What is your patient wearing? By Jeff Gastorf, DO FACOFP

Transcription

1 What is your patient wearing? By Jeff Gastorf, DO FACOFP

2 Disclosures None

3 Importance of medical devices Patient Engagement Importance to society What is the importance of medical devices? Doctor Engagement

4 Patient Engagement Health behavior apps Apple itunes store has over 12,000 apps related to health care. 1 Harris poll 2 37% people wear fitness trackers 78% of those wearing those devices find it useful to give that information to their doctors. Device Education Virtual Health Assistant 24 hour connection to experts Can be a benefit to both patient and physician Need to have educated patients to know what to call and when

5 Importance to the doctor Diagnostic apps Epocrates 5-Minute Clinical Consult ICD-10 coder Medcalc EHR Integration Meaningful use Stage II Clinical summaries Secure communication with patients Availability for patients to view, download, and transmit patient information about hospital admissions Appointment management Harris poll 2 60% of patients would prefer to schedule appointments by portal.

6 Importance to society Health monitoring Remote monitoring technologies could save as much as $197 billion over the next 25 years in the United States. 3 Analytics Pilot projects in India and Sri Lanka have found mobile devices very helpful in monitoring outbreaks of Dengue Fever. Telehealth Harris poll 3 in 5 adults would chose telehealth to do routine follow-ups and simple visits. 2

7 Where we came from Before 1700 s Early spinal decompression device. The Rack

8 Were we came from 1700 s Hearing aids Ear trumpets

9 Where we came from 1800 s Artificial Leech Elektroller

10 Where we came from 1900 s Iron Lung

11 Where we came from 1900 s First portable insulin pump

12 Where we are now Current Ventilator Insulin Pump

13 What has driven our progress Processing power Battery Life/Density

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16 Current Trends Pedometers Scales Thermometers Heart Rate Monitors Blood Pressure Monitors Body-Fat Analyzers

17 Pedometers First invented in France in 1780 Some of the best are within 5% American s on average take little over 5,000 steps a day. 10,000 recommended

18 Scales First historical evidence found near present day Pakistan dates to 2000 BC Spring scale invented in 1770 s Current electric scales use electrical current to determine pressure on scale. Also come with impedance to measure body fat analysis. Now with Wi-Fi

19 Thermometer Regular use of clinical thermometer was at the Viennese School of Medicine in the early 1700 s In 1868 Carl Wunderlich published temperature recordings from over 1 million readings in patients in the axilla and established temperature range from 36.3 to Current technology According to a 2001 research, electronic thermometers on the market significantly underestimate higher temperatures and overestimate lower temperatures. 5 Resistance temperature detectors Thermocouples Thermistor Infrared Now wireless

20 Heart-Rate Monitor First heart rate monitor was a wireless EKG heart rate monitor invented in 1977 to aid Finnish National Cross Country Ski team. Wireless personal heart rate monitors were in retail since Intensity training Chest strap is still more accurate than wrist models.

21 Blood Pressure Monitor Was not first monitored until the middle of 18 th century by Stephen Hales. Now have monitors that will wirelessly record your data and send it to your doctor.

22 Body-Fat Analyzer Most use electrical impedance Useful for following trends if used properly 4 and 8 electrodes are more accurate than 2 electrode models. Downsides Dehydration (up to 5 kg of excess fat) After meals (fluctuation of up to 4 5 %) Moderate exercise minutes before measurement (up to 12 kg of lean tissue)

23 Advanced medical devices Pacemakers Ventricular assist device Deep brain stimulator Implantable defibrillators Cochlear Implant

24 Pacemakers 1958 first implantable pacemaker First recipients lived about 18 months. Plagued by unreliability and short battery life. Advances have prolonged battery life and reliability. Newest pacemakers can be implanted by catheter

25 Ventricular assist device First successful implant was in 1966 Support for 10 days First long term implant was in 1988 Current smallest device is Heartmate II. Less than 3 inches in size

26 Deep Brain Stimulation Therapeutic uses for Parkinson s Disease, essential tremor, dystonia, chronic pain, major depression, and obsessive compulsive disease. Approved for essential tremor in 1997 Approved for Parkinson s Disease in 2002

27 Implantable cardioverter defibrillator First implant February 1980 Multiple studies show significant mortality improvement associated with patients with an ICD.

28 Cochlear Implant First human trials was in 1957 As of December ,000 people have received an implant.6

29 Future is now Hybrid closed loop insulin pump AiQ Smart textiles Bionics MC10 Prototype temporary tattoo Brain-computer interface

30 Hybrid Closed Loop Insulin Pump Currently being tested on type 1 Diabetes. (Medtronic Pivotal Trial) Bionic pancreas Test glucose every 5 minutes. Hopes to be available by April 2017

31 AIQ smart textile Clothing with implanted sensors that are able to measure Muscle stretch Force Temperature EKG EEG Moisture Heart rate Blood pressure

32 Bionics

33 Bionics

34 MC10 Biostamp Flexible computing Collect data such as body temperature, heart rate, brain activity, and exposure to ultraviolet radiation Constantly worn for 2 weeks

35 Brain-Computer Interface

36 Current and Future Concerns Future concerns Hacking medical devices Defending privacy Bioterrorism/Biocontrol due to nanotechnology Healthy people switching to technology Graduates from the University of Google Transhumanism Intellectual movement that aims to transform the human condition by developing and creating widely available technologies to greatly enhance human intellectual, physical, and psychological capacities.

37 References 1 Lena Sun, Mobile Diagnosis: Coming, but Slowly, Washington Post, January 17, 2912, p. E5. 2 This survey was conducted online within the United States by Harris Poll on behalf of eclinicalworks from March 12-16, 2015 among 2,033 adults ages 18 and older. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. 3 Robert Litan, Vital Signs via Broadband: Remote Monitoring Technologies Transmit Savings, Better Health Care Together Coalition, October 24, 2008, p Wunderlich CRA. Das Verhalten der Eigenwarme in Krankheiten. Leipzig, O. Wigand Translated by New Sydenham Society, Latman, NS; Hans, P; Nicholson, L; Delee Zint, S; Lewis, K; Shirey, A (2001). "Evaluation of clinical thermometers for accuracy and reliability". Biomedical instrumentation & technology / Association for the Advancement of Medical Instrumentation 35 (4): PMID Cochlear Implants. (n.d.). Retrieved December 11, 2015, from

38 Questions?

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