The future of personal health monitoring devices

Author- Kurt M. Tamaru, MD, MBA

The Emergence of Passive Monitoring Devices & Sensors

Early in my managed care career, I had the fortunate opportunity to work with several early and innovative companies that had entered into the realm of remote patient monitoring devices. These early generational devices began with blood pressure and weight scales and over time have evolved into multiple peripheral devices including glucometers, pulse oximeters, motion detectors, medication compliance, and video tablets. In addition, these devices have incorporated next generational wireless bluetooth connectivity paired to a smart phone which virtually eliminates the need for home internet connection or gateway devices. Growth in the wearable sensor market also includes clothing and nanotechnology sensors that can be incorporated with human tissue or implanted onto the body. These devices for home and personal monitoring continue to grow in adoption by the everyday consumers and have evolved into a culture of "Fitbit & Smart Watch Wearing" zealots. As these early adopters age, they will soon be looking for technology to assist them in their need to remain independent at home or convenience in caring for their elder parents or relatives.

Challenges with Devices for the Chronically Ill and Frail

The reliability and cost of these remote monitoring devices continues to improve whereby challenges with access to reliable hardware, device cost, and patient adoption are less of a barrier. Despite the rapid growth in the passive monitoring industry, the adoption in managing chronically ill or frail populations has been slow to evolve. Part of such slow uptake continues to be the lack of clinical process and programs to supporting the application of these devices. Ability to capture data and trending information with meaningful actions that avoids emergency room visits or higher acuity care due to delays in care are not simply solved by passive monitoring alone. While many companies offer a technological solution, they fail to provide the necessary clinical guidance and access to resources that are so critical to the successful use of monitoring devices.

Another key aspect missing until recently has been the reimbursement from payers to support the use of Remote Patient Monitoring (RPM) in managing chronically ill or frail populations. Early health care industry adopters and supporters of these devices were typically home health or at risk provider groups that were looking for more efficient ways to monitor and manage at risk populations at a lower operating cost. However, ability to reduce the cost burden of health care in at risk populations remains challenging for many in this space. There continues to be doubt in the efficacy of bringing these technologies into traditional health care management programs or lack knowledge and experience in developing supportive programs with devices.

Issues with Data and How to Respond

Companies with Remote Patient Monitoring devices have quickly learned that management of the data and trending was a critical and missing component. Often back end systems or dashboards were designed hastily or without natural work flows for clinical interventions that have meaningful impact in care. Furthermore, physicians were often left as the final contact point for multiple false alerts or erroneous data trends which only added to their busy patient call backs and without any adequate reimbursement for their time.

While the growth of consumer wearables and fitness devices to monitor activity and behavior have created an array of similar products and companies, the direct application for improved management of the frail or vulnerable at home elderly populations continues to be disputed and questioned. In my experience in working with various devices and clinical programs, the key reason for unproven results has been due to a paucity of significant data points over time and across multiple parameters. We often discount the complexity of the human operating system which includes multiple variables both physical, mental, and emotionally that play out in response to the human condition and manifestation of disease or burden of illness.

Optimistically, greater use of multiple data points to accurately capture meaningful trends or worrisome conditions earlier in their progression are being considered along with timely interventions that can be easily deployed. Most organizations that see effectiveness in their programs have purposely design clinical solutions with technology and monitoring devices as enablers to gain efficiency and minimize delays.

Security and Privacy issues continue to be a concern as we generate larger amounts of data around individuals as well as the integrity of wireless devices from potential hacking or cyber attacks. While concerning, passive monitoring systems pose less of a personal risk under a breach since data is only being communicated from passive non descriptive data inputs. In addition, actions or treatment that are implemented are based on aggregated and trended information as opposed to single data points like financial or personal demographic that might be easily used for means of financial gain or physical harm.

What is the Future of Devices and Passive Monitoring Technology?

No doubt that the industry sees many uses in patient and personal monitoring as a potential affordable safety net for aging in place however, increase consumer wearables have created a growing attraction and adoption for personal monitoring that has potential for the emergence of safety monitoring as a retail service much like the home alarm and monitoring services that exist today. Continued growth of the traditional PERS devices for emergency communication and monitoring will likely evolve into more application of sensors and other video and motion monitoring within the "Smart Home" environment. Application of devices and data will incorporate more Artificial Intelligence (AI) capabilities to decipher large amounts of data with greater sensitivity that will allow the clinical management of large populations without the need for traditional nurse of clinical interventions. As cellular enabled data bandwidth improve, we will see larger data consumption on a personal level of monitoring of hundreds of terabytes of information that has the potential for learning more about lifestyle and behavioral measures that impact health and well-being that we have never truly understood.

About the Author - Dr Tamaru is the managing partner at KT Health Services which is a boutique consulting, advisory, and early start up focused health care services company. KT Health Services as been engaged in development of consumer related health care devices and next generation technology and services to improve delivery of health care to all those in need. For more information, contact our offices at Toll Free phone 800-222-5959