A glimpse of new technologies post pandemic

Chronic health conditions are financially and emotionally costly. In response to the Covid-19 pandemic, many healthcare providers are re-engineering their pathways to promote point of care. Digital wellness wearables can assist in smart triaging of patients for timely referral to outpatient or inpatient settings for preventive care or timely intervention before the disease becomes difficult to manage. Wearables can also empower patients to better engage in self-care and the health ecosystem.

Wearables are small electronic devices that, when placed on the body, can help measure temperature, blood pressure, blood oxygen, breathing rate, sound, GPS location, elevation, physical movement, changes in direction, and the electrical activity of the heart, muscles, brain, and skin. This rich information can help track calorie expenditure, exercise, stress, healthy posture, poor sleep quality, cognitive decline, and even early warning signs of infection and inflammation. Wearables can empower one to continuously measure their health and wellbeing without the need for visiting a clinical center and immediately take an action when needed.

Remote care, using telehealth and wearables, has become a critical part of health operations during the pandemic and is expected to continue being a robust tool for providers and patients. Wearable technology will continue to evolve and provide significant benefits for patient care. These devices can be conveniently worn by or applied directly onto patients, and will enhance healthcare providers’ capabilities for conducting telehealth and home healthcare. They will also allow patients and their families to spend less time in hospitals for care that can be delivered more economically in an environment where the patient is most comfortable.

Smartwatch innovation is progressing rapidly, driven by advances in sensors, semiconductors, and artificial intelligence. Some smartwatches now feature optical sensors that continuously measure variations in blood volume and composition, using a technology called photoplethysmography (PPG). Algorithms produced and continually improved via machine learning use data from these sensors to provide insights into users’ activity levels, stress, and heart pattern anomalies. Companies are getting closer to enabling smartwatches to monitor blood pressure, using PPG and other technologies to detect signs of chronic hypertension, which can cause heart disease, heart attacks, and strokes.

Due to limitations of smartwatch technologies, smart patches have been developed as they are small and inconspicuous, affixing directly to a person’s skin. Some minimally invasive smart patches use microscopic needles that painlessly penetrate the skin to act as biosensors and sometimes deliver medications.

Unlike smartwatches, which provide a broad range of health data and insights, smart patches are typically designed for a single indication, such as diabetes management, patient monitoring, and drug delivery. Smart patches also employ a broader range of technologies.

For example, smart patches that measure heart rate variability often use electrocardiogram technology that tracks the heart’s electrical activity directly and more accurately than smartwatches. Smartwatches and smartphones still play an important role. Data from smart patches is being integrated with smartwatch and smartphone apps, sending data to these devices for display and analysis.

With the right technology, including interoperability capabilities, doctors could see wearable health data on a patient’s health record, gaining access to more comprehensive information to inform diagnosis and care.

Remote patient monitoring is the use of digital technologies to monitor and capture medical and other health data from patients and electronically transmit this information to healthcare providers for assessment and, when necessary, recommendations and instructions. Remote patient monitoring allows providers to continue tracking healthcare data for patients once they are discharged. It also encourages patients to take more control of their health.

The top three benefits of remote patient monitoring for patients include detailed information on personal health, faster access to healthcare services, and greater influence on own wellbeing through ownership of health data. This is particularly advantageous when the number of healthcare providers are in short supply and are located very remotely.

Remote patient monitoring is particularly beneficial in the management of chronic conditions, such as diabetes, heart disease, COPD/asthma, and cancer.

The benefits of remote monitoring for patients include better access to the healthcare team since these devices report real-time health data, fewer trips to the hospital saving time/money, improved quality of care from doctors, more control over personal health since the patients have full access to the data and can make necessary adjustments in their lifestyle.

A few examples of these de­vices are – blood pressure monitor using cuffs on patient’s wrists for hypertension management, weight monitor using a scale, blood glucose monitor, and spirometer.

The data from remote patient-monitoring devices can be transmitted to the hospital either by cellular network or through bluetooth technology. Cellular remote patient-monitoring devices collect and transmit patient health data over the same networks used by cell phones.

Companies that offer cellular-connected devices partner with cell phone companies to access their widespread networks. Bluetooth remote patient-monitoring devices transmit patient data over short-range wireless connections to devices that can connect to the internet.

It may be beneficial to offer a mix of connectivity options. Bluetooth devices deliver noteworthy advantages and may be worth offering to tech-savvy patients while defaulting to cellular devices. This strategy helps to mitigate risks on a patient-by-patient basis, but it also requires a flexible remote patient-monitoring platform.

In patients with severe heart failure, cardiogenic shock, and high-risk percutaneous intervention (PCI), the heart muscle is weak and blood cannot be pumped efficiently enough to get oxygen to all of the cells.

The impella pump is used to pull blood from the ventricle and push it out into the aorta, delivering oxygen-rich blood to the rest of the body. This allows the heart to rest while the doctor performs the PCI. Impella is a percutaneously inserted ventricular assist device (VAD) that pumps blood in parallel with the heart. It aspirates blood directly from the LV into the aorta, thereby maintaining physiological flow.

As compared to intra-aortic balloon pump (IABP) and extra-corporeal membrane oxygenation (ECMO), the impella pump has been shown to play a valuable role in reducing mortality associated with cardiogenic shock.

Atherectomy devices were developed to permit drilling and grinding plaque, calcium, and excess cellular material from the site of a coronary occlusion or stenosis.

The rotational atherectomy catheter (Rotablator) is designed for the removal of plaque from coronary arteries. This device, which has a diamond-studded burr at its tip, rotates at about 160,000 revolutions per minute and is particularly well suited for ablation of calcific or fibrotic plaque material. Philips has introduced a new excimer laser system to simplify challenging coronary and peripheral atherectomy procedures.

The catheters compatible with the Philips Laser System are indicated in more vessel types than in any other atherectomy device, and this is the only laser atherectomy technology proven for in-stent restenosis in both coronary and peripheral vasculature.

In addition, the system is also the only laser system available for lead extraction procedures (the removal of pacemaker or defibrillator leads around the
heart).