Caption: Stanford University’s Michael Snyder displays some of his wearable devices. Credit: Steve Fisch/Stanford School of Medicine
Millions of Americans now head out the door each day wearing devices that count their steps, check their heart rates, and help them stay fit in general. But with further research, these “wearables” could also play an important role in the early detection of serious medical conditions. In partnership with health-care professionals, people may well use the next generation of wearables to monitor vital signs, blood oxygen levels, and a wide variety of other measures of personal health, allowing them to see in real time when something isn’t normal and, if unusual enough, to have it checked out right away.
In the latest issue of the journal PLoS Biology , an NIH-supported study offers an exciting glimpse of this future. Wearing a commercially available smartwatch over many months, more than 40 adults produced a continuous daily stream of accurate personal health data that researchers could access and monitor. When combined with standard laboratory blood tests, these data—totaling more than 250,000 bodily measurements a day per person—can detect early infections through changes in heart rate.
Whether it’s a pedometer dangling from a belt loop or a skin patch to monitor heart rate and hydration levels, wearable and mobile devices have become essential gear for many of today’s fitness minded. But Darren Lipomi, a nanoengineer at the University of California, San Diego, envisions even more impressive things to come for optimizing workouts and bringing greater precision to health care. Lipomi is helping to build a future of “stretchable electronics,” semiconducting devices that will more seamlessly integrate with the contours of our bodies, outside and even inside, to monitor vital signs, muscle activity, metabolic changes, and organ function—to name just a few possibilities.
Lipomi and his colleagues specifically want to create a new class of semiconducting polymer that has the mechanical properties of human skin. This transparent “electronic skin” will have a soft elasticity to conform to shape, sense contact, absorb blunt force, and even self heal when dinged. It will do all of this—and possibly more—while continuously and wirelessly performing its programmed health-monitoring function. To help Lipomi build this future of real-time health monitoring, he has been awarded a 2015 NIH Director’s New Innovator Award. This NIH award supports exceptionally creative new investigators who propose highly innovative projects with the potential for unusually high impact.
When it comes to devising new ways to provide state-of-the art medical care to people living in remote areas of the world, smartphones truly are helping scientists get smarter. For example, an NIH-supported team working in Central Africa recently turned an iPhone into a low-cost video microscope capable of quickly testing to see if people infected with a parasitic worm called Loa loa can safely receive a drug intended to protect them from a different, potentially blinding parasitic disease.
As shown in the video above, the iPhone’s camera scans a drop of a person’s blood for the movement of L. loa worms. Customized software then processes the motion to count the worms (see the dark circles) in the blood sample and arrive at an estimate of the body’s total worm load. The higher the worm load, the greater the risk of developing serious side effects from a drug treatment for river blindness, also known as onchocerciasis.
Caption: Boston University researcher Ed Damiano with his son David, who has type 1 diabetes, in 2002. Credit: Toby Milgrome
From taking selfies to playing Candy Crush, smart phones are being put to a lot of entertaining uses. But today I’d like to share an exciting new use of mobile health (mHealth) technology that may help to save lives and reduce disability among people with type 1 diabetes—an advance inspired by one researcher’s desire to help his son.
By teaming a smart phone with a continuous glucose monitor and two pumps designed to deliver precise doses of hormones, a team from Boston has created a bionic pancreas that appears to control blood glucose levels in people with type 1 diabetes more effectively than current methods. That is a significant achievement because if blood glucose levels are either too high or too low, there can be serious health consequences.
In a healthy body, the pancreas masterfully regulates blood glucose levels by orchestrating the secretion of insulin and another hormone, called glucagon, which raises blood glucose. These hormones work together like an automatic thermostat, raising and lowering blood glucose when appropriate. However, in type 1 diabetes, the pancreas produces little or no insulin, leading to increased levels of glucose that gradually damage blood vessels, kidneys, and nerves, raising the risk of blindness and amputations.
Caption: New patch (left) and traditional Holter (right) for monitoring heart rhythms Credit: iRhythm Technologies (left); Misscurry,Wikimedia Commons (right)
There are thousands of “wellness” apps for smart phones and other mobile devices that will help you count calories, calculate your BMI, monitor your meds, boost your fitness routine, or quit smoking. These are now commonly referred to as “mHealth,” where the “m” stands for mobile technology. While these gadgets may encourage a healthier lifestyle, few of them have been tested rigorously for improved health outcomes over time, and they won’t necessarily keep you out of the ER.
Some of the most dramatic leaps in mHealth will arise when we have small, inexpensive wireless devices with sensors that can monitor your physiology—heart rate, blood pressure, blood sodium and glucose levels, breathing patterns, brain waves, and so on—and then transmit those data to your physician, who can then take actions that may spare you a trip to the hospital or even save your life.