the potential use of mobile and wearable sensor devices in the management of chronic diseases
DESCRIPTION
As the rate of information technology increases at an exponential rate, more and more devices and sensors which are capable of harnessing crucial data (such as vital signs) are being integrated into the healthcare ecosystem. The benefit of mobile technologies to intervene and improve health is increasingly becoming a topic of discussion. Through the use of examples from three primary chronic conditions, this report will critically analyse the scientific findings of the use of these sensors and the possible impact they might have on future diagnoses and improving the overall efficiency and accuracy of healthcare management. This report will specifically interrogate the multiple technologies which can be integrated for cardiovascular problems, diabetes and chronic obstructive pulmonary disorder. The overall findings concluded that these novel technologies would provide considerable improvements to healthcare, but would have to overcome several obstacles prior to total integration. A cost-benefit analysis would have to be done to overcome the previous more traditional approach.TRANSCRIPT
![Page 1: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/1.jpg)
The potential use of mobile and wearable sensor devices in the
management of chronic diseases
Timothy Delany09322833
Supervised by Dr. Brian Caulfield
![Page 2: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/2.jpg)
Source: Statistics Bureau
World Population Pyramids
![Page 3: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/3.jpg)
• High cost of healthcare
• Inefficient management of chronic diseases
• Poor regulation of health interventions
• Overcrowding of the hospital setting
Difficulties which currently exist in the healthcare ecosystem
![Page 4: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/4.jpg)
• 2nd Highest household expense
The Cost of Healthcare
• The number of insured is decreasing annually
• 32% of people refuse to see doctor when sick/injured
47% of this is because of the high cost
In 10 years, the Irish healthcare spend has doubled to $19 billion
Year % GDP (US) Cost ($)
2010 17.9 2.6 trillion
2020 19.8 4.6 trillion
![Page 5: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/5.jpg)
Obesity forecasts
Source: E-health Strategy
![Page 6: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/6.jpg)
• In the United States they make up ¾ of the healthcare costs, affecting more than 140 million individuals and accounting for $2 trillion/annum
• Major cause of mortality, accounting for 46% of global diseases
Chronic Diseases
• By 2020 – 89% of diseases in high income countries will be chronic
• In Ireland – chronic diseases make up 80% of the healthcare costs
![Page 7: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/7.jpg)
• Cardiovascular disease
• Diabetes
• COPD
Non – Communicable Diseases
In 2011, WHO called on governments to focus on reducing the prevalence of these major chronic diseases
![Page 8: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/8.jpg)
This case study will cover the following aims: 1. To describe the burdens the current healthcare ecosystem
faces, specifically with regards to chronic diseases. 2. To explain the potential that mobile and wearable technologies could have if integrated into this ecosystem. 3. To give an overview of various vital signs and measurements these devices can assess; specifically focussing on cardiovascular problems, diabetes and lung function. 4. To outline the potential implementation of current devices into the ecosystem of these chronic diseases.
Aims of this Case Study
![Page 9: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/9.jpg)
• Inefficient clinical trials
• Access to healthcare
• Patient compliance
• Nosocomial infections
• Access and transportation
Other Burdens
![Page 10: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/10.jpg)
Hospital Setting
• Full of highly resistant bacteria and pathogens
• 2/3rds of hospitals are contaminated
• Extranasal-methicillin resistant Staphylococcus aureus (MRSA)
• Potential to accelerate patient’s illness
• >100,000 fatalities in the US every year due to wrong medicines being received
![Page 11: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/11.jpg)
Clinical Trials• Current gold standard for configuring efficacy
of health interventions is randomised clinical trials (RCT)
• Have evolved slowly over time
Source: ClinicalTrials.gov
![Page 12: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/12.jpg)
• Long time lag between recruiting participants and publication
• High costs
• Limitations to current rating scales
• Irregularity of measurements/titrations
• Controlled circumstances and environments – significant outcomes already determined
Problem with Clinical Trials?
![Page 13: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/13.jpg)
What can be done to overcome these
burdens?
![Page 14: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/14.jpg)
![Page 15: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/15.jpg)
Evolution of Internet Connected Devices
Source: Cisco
![Page 16: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/16.jpg)
Creation of a New Patient-Centric Environment
Source: E-health Strategy
![Page 17: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/17.jpg)
Source: HIS Inc.
Forecast for wearable tech revenue growth ($bn)
![Page 18: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/18.jpg)
• Evaluation of disease, environmental toxins, motion, hormones, behaviour and other physiological variables
• Clinical trials to be carried out in multiple environments
• Improve knowledge of the etiology of illnesses
• Monitor fluctuations in health
• Continuous monitoring
Potential
![Page 19: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/19.jpg)
Important measurements
1. Cardiovascular Problems
2. Diabetes
3. Chronic Obstructive Pulmonary Disease
![Page 20: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/20.jpg)
![Page 21: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/21.jpg)
1. Cardiovascular Problems
• The heart beats roughly 3 billion times in a person’s lifetime
• No surprise that cardiovascular problems are the leading cause of death worldwide
![Page 22: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/22.jpg)
Blood Pressure
Crucial in prevention of cardiovascular diseases
Past measurements have failed to account for circadian rhythms
Ishikawa et al (2011) found 24 Hour monitoring of blood pressure provides a significant amount of information
![Page 23: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/23.jpg)
Difficult to exercise or shower with
Holter Monitor - 1949
1999
Device Integration
MacManus et al 2010 – mean systolic blood pressure decrease by 5.4mm Hg
Continuous monitoring has also lead to the discovery of ‘White Coat Hypertension’ and ‘Masked Hypertension’
![Page 24: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/24.jpg)
iHealth Sensor
![Page 25: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/25.jpg)
Heart RateHeart Rate
Arrhythmias, bradycardia and tachycardia often indicate asymptomatic diseases
![Page 26: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/26.jpg)
Device Integration
![Page 27: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/27.jpg)
![Page 28: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/28.jpg)
![Page 29: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/29.jpg)
2. Diabetes – Glucose monitoring
Global total has surpasses 350 million
It is estimated that 40% of diabetics in the U.S. are undiagnosed
Mobile phone intervention improved the glycated haemoglobin by 1.8%
Source: Quinn et al 2011
![Page 30: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/30.jpg)
Nanosensor Tattoo
![Page 31: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/31.jpg)
Amperometric sensing contacts
![Page 32: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/32.jpg)
3. Lung Function
3rd Leading Cause
210 million
Difficult to measure
![Page 33: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/33.jpg)
Varying levels of air flow volumes for lung diseases
Source: Cleveland Clinic
![Page 34: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/34.jpg)
Plethysmography and pneumography devices have been implemented into wearable technology
Spiro Vest
Source: Enokibori et al
Device Integration
![Page 35: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/35.jpg)
Discussion
![Page 36: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/36.jpg)
Possible Problems
Security – 43% of identity thefts are medical
Privacy – maintaining annomyinity
Data – sheer volume
Regulation – FDA list of guidelines
Noise – can obscure measurements
![Page 37: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/37.jpg)
Telehealthcare evolution (no. of people)
Source: E-health Strategy
![Page 38: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/38.jpg)
Future and Recommendations
• Pros appear to outweigh the Cons
• Numerous studies have found that continuous measurement is more effective
• Integrate sensors into current clinical trials
• Technologies will be obsolete though? Solution = continuous evaluation of evolving interventions (CEEI)
![Page 39: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/39.jpg)
Conclusion
• Advance the quality of health services and decrease overall cost of healthcare
• Improved studies outside of laboratory environment
• More high-quality RCTs need to be carried out to evaluate the clear advantage of these technologies
• In order for monitoring to succeed in the long term, integration of biomedical functionality, fashion and health added value are crucial
• Accurate and reliable real-time information -> better management
Higher precision, improved sampling frequency, fewer misleading data, greater convenience,
and lower cost
![Page 40: The Potential Use of Mobile and Wearable Sensor Devices in the Management of Chronic Diseases](https://reader036.vdocument.in/reader036/viewer/2022062615/5480ab6cb4af9f1b038b49e2/html5/thumbnails/40.jpg)
Thank You
Questions?
I’d like to acknowledge Dr Brian Caulfield for his guidance and support
Acknowledgments and Questions