Introduction to the Healthcare Revolution

The 20^th century heralded the first Revolution in Healthcare. From vaccines to radiology to sophisticated biomedical equipment to corporatized healthcare to collaborative R&D to multimillion-dollar funding in Healthcare research, we have seen it all in the last hundred years. The next revolution has already begun. It is the result of the convergence of several technology paradigms such as Mobility, Internet, Cloud Computing, Machine Learning, Big Data, Nanotechnology and Internet of Things. Wearable Devices, or just ‘wearables’ are a fine example of this convergence.

What are Wearables?

Wearable devices are small, biomedical equipment, no bigger than the palm of the hand, that is worn on the body.  They consist of biosensors which pick up one or more pieces of information from the body and relay it to a transducer on a continuous basis. The transducer is a component in the device that converts energy from one form to another. It converts the biosensor event into a signal that can be relayed as an alert to the user on what is called target receptor. Or they merely push data to the user while also saving the data in some form, somewhere (either on the device or on the Cloud).

The transducers and target receptors are worn on the human body or on clothing. As one can understand, the function of wearable devices (or this technology) is to detect certain changes in the body and provide real-time updates or information to either the user, or a physician who is involved in treating the user.

History of Wearables in Healthcare

Wearables may be a hip thing today but they have a long history. In 1956, a combination of biosensors and electrodes were used for the first time, to detect oxygen levels in a person’s blood. Since cardiovascular surgeries are delicate and need to monitor a whole lot of vitals of the patient, a device was designed to detect blood-oxygen levels of the patient in real-time and relay it to the surgery team in the operating room. The device became very popular (in the US and Europe) and triggered a flurry of research on biomedical devices.

Accordingly, in 1975, the first blood-glucose analyser was created. Thereafter, many experiments and innovations happened in this area. Advancements in material science and miniature electronics through the use of silicon, led to the invention of integrated hardware devices. These devices could process biomedical data and also share it in a readable format. After that, there has been no looking back. Pacemakers and defibrillators for cardiac life-support for patients emerged.

The revolution in telecom and communication technology led to Bluetooth, infrared and other technologies. They made visualization and transmitting of data easier. Today, we use wearable devices in both home and hospital settings. Examples are glucose monitors for diabetics, handheld oxygen sensors (that became popular during the pandemic), etc.

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What are they used for?

All wearables used in Healthcare can be broadly classified under three types:

Health monitoring devices:

These devices are intended to measure vital parameters like heart rate, blood pressure, body temperature, etc. The captured data is then transmitted to doctors on apps installed on their mobile phones or other devices. These devices comprise feature sensors (one sensor for each parameter) and actuators. They also have the required processing and communication capabilities, as well as the ability to store energy.

Therapeutic devices:

These devices monitor the patient’s vital parameters in real-time. They also measure metrics related to a particular treatment. Pain management devices, respiratory therapy devices, insulin pumps and rehabilitation devices come under this category. Some of these devices carry sensors for monitoring the patient’s physical condition, thereby helping doctors to adjust the therapy as required.

Activity tracking devices:

Initially, when these devices were launched, they were just meant to capture and show vital signs of the person. They were not intended for use in therapies or medical procedures. But today, they are. The vital signs measured pertain to specific diseases. The data captured is then synced with a mobile app and then transmitted to cloud-based healthcare platforms for further analysis.

Benefits of Wearables in Healthcare

• Disease management gets a boost: Wearable devices today are using biosensors to capture data around vital signs like blood pressure, heart rate, pulse, oxygen concentration, sleep patterns, and overall physical activity. They send medical alerts and reminders, and store patient health information (a lite version of Electronic Medical Records or EMR). All these become very useful while monitoring the person’s fitness levels, general wellness and in disease management.
• Act as enablers for remote medicine: Telemedicine made its foray in the late 1990s and early 2000s. It allowed physicians based at another location to talk to patients on various digital channels, view their reports, and then suggest the required medication. Wearables take such Digital Health Solutions to the next level. Since these devices capture all the vital signs in real-time and transmit the same to a physician immediately, it becomes easy to make more accurate diagnosis and prescribe the correct course of treatment. All this, without the physician physically meeting the patient.
• Democratizes access to healthcare: The direct benefit of the above is that more and more people in remote locations, with poor access to healthcare facilities can now receive timely treatment. This puts more and more sections of our population on to the public healthcare system, and improves overall health and wellness in the state/province/country. In a large country like India, this is the dire need.
• Relieves pressure on the healthcare system: The direct benefit of the previous point is that, doctors are less pressured to examine multiple patients in the available time-frame. This is a boon in a country like India, where there is always a shortfall in the number of doctors as compared to number of patients wanting to see them.
• Early-stage disease identification and treatment: An important aspect of these devices is the alerts that can be sent upon an event. That is, if the person’s heart-rate and blood-pressure is varying drastically at the moment, an alert can be sent both to him/her and his/her physician. By examining such alerts and the data around it, the doctor can identify a disease in its early stages. This way, the doctor can call for more tests, to confirm his/her suspicion. Once confirmed, relevant treatment can be given and the condition nipped in the bud before it has a chance to progress.
• Makes the leap from absence of disease, to real wellness: All the data captured by these devices are sharable. They can be fed to large data models to extract information on patterns around a disease, emerging trends in disease, and hence proactively suggest remedies. The possibility of personalized healthcare is more real now. This way, healthcare is transformed from taking a reactive or preventive approach that it does today, to a more proactive and predictive approach in the future. From an approach of reactive disease management to proactive wellness promotion.

Popular wearables today

The 5 most popular wearables commonly available today, are:

1. Wearable Fitness Tracker

This is an activity tracker that captures fitness-related data like step count, calories burned, heart rate, oxygen level and sleeping pattern. This makes it easy for the person to set daily fitness goals and make changes to them as required.

2. Smart Health Watches

These perform a wide range of functions. To begin with, they monitor the progress of workouts and then recommend relevant exercises, along with tutorials for the same. They also offer a personalized fitness routine. At the same time, they track diet and calorie intake, and provide reminders for taking medication.

3. Wearable ECG monitors

As the name implies, these portable monitors quickly detect irregular or abnormal heart readings, without having to place any electrodes on the skin. This way, one can get heart readings and analytics in a simple and straightforward manner.

4. Wearable Biosensors

These components use elements like antibodies or enzymes to detect levels of one or more biochemicals in the body. They make use of patches, gloves or tattoos to connect these sensors to the body. The response rate is faster and the direct benefit is that, diagnoses can be done quickly, thereby diseases can be treated at an early stage. This reduces the need for expensive hospitalization and advanced treatments later-on.

5. Wearable Blood Pressure Monitors

As the name implies, these monitors are convenient to use and provide accurate BP data, immediately, in real-time. This makes it easy to identify hypertension or hypotension in the patient by analysing these readings taken over a period of time.

6. Continuous Glucose Monitors (CGMs)

Also called Diabetes Monitors, these devices monitor blood-glucose levels on a continuous basis, which means one has historic data available with them. This consists of a sensor that detects real-time blood-sugar level, which is either implanted under the skin, or fixed (like a sticker) on the skin. A transmitter connected to this sensor picks up the data every 5 minutes and relays it to a device in the hospital, or the smartphone of the user.

Emerging trends

Several biomedical device manufacturers, research institutions, independent scientists and pharma companies are working on devices that could become a viable product soon. Their applications include:

• Sports training: Wearable devices that possess GPS capabilities makes it easy for sports trainers to get real-time information on their players’ performance and give relevant feedback. Example: Catapult GPS system used by professional soccer league D.C. United.
• Mining of health and wellness data: The data from multiple wearable devices can be offloaded on to a platform where experts will analyse the data and make recommendations.

Example: Apatheo platform which syncs data around sleep, step count, weight measurements, heart rate and nutrition info from MyFitnessPal, FitBit, Cronometer, Apple Health, MyMacros+ and Macros First.

• Ovulation prediction: By monitoring a woman’s vital signs, the approximate date of ovulation in her menstrual cycle can be predicted.

Example: The Ava bracelet and Oura Ring analyse real-time data of the lady’s skin temperature, heart rate, heart rate variations and respiratory rate, to predict ovulation.

• Fall Prevention: Fall Detection feature on the Apple Watch helps detect the possibility of a fall by the user. Even the Apple iPhone has a similar feature called Walking Steadiness.
• Detect infection risk: During the pandemic, WHOOP monitors analysed the wearer’s breathing patterns to detect risk of Covid-19 infection.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai Alwarpet – 044 4000 6000 •  Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801

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