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Wearable Medical Technologies

The use of wearable devices to track vitals (like heart rate) and activity monitoring has become mainstream with wristbands such as the Apple iWatch and the FitBit, to name just two. The use of wearable devices for detection and prevention of diseases, although less prolific, is also quickly gaining in popularity. The advancement of the technology itself, along with trends toward home care, telehealth and self-monitoring, are resulting in significant growth in this area. The miniaturization of sensors has played a key role in the development of wearable systems. Furthermore, an increase in aging population and chronic diseases, such as obesity, diabetes, chronic obstructive pulmonary disease, hypertension, chronic pain, and cardiac disorders, has resulted in higher demand for wearable technology.

Wearable devices can be embedded within smart clothing and equipment or adhered onto or inserted into the skin. Wearable devices are an effective way to manage, monitor, and provide feedback on patient health, as well as deliver medication and aid in the rehabilitation process. Wearable devices act as biosensors when attached to the human body. They are able to detect and monitor physiological data and provide drug delivery services for patients with medical conditions. Wearables can monitor multiple biomarkers simultaneously and provide patients with the constant monitoring and consistent daily action required to successfully manage ongoing health concerns. Whether it’s a cardiac or blood glucose monitor, insulin pump, blood pressure or body temperature monitor, or sleep apnea monitor, there are a multitude of wearable devices designed to help patients address their condition within the comfort of their own home. Devices such as skin patches, injectors, or stimulator can also help to manage pain or drug delivery. Telemetry-capable devices can provide physicians and caregivers with access to patient information and data tracking remotely.

(Photo Example of Corventis ECG Wireless Heart Arrhythmia Monitoring System)

Wearable Medical Technologies

One example of the use of wearable technology in the treatment of a medical condition is for patients with diabetes. The need for daily monitoring and follow-up action makes management of this disease through wearable technology a perfect fit. Sensors can now detect and trace ketones and chemicals, as well as signal low insulin to alert patients to take their medication. Therapeutic devices, such as insulin pumps, can provide continuous and timely delivery of drugs. Implantable sensors, like continuous glucose monitoring systems, can be used for the measurement and transmission of blood glucose. An artificial pancreas can provide glucose monitoring and insulin transfusions in one device. There are even non-invasive wearable alternatives for patients with diabetes, such as near infrared light-based devices.

(Photo Example from Gizmodo.com.au Australia on Wearable, Artificial Pancreas)

Another example of wearable devices in the medical arena are cardioverter defibrillators, designed to both monitor and treat dangerous abnormal heart rhythms. These life-saving vests can provide doses of electric current for people with dysrhythmias.

(Photo Example of Medtronic Implantable Cardioverter Defibrillator)

Wearable Medical Technologies

For the up to 55% of people suffering from chronic pain, wearable devices including patches, injectors, and nerve or muscle stimulators, can provide relief. Other examples of wearable devices include headsets that monitor electroencephalographic (EEG) information, ingestible sensor pills that contain a chip within a pill and provide information via accompanying mobile device applications, and even contact lenses that monitor the user’s current health status, such as lactate or urea levels, internal body temperature and other metabolic functions. There are wearables that can predict epileptic seizures, disposable incontinence pads and diapers that conduct urinalysis, and there’s an entire market devoted to wearable devices for women trying to conceive a child or monitor their fetus.

(Photo Example of iTENS Wireless Electrotherapy Transcutaneous Electrical Nerve Stimulation)

Rehabilitation wearable device use, such as exoskeletons, robots, and implants, has increased in recent years. These devices rely on inertial sensors for movement detection and tracking. The movement sensors are small, inexpensive and require very little power, making them increasingly accessible. Combining these devices with virtual reality technology can further improve motor skills in rehabilitation patients. Real-time augmented feedback is another technology example previously confined to direct provider services. Several systems are currently under development that will enhance rehabilitation wearable device use. For example, GE Healthcare is developing a wireless medical monitoring system that will allow the collection of physiological and movement data in the home setting. Another example of home-based rehabilitation technology is being developed by Philips Research. It will coach the patient through a sequence of exercises, prescribed by a physiotherapist, for motor retraining. A wireless inertial sensor system will then record the patient's movements, analyze the data for deviations from the target, and provide feedback to both the patient and the therapist.1 However, the cost of implementation for these more sophisticated rehabilitation devices in a home environment remains prohibitive for mass use.

Wearable devices that provide remote monitoring systems can potentially mitigate patient access issues, especially for those in rural areas. Wireless medical telemetry can monitor patients’ vitals through radio frequency, then transmit the patient data to caregivers. Emergency situations, such as falls, can be detected, triggering an alarm message.1 The technology has the additional benefit of not restricting patients to a bedside with a hard-wired connection. One potentially emerging trend

Wearable Medical Technologies

in the wireless telemetry arena is the use of a commercially available Programmable System on Chip (PSoC) that coordinates the signals from three sources. The PSoC microcontroller interconnects analog, digital, and programmable connections. The benefit to this technology is it reduces interference and provides a greater range.

One example of a wearable medical device used in healthcare settings specifically for caregivers are hand hygiene tracking systems. A hospital-acquired or health-care associated infection can be spread to susceptible patients in a clinical setting by various means. The Centers for Disease Control and Prevention estimates that in the United States alone, roughly 1.7 million hospital-associated infections cause or contribute to 99,000 deaths annually. The use of hygiene tracking systems, which function with an RFID wall-mounted sensor near hand-washing dispensers, helps to reduce the number of infections spread through medical providers.

(Photo Example from American Medical News on HyGreen’s Hand-Hygiene Tracking System)

Wearable Medical Technologies

Other examples of hospitals’ use of wearable technology include RFID tags sewn into x-ray protection vests and tracking of people who are exposed to highly infectious diseases, such as tuberculosis.

Although bio-implanted devices have become common for tracking animals, microchip implants remain a controversial wearable device for humans. There has been limited commercial exploration of the use of implanted wearable devices, with suggestion that implantable chips could be used to retrieve individual medical records. However, the technology has not been approved by the Food and Drug Administration.

Although the use of wearable medical technologies is becoming more popular, there is currently no standard testing protocol for RFID technology in healthcare settings. Georgia Tech Research Institute (GTRI), with oversight by AIM Global, the international trade association representing automatic identification and mobility technology solution providers, are currently working on standardization. They are partnering with MET Laboratories, a company that provides testing and certification services for medical devices. The protocol will test how RFID systems affect the function of implantable wearable medical devices, such as pacemakers, cardioverter defibrillators, neurostimulators, infusion pumps and cardiac monitors.

EXAMPLES OF TYPE OF MEDICAL WEARABLE?

EXAMPLES OF DISEASE OR CONDITION TYPE OF MEDICAL WEARABLE IS USED TO TREAT OR MONITOR?

Blood Glucose Monitor

Insulin Pump

Injectors

Implantable Glucose Monitoring System

Artificial Pancreas

Diabetes

Blood Pressure Monitor Hypertension

Skin Patches

Injectors

Nerve or Muscle Stimulators

Chronic Pain

Cardiac Monitor

Cardioverter Defibrillators

Cardiac Disorders

Sleep Apnea Monitor Sleep Apnea

Wearable Medical Technologies

EEG Headset Brain Wave Abnormalities

Disposable Incontinence Pads

Disposable Diapers

Urinary Tract Infections, Kidney Disease

Body Temperature Monitors Ovulation

Exoskeletons

Wireless Inertial Sensor System

Implants

Muscle or Joint Rehabilitation, Fine or Gross Motor Skill Rehabilitation

Programmable System on Chip Recovery

Hand Hygiene Tracking System

RFID Tracking of Infectious Diseases

Hospital Associated Infections

RFID X-Ray Vests Fractured Bones

Sources:

http://medcitynews.com/2013/12/5-ways-hospitals-implementing-rfid-tags-emerging-trend-healthcare/. Accessed 6/20/2017

http://illumin.usc.edu/assets/submissions/1192/Illumin%20Paper_Di%20Meng.pdf. Wearable Computing Devices: Medical Applications and Breakthroughs by Di Meng.

https://gtri.gatech.edu/casestudy/new-protocols-will-test-effects-rfid-systems-medic. Accessed 6/20/2017.

1https://jneuroengrehab.biomedcentral.com/articles/10.1186/1743-0003-9-21.