Connected tools in healthcare
Connected tools, also known as the Internet of Things (IoT), have been present in our hospitals for many years. In our day-to-day lives, they are becoming more and more common and an integral part of many areas of our lives, including our health, without us even being fully aware of it. Just think how many people around you are now wearing an activity bracelet or a connected watch on their wrist!
Other examples could be blood pressure and glucose monitors, which often connect with apps we can install on our mobile devices, offering additional, and very useful, functionalities for monitoring chronic diseases.
As for connected tools offering more futuristic functionalities, they are on the increase, and it's worth taking a closer look at them, to discover these unsuspected new uses, and to reflect on the future of these connected objects.
How are connected tools useful in healthcare?
There are a number of ways in which these tools are particularly useful in healthcare. For example, they can facilitate:
Follow-up and monitoring of a person's state of health, at home, by a caregiver or by a remote treatment team. This team can then monitor a large number of patients, and issue alerts in the event of data deviating from the target range;
Patient management of chronic diseases, facilitated by apps that not only automatically synchronize and store device data, but also analyze it and offer trends and feedback to the user, supporting awareness or offering personalized advice.
Direct follow-up with the healthcare provider, via telemedicine, which can, among other things, help improve care accessibility;
Patient autonomy, enabling them to better understand and manage their health at home, and in a much more autonomous way;
Health research, through the use of data generated by a large number of users. This can help to understand day-to-day illnesses, their evolution, the user habits and their impact, and much more information that can be used to develop the therapies of the future.
Innovative connected tools
Here are a few concrete examples of connected devices that are interesting, surprising or paving the way for the tools of the future.
It's important to point out that many of these new devices have not been the subject of studies proving their safety or efficacy, let alone been approved as medical devices. So, if you're interested in one personally, or in making a recommendation, you need to be cautious and well-informed. In particular, the issue of data confidentiality is often raised when it comes to these connected health devices.
Note, however, that when a tool is identified as being approved as a medical device, it is taken for granted that studies have been carried out and that the results were conclusive, even if this is not explicitly mentioned below.
A brain stimulation device for the treatment of depression and anxiety disorders
Via a headset called Flow, this system offers an additional alternative in the treatment of depression and anxiety disorders. Flow delivers transcranial direct current stimulation (tDCS), a therapy that has long been used clinically to treat depression, but this time, at home.
The app, required to use the headset, offers a therapy program covering a range of topics from behavioral therapy to lifestyle habits such as meditation, sleep, diet and exercise. The app also invite users to take a depression severity test (MADRS-s) at intervals, with the aim of tracking the changes, and to increase awareness of state changes over time.
This device is particularly interesting because it has been the subject of 2 clinical studies, one of which concludes that "Stimulation was well-tolerated and accepted, with mild tingling sensation and scalp discomfort being the most common side effects. [It] highlights the applicability, acceptability, and promising results when combining home-based tDCS with psychotherapy and pharmacotherapy to manage depression and anxiety symptoms in clinical practice." (1)
For pelvic floor health
Classified as a medical device within the European Union, MyPeriTens is a wireless, app-connected tool that uses transcutaneous electrical nerve stimulation (TENS) to relieve pain, and electrical muscle stimulation (EMS) to strengthen pelvic floor muscles.
MyPeriTens also includes exercises based on Kegel's method, and could therefore help in the treatment of certain forms of urinary incontinence.
For asthma and COPD (chronic obstructive pulmonary disease)
Propeller is a connected healthcare tool consisting of a sensor that attaches to an inhaler (sometimes called a pump) for the treatment of asthma or COPD, and communicates with the app of the same name. The latter collects data on medication use and creates a personalized profile to promote compliance with the treatment plan.
Other features include reminders to take medication, monthly reports on inhaler use, a daily overview of air quality and weather forecasts, tracking of rescue medication use to identify triggers, and a function to locate misplaced inhalers.
The system has been the subject of several acceptability and clinical value studies. One such study demonstrated a significant reduction in rescue medication use and an improvement in asthma control scores “among adults initially lacking asthma control” (2).
A ring for your health
Oura is an attractive ring that can be worn on the finger, day or night, and measures various body parameters, including heart rate, blood oxygen level (saturation) and temperature. It is connected to an app that offers advanced sleep tracking, daily scores for sleep and physical activity, and personalized advice for maintaining a healthy balance.
Long-term trends are offered, helping to understand the impact of choices and environment on the body.
The app also suggests activity goals and encourages moments of mindfulness, offering guided meditations.
Finally, the app offers a web-based platform with advanced graphics and the ability to export data.
To prevent and relieve migraines
Nerivio is a prescription-only device approved by the FDA for the acute treatment of migraine with or without aura in people aged 12 and over, and has the equivalent CE mark in the European Union.
The device consist of an armband worn for 45-minute electrical neuromodulation treatments, which activate natural pain pathways to inhibit migraine.
The application allows to control the intensity of the treatment, and keeps a log of migraines and migraine symptoms.
A new level of guidance during meditation
Muse is a headband that acts as a real-time meditation coach. EEG sensors detect when the mind wanders, and the app then provides an audible cue to bring the user back to the present moment. Guided activity thus helps to ignore distractions and achieve higher levels of concentration and attention during meditation.
The acceptability and effectiveness of Muse has been the subject of a small, published pilot project, which demonstrated health benefits, safety and acceptability of the device, and the absence of reported side effects (3).
An "intelligent" pillow
Zeeq is a pillow that analyzes sleep. Connected to the app of the same name, it provides a sleep score and snoring and movement statistics.
In addition, users have the option of subscribing, unlocking additional features, such as a gentle vibration warning when the users snore, to encourage them to modify their sleeping position and thus reduce their snoring.
To detect cardiac arrhythmias
KardiaMobile devices, approved as medical devices by Health Canada, the FDA and the European Union, can detect common cardiac arrhythmias at home in just 30 seconds. By simply placing the thumbs on the device, medical-quality electrocardiograms can be recorded anytime, anywhere. The connected app provides instant analysis of normal results or of a potential problem, and lets you share the recordings with your doctor, or send the result to a cardiologist for analysis, for a fee.
The present and future of connected healthcare tools
As you can see, connected healthcare devices now exist in many areas of healthcare. We've named just a few, but could have added to this list: cyberpills, insulin pumps that calculate and inject the required insulin dose, connected beds, smart pillboxes, smart patches, and many more!
Although the efficacy and safety of each of these devices is not always proven, some are approved by major regulatory agencies in North America and the European Union. In all cases, it would be prudent to speak with a healthcare professional before purchasing or using any of these devices.
The future holds other connected tools that could modify or add to the treatment of several diseases for which current treatments are unsatisfactory, such as Parkinson's Disease and Alzheimer's Dementia.
There's even talk of implanted microchips that could one day be used to monitor our health parameters, not to mention nanobots! So, when it comes to connected tools, the future will continue to surprise and impress us!
Mónica Sobral, Raquel Guiomar, Vera Martins, Ana Ganho-Ávila, Frontiers in psychiatry, 2022 Oct 6, Home-based transcranial direct current stimulation in dual active treatments for symptoms of depression and anxiety: A case series, https://pubmed.ncbi.nlm.nih.gov/36276322/
Merchant RK, Inamdar R, Quade RC, The journal of allergy and clinical immunology. In practice., 2016 Mai-Juin, Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial, https://pubmed.ncbi.nlm.nih.gov/26778246/
Ghosh K, Nanda S, Hurt RT, Schroeder DR, West CP, Fischer KM, Bauer BA, Fokken SC, Ganesh R, Hanson JL, Lindeen SA, Pruthi S, Croghan IT, Journal of primary care & community health, 2023 Jan-Dec, Mindfulness Using a Wearable Brain Sensing Device for Health Care Professionals During a Pandemic: A Pilot Program, https://pubmed.ncbi.nlm.nih.gov/36960553/
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