Wearable medical monitoring devices: innovation continues

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Wearable medical monitoring “smart” devices that monitor vital signs, monitor medication use, and monitor patients after surgical procedures. These devices, which can take the form of rings, watches, glasses and clothing with embedded sensors, have created new ways to manage diabetes, hypertension, heart disease and other medical problems.

Wearables inventor Xuanhe Zhao, PhD, professor of mechanical engineering and professor of civil and environmental engineering at the Massachusetts Institute of Technology in Boston, said wearable devices such as continuous glucose monitors and electrocardiography monitors are having a significant impact on medical practice, especially in digital and precision medicine. “We hope that wearable imaging platforms such as bioadhesive ultrasound (BAUS) for imaging various deep organs will further impact the field,” said Dr. Zhao.

He and his colleagues have developed a new postage stamp-sized ultrasound adhesive that provides clear images of the heart, lungs and other internal organs. The device is attached to the skin and can provide continuous ultrasound imaging of the internal organs for 48 hours.^1,2

Currently, ultrasound imaging requires bulky equipment available mostly in hospitals and doctors’ offices. Wearable ultrasound monitors can be applied to hospital patients in a similar way to electrocardiography stickers that monitor the heart’s activity, and can continuously take pictures of internal organs without requiring a technician to hold the probe in place.

The researchers applied the ultrasound stickers to volunteers and showed that the devices produced high-resolution images of major blood vessels and deeper organs such as the heart, lungs and stomach. When volunteers performed various activities such as sitting, standing, running and cycling, the stickers maintained strong adhesion and observed changes in major organs.

Dr. Zhao’s team envisions that ultrasound patches will be attached to various parts of the body and connected to a smartphone, with artificially intelligent algorithms analyzing the images on demand.

“One of the biggest challenges will be the translation and commercialization of BAUS devices,” said Dr. Zhao. “We hope to be able to translate BAUS devices in the next 3-5 years. Initial applications will be within hospitals where the BAUS platform can provide long-term continuous imaging of patients undergoing physical tests such as treadmill running. In the future, BAUS devices will hopefully become wearable consumer electronics devices similar to Apple Watch or Fitbit bands.

Another innovator in wearable medical technology is Rose Faghih, PhD, associate professor of biomedical engineering at the NYU Tandon School of Engineering in New York City. Dr. Faghih and his colleagues developed algorithms for a technology they call MINDWATCH, which monitors electrodermal activity (EDA), a measure of brain activity related to emotional states, and assesses internal emotional arousal. Internal stressors caused by pain, fatigue, or a heavy schedule can cause EDA changes that are directly related to mental state.³ The technology ultimately provides stimuli that help patients return to a neutral state of mind. For example, if a person is under a lot of work-related stress, MINDWATCH can pick up on this and automatically play relaxing music.

“Widespread use of wearables could ultimately help detect early signs of poor health in everyday life, hopefully reducing hospitalizations and healthcare costs in the long term,” said Dr. Faghih.

He also noted, “For widespread use of wearables in medical practice, HIPAA-compliant data storage and transport systems for wearables must be enabled to keep patient data safe and secure.”

Dr. Faghih noted that a lack of insurance could be a barrier to greater use of wearable medical technology. “In order to reduce health care costs through the use of wearables in the long term, insurance companies need to develop policies to make wearables more accessible to individuals and encourage the daily use of wearables as part of routine medical care,” he said.

Wearable technology in healthcare is designed to complement, not replace, physician care. Researchers have shown how sensors that record movement patterns can help detect health problems in older people at an early stage, including depression, risk of falls or cognitive impairment. In the future, such technologies could help adults age 65 and older stay in their own homes for longer, thereby easing pressure on the health care system.⁴

Definitions

Wang S, Chen X, Wang L, et al. Bioadhesive ultrasound for long-term continuous imaging of various organs. Science. 2022;377 (6605):517-523. doi:10.1126/science.abo2542
Ma Z, Bourquard C, Gao Q, et al. Ultrasound-guided solid bioadhesion. Science. 2022; 377 (6607):751-755. doi: 10.1126/science.abn8699
Amin R, Faghih R. Physiological characterization of electrodermal activity allows inference about real-time scalable autonomic nervous system activation. PLoS Comput Biol. 2022;18(7):e1010275 doi:10.1371/journal.pcbi.1010275
Schütz N, Knobel SEJ, Botros A, et al. A systems approach to remote health monitoring of the elderly: implementing zero-interaction digital output. NPJ Digital Med. 2022;5(1):116. doi: 10.1038/s41746-022-00657-y

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