Health wearables and other mobile measuring and monitoring devices are emerging as key elements in the consumer-oriented first tier of healthcare (see: Defining and Delineating the Changing First Tier of Healthcare). In the emerging scenario, smartphones will serve as mini-computers to integrate and communicate health data generated at home (see: Smartphones Provide a Key Element in Our Personal Health Management Systems). When relevant and necessary, such data will be communicated to the cloud for access by healthcare professionals for further action. Given this backdrop, I pay particular attention to announcements about new functionalities deployed in wearable devices. A recent article thus caught my attention (see: FDA clears wearable device to better monitor patients). Below is an excerpt from it:
The Food and Drug Administration has approved new wearable technology that offers non-invasive cuffless monitoring of blood pressure, oxygenation and heart rate. The device, made by Biobeat, can be used in hospitals, clinics, long-term care settings and in a patient’s home. The product, which received FDA 510 clearance, includes a smartwatch displaying heath metrics and a patch that can be placed anywhere on the upper torso to gather additional health metrics. The wearable devices also offer continuous monitoring with real-time alerts and trend analysis.“This is the first cuffless blood pressure solution to be cleared by the FDA,”....This clearance opens tremendous opportunities for remote monitoring of vital signs.”
Biobeat’s technology is based on reflective photoplethysmography, or PPG, an optical technique that measures blood volume changes in the microvascular bed of tissue used to non-invasively make measurements at the skin surface. “Though we currently have two configurations—a wrist watch and a patch—Biobeat’s sensor can be adapted to any type of measurement and lifestyle configuration,” says Chief Medical Officer Arik Eisenkraft, MD. “While blood pressure, heart rate and oxygenation are the backbones of monitoring, we will continue to work with the FDA to approve additional parameters for our devices.”
Twenty-four hour blood pressure monitoring at home by whatever means yields multiple readings which can then be averaged to obtain the mean BP for the period. Such measurements avoid white coat hypertension. Using technology like that announced by Biobeat avoids consumer measurement errors with blood pressure cuffs and provide a new perspective on the diagnosis of hypertension. We are now at a point when the healthcare consumer has access at relatively low cost to a large set of health measuring/monitoring devices such as Apple Watch 4, Fitbit Versa 2, Omron Evolv Bluetooth Wireless Upper Arm Blood Pressure Monitor, KardiaMobile 6L, and AccuMed CMS-50D1, a pulse oximeter. They are interfaced to smart phones to create what is beginning to resemble a home health network. Lacking now but soon to be available will be algorithms to interpret this torrent of data. Instances of individual algorithms to interpret small data sets are easy to find such as the one available on the Apple watch via the ECG app that can diagnose atrial fibrillation.
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