Category: Personnel Health Monitoring

Article

An add-on could allow a smartphone to become a portable pathology lab

Researchers create tech that turns your smartphone into a medical diagnostic tool | Fast Company

University resources

Multimode smartphone biosensing: the transmission, reflection, and intensity spectral (TRI)-analyzer | Professor Brian Cunningham, University of Illinois

My Comments

In most situations, pathology testing has required that the samples be sent away to a central laboratory to be analysed in to something meaningful for the professionals who prescribe them. This would typically take more than a day unless the laboratory was co-located with the facility that collected the sample such as in a hospital.

But there are some steps being taken to use a common smartphone as the equivalent of a pathology lab for most of the common tests. The goal with these devices is to allow the analysis of the sample and communication of the results to the end-user with a very short lead-time.

The first one of these solutions was a portable spectrograph device developed by Columbia University that connected to a smartphone’s headphone jack and worked with a special app to identify the presence of pathogens associated with certain diseases. There was also a view to have it work with less-expensive devices that could run user-installed software like the iPod Touch or low-tier Android phones, along with the ability to work on very low power.

The second one of these solutions attaches to an existing compatible smartphone and makes use of that phone’s camera and LED “flash” light to analyse the sample. It could also be set up to work with an integrated green-light laser diode as an alternative analysis light source.

This time, the sample of blood, saliva or urine is collected in a special microfluidic cartridge which means that the same “lab” could be used for multiple tests. There is a goal with this technology to adapt most of the common pathology tests to be performed with this hand-held “path-lab” and the goal can be achieved by reprogramming the software that is the companion app for this device to suit the test.

Personally, I would see these technologies initially work with the common ailment-specific “screening” tests or various “wellness” tests like cholesterol tests. There will also be an appeal to implement them with various drug tests where there isn’t a goal to achieve forensic-level accuracy. Similarly, medicine-level tests associated with chronic-illness treatment could be evolved to this technology.

But why is the idea of purposing a smartphone or similar device as a portable pathology lab appealing?

The key driver is to obtain there-and-then results suing highly-portable cost-effective equipment.

One use case is to do one or more pathology tests on a patient as they are transported in an ambulance to hospital and have the results communicated to the emergency department before the patient arrives. This also extends to situations where there are many casualties such as on a battlefield or other disaster zone. In this case, the smartphone with the handheld “path-labs” would be able to provide better-quality information for on-site treatment teams, rather than having to transport many samples to ultra-busy laboratories who may not communicate the results in time.

The rural community will also benefit in the context of routine tests especially where the nearest capable pathology lab is a long distance away from the village or town. Here, flying-doctor services, district nurses and the like can perform the common tests at the patient’s home and pass them on to regular general-practice doctors or specialists as well as making the patient and carer known of these results. It also augments the use of mobile devices as part of telemedicine efforts that can benefit this community.

But the same situation also applies to delivering healthcare in to third-world countries, something typically facilitated by the many volunteer organisations who answer this need. Here, the volunteer organisations can use this technology for identifying disease risks or organising the right treatment in a “there-and-then” manner.

Then there is the ability to use this technology as part of at-home healthcare programs including supporting the concept of ageing-at-home. This can be about using it as part of medicine management or monitoring long-term illnesses and assessing the effect of treatments without needing to go to a doctor’s clinic or hospital.

What is being seen here is the ability for cost-effective smartphones and similar highly-mobile devices that are based on platforms that support user-installable software to be used as part of personal healthcare in any part of the world.

There is a strong interest in using Internet-based connectivity as a tool for facilitating in-home healthcare.

A Bluetooth-connected pulse oximeter in action

This involves the use of a mix of sensor types that are typically used to observe a patient along with the use of regular, mobile and other computing devices to process and present this information to the carers and to the medical professionals. It also includes implementing voice and video telephony to allow medical professionals to communicate with the patient without the need to frequently travel to where they live.

Why the interest?

Ageing at home

This is where a senior citizen is able to live independently at their home as much as possible but have supporting care from relatives, friends and professional carers.

A tablet used as part of an in-home telemedicine setup

One of the reasons driving “ageing at home” is the fact that the generation of people born through World War II and the post-war Baby Boomers will be entering their senior years which will place strong demands on health care and welfare facilities that cater to this group of people.

Another is that an increasing number of aged-care facilities have been associated with substandard quality of care – “I don’t want to end up in the nursing home”.  This is brought about with more of us being aware of this level of care either through observing how those we have known in our life’s journey that were looked after in those facilities were being treated, or hearing about instances of substandard care in the media such as the infamous “kerosene bath” incident that hit the news in Australia in the early 2000s.

This has also been driven by the trend towards health-care deinstitutionalisation affecting geriatric and palliative care where there isn’t a desire to rely on large facilities for this kind of care.

Other healthcare needs

Increasingly hospitals are looking towards “hospital in the home” or similar programs as a way to provide ongoing care for convalescent patients and those with illnesses that require long-term attention. Here, the care associated with what would typically be provided in a hospital, typically nursing-focused procedures, would be offered at the patient’s home but with visiting nurses, doctors and allied staff.

Even obstetric care is also affected by this trend, with an increased preference for minimal hands-on professional care for low-risk mothers when they go in to labour. Similarly, low-risk psychiatric care is being delivered at home thanks to telecommunications-based technologies.

The advantages that are being put forward for this kind of care is that the patient can stay in the familiar surroundings of their home and, again, has been underscored by the concept of deinstitutionalisation in healthcare. Governments and others also see it as a cost-saving because they can focus a hospital’s beds towards those needing acute care.

The rural community are seeing an application for this kind of technology so as to avoid the need for frequent long-distance travel which would be of importance when it comes to specialised or advanced healthcare.

How is the kind of healthcare delivered?

Here, the focus is on observational healthcare where medical professionals can assess the situation based on either the data that is collected or through communications with the patient. In some cases, it may be based on an event-driven principle where the professional is alerted if the situation goes beyond certain limits.

This is facilitated through the concept of “telemedicine” where the data is conveyed through an Internet connection and has been facilitated through various technologies.

One of these is “machine vision” where one or more cost-effective high-resolution cameras feeds images in to a platform-based computer which runs software that recognises and interprets these images for medical use. One application that was put forward was to observe a patient’s pulse using a camera that observed the brightness of one’s face as the heart beats. Another application is to use a smartphone’s or tablet’s camera to read fluid-analysis strips as part of assessing urine or blood while an app in that device interprets this information rather than a person comparing what is seen on the strip against a chart.

Another of these is the implementation of common communications technologies like Bluetooth, Zigbee or Wi-Fi in sensor devices. This can lead towards the existence of cost-effective sensor devices that can work with existing computer devices with a minimal need for extra hardware, while these devices can use cost-effective software to interpret and present this information. This has led to startup companies and tech innovators developing devices like “wandering-alert” socks that work with Bluetooth and apps.

What needs to be done?

An issue that will affect in-home telehealth is where device manufacturers and health providers legally stand when it comes to providing these services.

One of the questions that is being raised is the use of non-medical sensor devices for medical applications. One of the scenarios is the use of a general wellness device like a fitness band or a wellness-focused thermometer as a medical sensor for clinical purposes. Another scenario would be the use of a “non-wellness” sensor like a security system’s PIR and door sensors, a home-automation sensor, or a smartphone’s camera for medical-observation purposes with these devices feeding their data to software running on a platform-based computing device.

These questions are being examined by the US’s Food and Drug Administration with respect to wellness-focused devices serving as medical devices in this context. But implementing home automation and security in this context may require a case-by-case assessment based on the actual installation and would only work with geriatric, psychiatric or allied situations where observational healthcare is the order of the day.

Similarly, software that uses devices like cameras for medical reasons like “machine vision” may have to be certified by medical-device authorities to be sure that the software provides accurate results no matter the input device. In the case of software that uses cameras, there would be a requirement for a minimum resolution for the camera to turn out consistently accurate results.

Conclusion

Once the issues that affect the provision of Internet-assisted in-home health care are identified and worked out, then it could be feasible for the home to be a place to deliver continual health care.

Article – From the horse’s mouth

Lab Of Things Helping Seniors Who Live Alone | Microsoft Research

My Comments

I have provided a lot of coverage regarding the concept of technology assisting the “ageing at home” principle where older and infirm people can stay at home and live in dignity knowing that the people close to them and their carers can act as a safety net for them.

Here, I had covered technology being used to guide seniors with shopping and food-preparation along with use of existing technology like cameras for medical observation. I have also covered in an article about CSIRO doing research in this field with a view of using the “Internet Of Everything” technology like energy sensors, movement sensors and smart locks to assess whether someone is keeping well such as knowing if they are going in to the kitchen to keep themselves nourished or if they are surfacing and going outside to collect the paper or mail.

Microsoft is working with their research laboratories in China to address the issue of ageing at home in the Asian communities. This is because these communities are becoming increasingly older like most of the world thanks to the good healthcare that is being made available to them.

Here, they are identifying how older people who are living independently at home coping, including factoring in cultural issues. They are also implementing robotics to build a medical-supplies trolley to serve the medicines that these people will need at the proper times as well as shoehorning the Kinect movement sensor as a fall sensor to detect if one is falling or convulsing.

The medicine trolley doesn’t just work with medicines that require regular doses but also can work with medicines that are taken in response to symptoms like asthma attacks and is based around knowing what the symptoms will look like. The Kinect sensor as a fall sensor has to work in a manner to assure personal privacy which is important because of the fact that some of these falls or convulsions can occur when one is using the bathroom or toilet and these devices could be located there.

What I see of this is various technologies that make use of the computer, the home network and the Internet Of Everything are being used to create a safety net for older people or people with chronic illnesses who want to preserve independence and dignity.

Article

Smartphone accessory puts HIV diagnosis in doctors’ pockets | Engadget

My Comments

Smartphones will soon come in to play with more pathology tests

Increasingly, the smartphone’s integrated camera is being used as part of machine vision for medical applications. These technologies are based on the concept of litmus paper which changes between different colours depending on whether a chemical solution is acidic or alkaline, something a few of you may have seen demonstrated in the high-school chemistry class. The first application I highlighted was to use a urinalysis “control stick” along with the smartphone’s camera and a special app to identify what is in urine that is passed. Now this technology is being brought to blood analysis mainly to test for HIV, E. coli and staph in a patient’s blood. Here, a very small amount of the patient’s blood needs to be put on the film and it be examined by the smartphone’s camera with that phone running a special app. It avoids the need to send the sample to a laboratory to be analysed, because the film turns a different colour in the presence of an antibody makeup representing a particular disease. This is pitched at third-world communities or rural communities where it is cost-prohibitive for them to have a pathology laboratory located in a short-enough distance to provide quick-enough turnaround for test results for these diseases. There is even the ability where the pictures can be sent out to somewhere else for better expert opinion if the testing centre doesn’t have someone who is skilled enough. There are plans to even adapt this technology to detect more illnesses or check for pathogens in food and water. What I also see of this is it could open the path to “on-the-spot” screening-type pathology tests that dodge the need for sending out samples to a lab which I see as a boon for rural communities or telemedicine applications.

Article

FDA draws line between wearable health gizmos and proper medical gear | The Register

My Comments

FDA to be able to qualify wearables like this Sony Smart Band to a standard acceptable for general wellness

As the market fills up with more wearable gizmos that measure our health, health-protection and consumer-protection authorities need to step in to properly and independent qualify a device’s health or wellness abilities.

Here, the US Food and Drug Administration have defined two levels of classification for these devices. They will have one, known as “general wellness”, which will cover measuring heart rates, distance walked and similar parameters that one needs to know about staying well. This is compared to a higher level for equipment needed to diagnose or cure illnesses. The differences that would be highlighted would be that the higher level is that the device is subjected to rigorous testing to be sure it can show consistently-accurate measurements and operate in a consistently-reliable manner.

But these Bluetooth-connected medical sensors are still considered medical devices

They see this more as a line in the sand between something you could buy off the shelf and use at home versus a medical machine that is used as part of clinical treatment.

A question that may be raised is if a device is being used as part of medical supervision and monitoring, especially for a chronic illness is whether a “general wellness” class of device would be considered suitable for this application rather than a fully-qualified clinical-grade health-monitoring device. This could be seen as being of issue when it comes to in-home monitoring of diseases like, especially, diabetes where the patient’s blood sugar levels are to be monitored constantly.

Another question that has to be raised is if a device is dependent on extra software such as devices that work according to the “app-cessory” model, whether the software would be tested to see if it is compliant for medical-grade or general wellness use. This is more so as an increasing number of medical devices in the hospital and home are dependent on external computing power or there is the increased use of “software-only” diagnosis functionalities like Webcam-based machine-vision to measure one’s pulse using a computer or smartphone.

This issue may be worth investigating further by other health authorities and consumer-protection authorities especially when it comes to classifying devices that are pitched for personal healthcare.

Articles (German Language / Deutsche Sprache)

Swatch bringt seine eigene Smartwatch | PCTipp.ch

Swatch arbeitet an Fitnessuhr | Netzwoche.ch

My Comments

The Swiss aren’t far behind on the smart-watch bandwagon but are taking it a different path so as to preserve their craft and identity.

Swatch is developing a fitness-focused smartwatch that is totally different from the rest of the crowd. Here, this is more a watch that tells the time but is equipped with fitness sensors to measure how healthy you are. They are drawing on EM Microtechnology who is part of the Swatch Group and this company also have worked on GPS technology for a variety of fitness-driven applications.

But Swatch and Tissot, both part of the Swatch Group, are focusing on simpler fitness-focused smartwatch designs rather than the current equivalent of the 80s-era digital multifunction watch. They are approaching watch design on a “horses for courses” basis where different watches suit different people and different occasions. I see this as being highly important because, for example, a woman may want a watch that looks the part on her slender wrist or a man may want to have a dress watch for going out to impress along with a fitness watch for long walks and a utility smartwatch for day-to-day use.

Apple have been “picking Swatch’s brains” about their watch-construction methods but Swatch deny the idea of forming a partnership with them, especially concerning the iWatch idea that has been floating around. As well Swatch are trying to achieve the “best smartwatch” goal rather than being the first.

What I see of this is that the Swatch group are being the first of the Swiss watch legends to link their special craft with today’s smart-wearable technology development.

Article

CSIRO app to help older people live at home safely | Aged And Community Services Australia

My Comments

Increasingly, the home network is becoming a key feature to support the “ageing at home” concept where an older person can live in their home yet is monitored for signs of ill-health or is assisted as they complete regular tasks using the technology supported by these networks.

One of the main goals is to support the concept of deinstitutionalisation in aged care and allied health care, which is becoming more relevant as we see an increasingly-ageing population accelerated by the baby boomers reaching the old age. This concept also reduces the need to build many aged-care facilities which also reduces the costs associated with building them.

There have been efforts in the UK to provide for dignified independent living for older people including the use of projected text to remind Alzheimer’s patients of stages in a cooking procedure and a GPS system to help with shopping. Similarly, IRIS who is a company in the US is distributing through an American chain of  hardware stores products and services that also are about keeping tabs on one’s elderly relatives. This is being augmented by Fujitsu refining technology that makes a digital-camera image sensor measure one’s pulse which comes in handy with in-home aged care.

In the latest effort, the CSIRO have established a system to help with this concept. This is based around a mobile-platform tablet that works along with a system of sensors to observe the health and well-being of the senior citizen.

Energy sensors aren’t just to “be green” in this case, but to monitor use of appliances as part of a healthy daily lifestyle. For example, knowing if they have used the kettle to make a cup of coffee or tea at all or the use of a “cooking device” such as the stove, the microwave oven or toaster oven indicates if the person is well and looking after themselves. Similarly, knowing if they have left the oven or stove hob on for too long can indicate a dangerous situation.

Similarly, those motion detectors that are part of a security system can also identify whether the person has entered particular rooms like the kitchen as part of their regular activities. These work alongside various health sensors like blood glucose monitors or pulse monitors to observe the health of the older person.

This information is presented on a mobile-platform tablet to allow the person to see how they are keeping with life and a carer or the person’s loved ones can know what is going on if there are abnormalities. There are options in this system to help with assuring data privacy so that people only have access to this data only if they need it as part of the health-care plan for the elderly person.

Some other devices can work as part of this same equation such as the new breed of residential “smart locks” that effectively work as a business-grade access-control system for our homes. Here, they could be able to identify whether the door was locked or not and, preferably, identify whether it was locked or unlocked from inside or outside. This could, for example identify whether they got up and went outside to get the paper or mail for example thus knowing if they are well.

There can be questions raised about the use of technology as part of “ageing at home” in the context of over-monitoring the elderly population or stripping out the personal aspect of the care that is to be provided to this population. What needs to happen is that relatives and friends, along with professional carers need to engage with the older person for their health and welfare and not just have these systems monitor them for abnormalities.