Digital technologies are disrupting healthcare through wearable devices, sensors, and telemedicine. Wearables can monitor vital signs, track activity, and deliver therapies. Sensors can be embedded in materials like plasters to continuously monitor health metrics. Devices also enable remote monitoring and virtual consultations. While these technologies offer benefits like early detection and increased access to care, their adoption faces challenges regarding user experience, clinical validation, and safety that require further research.

1. Back to the Future: Digital trends
in Medicine
Ivan Olegario, MD, MDC
August 9, 2016

2. Medical scheme “product” life cycle
Time
Declining beneficiaries
Escalating costs
Inefficiency
Waste
Innovation
SuccessSuccess

3. Technology adoption
Source: Gartner 2015

4. Source: Frost & Sullivan

5. Technology use matrix
GOALS USERS
Physicians Patients
Prepare and prevent E-Learning
Virtual dissection
Curated online information
Data and diagnostics Wearables
Real-time diagnostics
EMRs
Wearables
Personalised genomics
Therapy and follow-up Robotic interventions
Telemedicine
Multidisciplinary therapies
Artificial organs
Adherence controls
3D-printed biomaterials

6. What does the future look like?
Source: http://lifesciences.ieee.org/articles/487-a-survey-on-ambient-intelligence-in-healthcare

7. Digital technologies predicted to disrupt healthcare
Source: The 7 Biggest Innovations in Health Care Technology by Brian Honigman
Wearable Tech- like Google Glass
Hybrid Operating RoomsDigestible Sensors
Nanobots in Blood
Fingertip Surgery
3D Printed Biologicals

8. Personal Health Devices
• Personal health devices can:
– Provide information or
– Sense and respond,
– or both.
• They can provide intervention or everyday support.
http://www.eee.bham.ac.uk/woolleysi/projects/index.htm
http://www.disetronic-ca.com/dstrnc_ca/rewrite/content/en_CA/3.2:20/article/DCM_general_article_53.htm
http://mlearning.edublogs.org/2006/11/20/m-learning-is-vital-for-industry-compatibility/

9. Blood Pressure/Pulse Monitors
• Automatic large LED blood
pressure systolic / diastolic /
pulse readout with fuzzy logic.
• Automatic inflation & deflation
• 48 sets of memory to monitor
your progress plus date / time /
average pressure
• Requires 2 x AAA batteries.
Tatung http://www.tatung.com/med/product.html

10. AMON - Advanced Telemedical Monitor
• A European project from ETH, Zurich
• Designed to be worn by cardiac
outpatients, the device allows remote
monitoring of blood pressure, pulse,
oxygen saturation, body temperature and
2-channel ECG signals.
• AMON: A Wearable Medical Computer for
High Risk Patients,
P. Lukowicz, U. Anliker, J. Ward, G. Tröster, E.
Hirt, C. Neufelt,
ISWC 2002: Proceedings of the 6th
International Symposium on Wearable
Computers, 7.-10. October 2002, pp 133-34

11. Glucose monitoring and
Wearable Insulin Pumps

12. Biofeedback and “Inner-active” Games
• Biofeedback – monitoring and altering a
body function such as breathing, heart
rate, blood pressure through relaxation or
imagery.
• ANTENSE® Biofeedback anti-tension
device: $160
• emWave Personal Stress Reliever® $199
• The Journey to Wild Divine, the first in a
series of “Inner-Active” computer
adventures
– Biofeedback in an entertaining
multimedia experience $187.50
Top left: Antense® Anti-Tension Device
Top right: http://www.holisticonline.com/Biofeedback.htm
Bottom: http://www.myemwave.org/about_emwave_stress.html
http://www.luxevivant.com/index.asp?PageAction=VIEWPROD&ProdID=166

13. The “Digital Plaster”
• A device embedded in ordinary plaster
• Includes sensors for monitoring health-
related metadata such as blood
pressure, temperature and glucose
levels.
• If the results show abnormal signs,
patients and doctors would be notified.
• Can be integrated with motion sensors.
[The Toumaz Digital Plaster]

14. Portable TENS
• TENS machines are used for pain relief,
for example, by chronic pain sufferers or
for pain during child birth.
• From NHS Direct: “a pad that administers
small amounts of electrical current,
blocking pain signals and stimulating
endorphins”
An NHS-Approved TENS machine
http://www.maternitytens.com/index.asp?function=DISPLAYPRODUCT&productid=9.
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=914

15. Personal Mobile Electrotherapy
• NovoCure is currently performing
clinical trials using 100-200 kHz
electric fields (tumour treating fields
or TTFields), to stunt the growth of
cancer cells.
• Inhibits microtubule spindle
organization and resultant mitosis
• Leads to apoptosis
• Animal and early human trials appear
promising.
Safety cap.
A glioblastoma patient wears the NovoTTF-100A.
http://sciencenow.sciencemag.org/cgi/content/full/2007/530/3

16. Live clinical record
• Readings appear as a live database
• Standard queries and interfaces can be used to
manipulate the data
• On-line services used to process the data
• Exploits existing grid standards for reliability
• Presents a range of different interfaces for
clinicians
• Provides range of feedback to patients.

17. Research Questions: Qualitative
• System-centred research questions
– How can sensors, systems and data interact and
combine or synergise?
• User-centred research questions
– How can users manage and interpret all this new
information?

18. Research Questions: Quantitative
• Can we help people (doctors and patients) keep well
and optimise health? (Clinical outcomes)
• Can we use new technology to make more people
more well more of the time ... with less money?
(Health economics)
• Can we avoid exposing people to excessive
electromagnetic fields? (Risks)

19. Impact to practice
• Much left to be done
• Start thinking about it NOW!