This has been a big year for connected health. With the new administration, there’s actually been a push for more technological development in healthcare. The Food and Drug Administration (FDA) is improving processes for approving new medical devices and so-called Digital Therapies. Medicare is slowly starting to cover new classes of medical devices such as Dexcom’s CGM (continuous blood glucose monitor). This year the annual conference that had been known as the mHealth Summit changed name and location. It became the Connected Health Conference and moved from just outside Washington, DC to Boston’s World Trade Center, in Boston’s burgeoning Seaport neighborhood.
While the conference had always focused on technology, this year I saw more recognition that the technology needs to show positive economic benefits and positive outcomes in order for it to be viable. There was more discussion about return on investment, and more emphasis on deployment as opposed to trials. These are all good things. The technology companies that have either moved into this space or have grown up within it are finding out the hard way that healthcare doesn’t move at the same pace as Silicon Valley, as was pointed out by Qualcomm Life President Rick Valencia.
Among the biggest issues that were taken up by a number of speakers and panels were those of Artificial Intelligence (AI), Big Data and machine learning. If you’re not familiar with these terms as they apply to healthcare, you might want to take a few minutes and read these linked articles. We heard presentations from the likes of Intel, IBM Watson Health, and others addressing both the inevitability and desirability of all three. But there are still privacy and security concerns, as well as issues about what this will mean in terms of the quality of healthcare, issues all worthy of discussion.
The Model Is Broken
Let me begin with the premise that the current model of providing healthcare on a one to one basis is broken, and will be even more broken as the system is overwhelmed by the number of baby boomers who will demand an ever-increasing level of medical care and services as we age. Right now when you sit down with a doctor or a specialist, they spend much of their time focused on a diagnosis. They are entering data into the computer based on the patient’s description of symptoms, etc. Only after that’s done can the doctor even begin to think about treatment. Often the diagnostic process may consume 90 percent of the visit time while treatment recommendations get far less. Even then, your doctor is generally working from within his or her own experience base, drawing from experience with hundreds or thousands of patients.
But now with big data, we have the ability to draw on the information from tens of millions of patients. Instead of limiting the physician to a handful of the tens of thousands of publications out there, machine learning applications hold the hope of being able to digest all of that content and deliver precisely what’s relevant to the case at hand. Artifical Intelligence can sort through the diagnoses and make recommendations on a course of treatment. None of this limits what the physician can do. On the contrary, these technologies dramatically leverage the knowledge he can worth with to bring the patient more precise care. And when you add in the expanding ability of medicine to look at the genomics of an individual, the possibilities for improving so-called precision medicine become almost mind-boggling.
Medical Records, Privacy and Security
The way that the big data engines gather their data is by drawing on Electronic Medical Records (EMR’s) or Electronic Health Records (EHR’s). But often patients are reluctant to share their data for reasons of privacy or security concerns. They should fear less and help more. Every time a record is added to the database, it’s one more point that can help the next patient with a diagnosis. And the way it’s done is that only the information about the condition, disease, etc. is pulled into the mix, not the names or anything else that would tie an individual to the data. It cannot be disaggregated to identify a single patient. However, patients should still be concerned about the security of their records, anything that would disclose personal information such as name or address or Social Security number. Because those are the records that could theoretically be used to discriminate based on genomic tendencies or pre-existing conditions.
Onward to the Tech
There was a lot of new and innovative technology to see and hear about at the Connected Health Conference. One area that’s creating a lot of buzz is virtual reality, known as VR. Some months ago we took our first look at VR for our audience and introduced you to a company called Rendever. They were on hand in Boston demonstrating the system they are using in an institutional setting to help the elderly fight off dementia. The system also has benefits in helping the elderly deal with issues of social isolation by allowing them to revisit their old neighborhoods. Another company doing VR for the elderly is One Caring Team, creator of Aloha VR. Their approach is somewhat different, aimed at individuals who are more likely to be at home than in an institution. They work with the families to create unique content designed for each patient.
Cedars-Sinai Hospital in Los Angeles unveiled a program it has created using virtual reality to mitigate pain in hospitalized patients. According to the hospital, the therapy can reduce pain by up to 25%. The aim here is to create an environment that will allow patients to be distracted from their pain by taking a virtual walk on a beach or a hike through the woods.
While we’re on the subject of headsets, we came across a New Haven, Connecticut company called SphereGen that’s created an awesome holographic projection system called the DiCom Director. It’s already being deployed at medical schools such as St. George’s in Grenada. Instead of using totally immersive virtual reality, it uses augmented reality (AR) to project an image in its headset. The user can interact with the image, and equally important, interact with others using the headsets to discuss what they are seeing and to delve deep into the image. I saw a demonstration of a beating heart, complete with cutaways of the various chambers, all the while being able to interact so others could see what I was pointing to. Founder Ted Dinsmore says the primary use of the product is in radiology.
What’s on Your Wrist?
As you might imagine, there were many wearable companies on the exhibit floor. Fitbit’s Health Group was on hand showing off the health benefits of its fitness trackers, which are now being used in a variety of wellness programs by companies such as Qualcomm, United Healthcare, the Cleveland Clinic, Virgin Pulse and a host of others.
BeWell Connect displayed its suite of medical grade wearables. BeWell was also showing a device that does vital sign monitoring called VisioCheck that is a fraction of the size of the devices you find in hospitals and ideal for remote patient visits and visiting nurse services.
The company has an app that links together the data from all of its consumer-oriented devices such as blood pressure cuff, blood glucose monitor, no-touch thermometer, wireless scale, TENS device, fitness band, baby scale, and oxygen sensor.
Another company with a suite of wearable devices is Sensogram Technologies. It is making the SensoSCAN, a device that sits at the end of your finger and can continuously measure a variety of vital signs including heart rate, blood pressure, oxygen level and respiration. Unlike other consumer blood pressure cuffs, this can even measure blood pressure while you sleep, allowing it to spot anomalies like sleep apnea. The data can be downloaded to an app and shared with your caregiver.
Coming soon, in Connected Health Conference Part II, a look at some other new technologies as well as companies that are taking on some of healthcare’s biggest challenges including diabetes management and medication adherence.