INTEGRATION OF WEARABLE DEVICES IN PRECISION MEDICINE PRACTICES
What is Precision Medicine?
Precision medicine also known as personalized medicine is an innovative approach to tailoring disease prevention and treatment that takes into account differences in people’s genes, environment and lifestyles. Precision medicine is being used for certain types of diseases like cancer, diabetes to help know what tests and treatment are best.
The goal of precision medicine is to enable patient-centric decisions that meet the triple aims of improving patient health, improving patient experience, and reducing costs
What are Wearable Devices in Healthcare?
Smart healthcare/medical devices, also called wearable devices, are designed in such a manner that they are worn on the human body, embedded into the body’s clothing, or implanted in the human body. Materials that go into their development generally include plastics, polymers, silicones, metals, electronics, batteries, biocompatible materials, and adhesives. The primary function of these devices is to detect and track bodily changes, collect data, monitor health conditions, and provide real-time updates.
A prominent advancement in healthcare IT, wearable medical devices are over time, becoming more sophisticated and diverse, incorporating sensors, wireless communication, and data analysis.
Top Examples of Wearable Medical Technologies
The top ten examples of wearable healthcare technologies include the following.
Fitness Trackers: use sensors like accelerometers, heart rate monitors, and gyroscopes to monitor physical activity, such as steps taken, distance traveled, heart rate, sleep patterns, and calories burned.
Smartwatches: a popular mobile accessory as well nowadays, smartwatches offer a plethora of options from heart rate monitoring, GPS tracking, sleep tracking, and ECG (electrocardiogram) recording to integration with fitness and healthcare apps too.
Continuous Glucose Monitors (CGMs): used to check blood glucose levels, mostly by diabetics. Their usage involves placing a small sensor under the skin that measures the glucose levels and sends the data to a paired device, like an insulin pump or smartphone.
Wearable ECG Monitors: record the electrical activity of the heart over a period of time for detecting cardiac abnormalities and irregular heart rhythms. Used by individuals with heart conditions.
Wearable Blood Pressure Monitors: individuals with hypertension and irregular cardiovascular health use these devices to measure blood pressure continuously.
Wearable Respiratory Monitors: smart inhalers or respiratory rate monitors are used by individuals with respiratory conditions like chronic obstructive pulmonary disease (COPD) and asthma to manage their symptoms and medications better.
Posture Correctors: used for maintaining proper posture. They are growing popular in today’s era, where most jobs require sitting at desks for long periods. Posture correctors provide reminders and feedback when the person is slouching or sitting incorrectly.
Remote Patient Monitoring Systems: comprehensive systems used to remotely monitor the patient's vital signs, activities, and health conditions. These systems incorporate multiple wearable devices and sensors and enable healthcare professionals to monitor patients and track their progress with ease remotely.
Hearing Aids: small electronic devices that make sounds louder for people with hearing loss. Worn in or behind the ears and help enhance everyday communication. Modern hearing aids come with features like wireless smartphone connectivity, noise cancellation, and customizable sound settings.
Smart Clothing: garments embedded with sensors to track health metrics such as body temperature, respiratory rate, heart rate, and body movement. Useful for remote patient monitoring and sports performance tracking.
Wearable/Smart Implants: a relatively new technology, wearable/smart implants are electronic devices implanted in the human body that can be worn like a piece of clothing or an accessory. They are designed to monitor and track various health metrics, provide targeted drug delivery, and enhance sensory capabilities. A rising example of this is Neuralink, which has also received approval from the FDA for clinical trials.
The Future of Wearable Technology in Healthcare
Wearable technologies will play an important role in advancing precision medicine by enabling measurement of clinically-relevant parameters describing an individual's health state. The lifestyle and fitness markets have provided the driving force for the development of a broad range of wearable technologies that can be adapted for use in healthcare.
With the potential to revolutionize healthcare with data and emerging technologies, wearable devices will continue to empower healthcare professionals to impart better medical care. One of the key emerging technologies is the integration of wearable devices with artificial intelligence and machine learning (AI and ML) platforms to provide personalized healthcare solutions. Another prediction is the development of more advanced wearable devices that can monitor physical and mental health.
Wearable technology has already made a significant impact on the healthcare industry, and its potential for the future is immense. Here are some possible scenarios for the future of wearable technology in healthcare:
Personalized Treatment: Wearable devices can collect vast amounts of data on an individual's health, including vital signs, activity levels, and sleep patterns. With advanced analytics and artificial intelligence, healthcare providers can use this data to create personalized treatment plans that are tailored to each person's unique needs and conditions.
Chronic Disease Management: For people with chronic conditions like diabetes, heart disease, or asthma, wearable technology can provide continuous monitoring and early detection of symptoms. Healthcare providers can use this data to intervene early and prevent more severe complications from developing.
Remote Monitoring: Wearable technology can also facilitate remote monitoring of patients, allowing healthcare providers to track their progress and adjust treatment plans without the need for in-person visits. This can be particularly beneficial for people in rural or remote areas who may have limited access to medical care.
Predictive Analytics: With the help of machine learning and predictive analytics, wearable technology can identify potential health issues before they become critical. This can be achieved by analyzing patterns in the data and alerting healthcare providers of any anomalies or changes in a person's health.
Prevention: Wearable technology can also play a critical role in disease prevention by encouraging healthy behaviors and habits. For example, fitness trackers can motivate individuals to exercise more, while smartwatches can remind people to take their medication on time.
In this blog, we will survey the potential roles for technology - including wearable devices, mobile apps, and big data analytics platforms -in the development of novel precision medicines that engage the patient–consumer. In particular, technology offers developers unique opportunities to stratify patients and deliver more personalised care by at least five strategies.
1. Mitigate the risk of non-adherence diluting an intervention’s effect
Adherence is a major challenge for many indications; non-adherence can reduce the net efficacy of an intervention in target demographics. Wearables and companion apps can be used to identify patients who need the most guidance and engage personal networks to encourage behavioural change. This category of wearables and apps provides safeguards against non-adherence, thereby enhancing the efficacy of a doctor's treatment.
Depending on the indication, there are two monitoring and support mechanisms to explore: apps that provide patients with continuous reminders based on either a) a doctor's orders or b) a patient’s own physiology.
In the first case, an app called Medisafe lets patients and their families track prescriptions and their own adherence to those prescriptions. Medisafe can illustrate the barriers to that patient's adherence, and the app's developer claims that Medisafe increases adherence to prescriptions by 72%.
A second mechanism to encourage adherence is employed by Dexcom's Continuous Glucose Monitor, which continuously alerts diabetics and their families of adverse changes in the patient’s blood glucose level. This app allows family members to assist the patient even when the patient is unable to resolve an adverse event on their own.
The latter category of apps enables a patient to engage with their own disease management in ways they could not before, which may in turn, increase adherence. For instance, technologies that allow hypertension patients to self-monitor their blood pressure have been available for some time. These devices are known to increase adherence to hypertension medication, possibly because patients are motivated by seeing themselves achieve target levels.
Before introducing a new technology in a clinical setting, either alone or in combination with an existing intervention, it is necessary to validate the apps or wearables for the intended clinical use and patient demographic.
2. Deliver treatment at the right time, even for unpredictable episodic indications
Precision medicine is about ensuring that patients receive the right intervention at the right time. However, some indications, by their nature, require episodic treatment on an irregular, unpredictable basis. Often, proactively treating those episodes can reduce their severity. Thus, a system that helps patients predict episodes can, from the patient's perspective, deliver on the promises and benefits of precision medicine.
Some apps target the issue of unpredictability by assessing patterns in a patient's environment and interpreting them for the benefit of the patient. For instance, the Icahn School of Medicine's Asthma Health app not only tracks a patient's symptoms and treatments, but also alerts him or her about local asthma triggers and sends these data to the patient's doctor so he or she can adjust the patient’s medications if needed.
This app makes it easier for patients to engage in proactive care and could potentially serve as an adjuvant to episodic treatment plans
3. Accelerate intervention
Some wearables let patients directly collect data on their own health and instantly transmit that information to their doctor, allowing for more immediate care from healthcare providers. This strategy can turn, for example, an otherwise standard EKG into a personalised direct line for earlier alert and treatment.
One innovative wearable called Kardia, by AliveCor, turns a patient's smartwatch into an EKG that can detect atrial fibrillation, the most common heart defect. Data for an event can be immediately transmitted to a doctor, along with a voice note about how the patient is feeling. This wearable produces a more efficient means for diagnosis and treatment, and can augment a patient's self-care regimen.
4. Reduce risk during the inpatient-to-outpatient transition
For indications impacted by shifts to bundled payment or episodic care reimbursement models, technology can augment the economic value proposition of a product. Many apps now target the critical period immediately following hospital release and function to minimise readmission and non-reimbursable adverse events.
One of those apps, Care at Hand, helps elderly patients regularly update their providers about their health and filters patient responses to alert front-line healthcare staff when patients need care. After adding this app to their standard care regimen, one elder care centre reduced its 30-day hospital readmission rate by 40%. A women's hospital trialled a similar app for care after breast-reduction surgeries. This app helped reduce the need for follow-up visits, lowered the 30-day readmission rate, and suggested post-op costs could be cut hospital-wide by up to 30%.
The successes of these two apps demonstrate the extent to which a product's reimbursement potential can be enhanced by the personalised provision of care at critical transition points.
5. Cost-efficiently deliver mass-personalised care
Apps can also add value to an individual's treatment regimen by delivering personalised advice to live a healthier life without overtaxing a physician. MD Revolution provides patients with personalised care from healthcare professionals and, at the same time, automates the process to reduce the burden on physicians and other front-line staff.
Conclusions:
Wearable technologies will play an important role in advancing precision medicine by enabling measurement of high information content and clinically-relevant parameters describing an individual’s health state.
We can predict that with the development of science and technology and the popularization of personalized health concepts, wearable devices will play a greater role in the field of health care and become better integrated into people’s daily lives.
References:
https://www.linkedin.com/pulse/revolutionizing-healthcare-how-wearable-technology-changing-game
Student Name: Masarrath Unnisa
Student ID: 247/122023
Qualification: Pharm-D
e-Mail ID: imasarrath@gmail.com
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