by Christopher M. Cirino, DO MPH and Shama Nosheen, MD
One of the implications of the smartphone era is everything is in the palm of your hands. Small gadgets easily surpass the capabilities of their room-occupying prototypes or the personal computers that followed. Not everyone had access to those computers, but now almost everyone has a smartphone. Today an estimated 6.65 billion people own a smartphone – 84% of the world’s population.
Healthcare and technology have had unparalleled development, making health care’s portability inevitable. We are entering an era of personalized medicine that places the responsibility back in the patient’s hands – literally. Pairing handheld technology with health offers patients an opportunity to gain greater feedback on their health, potentially permitting behavior change.
Here are some of the handheld medical devices that you might be interested in owning to upgrade your access to healthcare and your efficiency:
- Handheld Ultrasound Devices
- Medical Tricorder
- ECG Smartwatch
- Sleep Apnea Home Kits
- Improved Glucose Monitoring with Handhelds
Handheld ultrasound devices for smartphone
Necessity is the mother of invention. For ages, doctors have been carrying around stethoscopes, pulling them out of their pockets, diagnosing patients with them, and ultimately saving lives. In 1816, Rene’ Laennec of France invented the first stethoscope after feeling uncomfortable placing his ear on a female patient’s chest to listen to her heart – a longstanding practice. Today, multiple iterations later, stethoscopes can be purchased equipped with doppler devices that allow amplification and visualization of the sound.
Ultrasound uses high-frequency sound waves that echo back to provide an inside view of the body. They are noninvasive, safe, and radiation-free. Traditionally, we think of ultrasounds as heavy machines used for fetal monitoring in pregnancy. However, ultrasounds have a range of uses, including diagnosing heart conditions, lung conditions, abdominal and pelvic organs, like kidneys, ovaries, liver, and pancreas. Physicians can use ultrasound to guide procedures like biopsy and needle aspiration.
Physicians frequently order ultrasounds to evaluate a concern after the visit. Today, portable ultrasound devices may supplement or replace stethoscopes as a routine part of the examination. Technology has an advanced ultrasound to the point where they are connectable to smartphones or tablets, give as detailed images as large machines, and provide real-time bedside input and diagnosis.
The implications of this technology in the palm of your hand are endless. Companies like Butterfly IQ, Philips Lumify, SonoSite, and Vancouver-based Clarius have brought into the market handheld ultrasound devices costing under 7,000 dollars (U.S.). Some devices are even below 2,000 dollars (U.S.) Traditional machines can cost up to 200,000 dollars.
Handheld ultrasound devices have been a game-changer, expanding from emergency care and ICUs to point-of-care ultrasounds (POCUS) for hospitalists and home care use. The idea that these machines can be in the hands of every physician, especially in the remotest parts of the world, makes it a perfect solution to the global challenges of access to care—no wonder this industry is growing at 7.4% and is currently worth 4.2 billion. Artificial intelligence (AI) and deep learning (DL) may allow users with limited experience to identify and detect abnormalities using recognition software.
Did you think the tricorder used by Dr. Leonard “Bones” McCoy from the T.V. show Star Trek would ever be real? You aren’t alone. A 10 million USD global competition known as Qualcomm Tricorder X Prize was launched in 2012 to prompt scientific communities worldwide to create such a Tricorder device.
A tricorder is a portable device that can diagnose different diseases and assess vital signs such as oxygen, heart rate, blood glucose, etc. A tool like this would help eradicate the need for health care professionals and receive direct health care without being at a health care facility like a hospital or clinic.
Countries worldwide participated in this competition, and some of these countries came up with excellent innovations. Of the 312 teams that competed, DxtER by Final Frontier (now Basil Leaf Technologies) claimed its prize as the winner in 2017. It is an advanced wearable continuous vital signs monitoring gadget that has sensors to measure five core vital signs (pulse, blood pressure, respiratory rate, pulse ox, temperature), ECG strip, urine testing and needleless white cell count, hemoglobin, blood count, and glucose. It is also capable of diagnosing 13 health conditions.
This technology is the beginning of the era of automated diagnosis of medical conditions, yet it can only be used for screening purposes. Although it is still in its approval stages, the ultimate goal for this technology is to improve access to enhanced healthcare.
Smartwatch for ECG
An electrocardiogram (ECG) monitors the heart’s rhythm and electrical activity. It is a procedure relegated to a health care setting. The smartwatch industry has introduced heart monitoring wearable devices. Many companies like Apple, Samsung, Withings, Fitbit, and AliveCor are making devices with sensitive analysis of heart rhythm, allowing the detection of conditions like atrial fibrillation (Isakadze, 2020). There is enough evidence to believe that their data is reliable, yet it is for information purposes only, and a doctor makes the diagnosis.
They can screen patients at high risk for heart conditions and those experiencing symptoms. This ECG feature of smartwatches shows promise in the management of Cardiac Diseases and prevention by alerting patients when their health is in danger and saving lives.
Photo by Luan Rezende on Pexels.com
Sleep trackers and Sleep apnea Home Kits
Sleep Apnea is a disorder in which breathing is interrupted during sleep. It has serious health consequences if left untreated. Traditionally, a sleep study (polysomnography) detects it, as it evaluates brain, lungs, and heart functions with different monitoring devices.
With the increased prevalence of sleep apnea, sleep trackers and Home Sleep Apnea Testing (HSAT) kits offer more convenient and increasingly accurate technology for diagnosing sleep apnea. These kits include smartwatches, smartphones, and other wearable devices. The least expensive technologies come as Bluetooth pulse oximeters recorders that pair with the smartphone.
The new smartwatch ScanWatch is now equipped with an oximetry probe that measures the concentration of oxygen in the blood, and along with the heart rate, it detects any episode of sleep apnea. Although these home kits are revolutionary in their self-administration, they do not replace a formal sleep study – one that can also be performed at home.
Technology has also ushered in direct-to-consumer evaluation for sleep apnea. Multiple companies now make it as easy as it is to order a book online. A consumer can add a sleep test to the cart with no appointment needed. It includes a video chat with a sleep physician, a delivered home test, and a personalized sleep report after the test is reviewed. If sleep apnea is identified, a doctor provides a prescription and therapy options.
Move over smartwatches – here are smartrings! The Generation 3 Oura Ring offers a sleek, lightweight, and water-resistant ring that has the capabilities of heart rate detection, sleep assessment, and pulse oximetry sensing. The device pairs with a smartphone and records information that gives the wearer a newfound awareness (a-wear-ness!)
About 1 in 10 adults has diabetes mellitus, approximately 463 million people worldwide, and most reside in low and middle-income countries. One in two are unaware of their diagnosis. Diabetes is a disease in which the pancreas produces insufficient insulin, and the tissues are resistant to it. High blood sugar is inflammatory and can cause severe damage to the body and its organs.
Self-testing blood sugar is crucial for people with diabetes to monitor their disease and prevent consequences. Home glucometers for measuring blood glucose concentration require using a small drop of blood on a test strip from a fingerstick. Although they have been around since the 1980s, glucometers have improved in size, cost, and efficiency.
The market right now is saturated with companies selling glucometers below 100 dollars. They are now widely available in developing countries, yet the costs remain high due to the requirement of test strips.
The inconveniences of test strips and finger pokes were the impetus for developing noninvasive glucose meters that use light technology. People with diabetes now can sync a glucometer wrist device with their smartphones to provide them with ongoing reports of their blood glucose levels. The optical-based sensors give them active feedback on the cause and effect of their diet and may enable behavior change (Ehrhardt, 2020).
Because wearable devices yield massive amounts of data, artificial intelligence software will be developed to process it and provide information for facilitating a diagnosis (Yu, 2018). The software can alert patients of their conditions and when it is necessary to consult with a doctor.
Handheld technologies have revolutionized health care, transferring health responsibility back to the individual. Handheld devices enable people to understand their bodies through feedback and inform doctors what they need to know about it. People in remote areas will soon have access to a similar quality of care. Technology enables a doctor and patient to form an alliance and ensure a partnership for optimal care.