure Management System, the first-ever wireless monitoring tool aimed to reduce heart failure hospitalizations and improve quality of life for cardio patients.
A tiny, wireless monitoring sensor, not bigger than a dime, is implanted in the pulmonary artery to measure pulmonary artery pressure, a procedure normally conducted in the hospital when patient’s heart failure conditions become critical. The new wireless option allows doctors to monitors patients remotely from home. After implanting a sensor via a catheterization procedure a patient is able to read data of his cardio pulmonary pressure from a small device installed in his/her house. The data are immediately sent to the secure Web site monitored by a physician who, if necessary, will be able to adjust medications and treatment process to patient’s health conditions.
According to the results of CHAMPION Trial American Heart Association 2014 the the devices can help clinicians to reduced HF admissions by 37% 
Contrary to the flood of allegedly consumer health applications designed for “healthy and wealthy” that fail to address the needs of chronically ill, aging or poor, the new wave of applications linked to miniature medical devices are embracing those who can really benefit from mHealth promises. Extended to the commercial environment, such device applications could finally bridge the gap between consumer and professional medical environment. A prudent developer should consider building connections to medical engineering companies, such as MedCube or the likes, to design applications with relevant health data sets to be successful on the market.
- Adamson et al., Impact of Wireless Pulmonary Artery Pressure Monitoring on Heart Failure Hospitalizations and 30-Day Readmissions in Medicare-Eligible Patients with NYHA Class III Heart Failure: Results from the CHAMPION Trial AHA 2014, Chicago. Abstract 16744