Introduction to Wellbeing Diagnostics
Author: Holly Young
Wellbeing diagnostic devices are tools that can assist in monitoring conditions such as health statistics, including heart rate and blood pressure. In recent years these have proven to be beneficial in diagnosing and managing health conditions in a remote environment. Wellbeing diagnostic devices have evolved rapidly in recent years due to how devices such as the smartphone have rapidly changed to adapt to a more modern lifestyle. The technology underlying these mechanisms in smartphones, mainly the embedded sensors, have advanced in terms of being able to be miniaturised, their energy requirements and sensitivity and the costs becoming more reasonable as their day-to-day use has increased (1).
Over the last few decades, an increase in life expectancy has resulted in a need for rapid, evolving, cost-effective healthcare and medical technology. According to WHO, the number of people over 65 years old outnumbered the number of children under the age of 5. The ageing population is causing a significant socio-economical strain on society, especially for their welfare and healthcare needs as costs continue to rise due to increasing medication prices, expensive equipment and costly hospital care, coupled with shortages of healthcare personnel. Innovative technology could be the answer to resolve these issues and make healthcare services more affordable and accessible to all. Additionally, innovative technology would open the opportunity for people to access medical care and advice from any location more readily removing the need to wait to try to book time-restricted appointments (1, 2).
Wellbeing diagnostics has had a lot of interest surrounding it as long-term health monitoring provides a real benefit; it allows patients to monitor their wellbeing and flag up indications of irregularity. Traditional practises included frequent and long-term hospital stays which strain healthcare resources, whereas the introduction of wellbeing diagnostics devices such as smartphones and smartwatches could provide a cost-effective, resource-efficient alternative by monitoring patients remotely (1).
Over the years, smartphones have evolved to keep up with society’s changes and requirements. They have numerous biosensors embedded including GPS sensors, magnetometers, ambient light sensors and more. Each sensor can measure a variety of health parameters including heart rate (HR), HR variability (HRV), respiratory rate (RR) and health conditions such as eye and skin disease. This turns a primarily communication device, into a multi-purpose device that can monitor health by collecting data that can be analysed and stored on the phone. The records can also be sent to healthcare services/providers to be reviewed. Smartphones are also known to transfer data over high-speed internet networks whilst going about their day-to-day lives which means they can collect data remotely but also remain connected to the healthcare system (1).
An example of a smartphone app that can be used to monitor patients with Alzheimer’s disease (AD), is known as iWander. It utilises the GPS feature of smartphones to track the users and contains details such as their age, their stage of dementia and home location to personalise the software. If a patient is detected from their normal address at an abnormal time of day or during adverse weather conditions, it can evaluate if the person may be disorientated and confused. The app registers this and will ask the person to confirm their location and if it receives no response then it will alert family members or emergency services/care providers (3).
Smartwatches are wellbeing diagnostic tools capable of measuring heart rate, blood oxygen saturation and skin temperature. These devices over recent years have also been made wireless and can connect to smartphone devices and statistics can be monitored daily and recorded on a mobile app. They are most used as health and fitness trackers tracking daily step counts and monitoring sleep cycles (4).
Smartwatches typically contain 16 sensors, all of which work to help measure and record health data. Here are some of the key sensors that work for health monitoring
Global Positioning System (GPS) sensor tracks your location by synchronising the user’s location, velocity and time data by using satellites, a receiver and algorithms. Magnetometers work alongside the compass and GPS in a smart device to determine an exact location. This is useful in smartphones and smartwatches for fitness and safety reasons as they can allow users to track their progress if they are on a run, or if the user suffers from diseases like Alzheimer’s the GPS can locate the user and call for assistance.
3 axis accelerometers can track the direction and speed of movement, useful when tracking user activity. This can be combined with the gyroscope to help determine if the user is running or jogging on the spot and remove motion from violent shakes that can impact the data recorded from activity.
Bioimpedance sensors measures sleep, heart rate, respiration rate and more by delivering very small amounts of current to test the resistance your skin is offering.
Electrocardiogram (ECG) sensors detect the small electrical impulse released with each heartbeat. This is detected by the sensor electrodes and measured in the device.
Other additional sensors that have appeared in some smartwatches include the UV sensors that detect whether the sunlight is harmful and the electrodermal activity sensors that measure stress levels and heart rate simultaneously. (5)
The utilisation of health and fitness apps increased by 15% from 2012 to 2019, a study taken in both the UK and the US found that 3 in 5 of those with a smartwatch/fitness tracker used the device to count daily steps. 44% of people were found to use the device to track heart rate, 40% to track sleep and 27% to monitor blood pressure (6).
The pacemaker is an implantable wellbeing diagnostic tool. It is a cardiac device that involves the long-term monitoring of the heart. The ability to monitor these devices remotely decreases the need for constant direct monitoring by healthcare providers, can assist in predicting any cardiac events which may occur and therefore allow the correct treatment to be taken ahead of time. Pacemakers are used in the treatment of an irregular heartbeat, it uses low-energy electrical pulses to regain the heart’s normal rhythm whenever it detects an irregular beat. They have proved extremely beneficial in the management of heart problems (4,7).
Biosensors have proven to be a great asset to the medical diagnostics field. Its potential and ability to detect and quantitatively measure levels of specific analytes within bodily fluids rapidly and accurately are ideal for wellbeing wearables and point-of-care (POC) diagnostics as seen in wearable continuous glucose monitoring devices and monitoring heart rate/rhythms. Within each of the technology mentioned above, biosensors play a great part to allow the development of these wearable devices but their potential and applications are not limited to this (8).
These vast developments in wellbeing diagnostic devices over the past 20-30 years has helped people to gain control over the monitoring of their own health and wellbeing. Whilst this could seem to be marketed for the younger generation, as they are more familiar with modern technology, these devices could benefit older consumers the most. For example, an Apple watch/device can detect when a person has fallen and call for assistance. With such long waiting times for appointments and treatments in hospitals nowadays, heightened by the COVID-19 pandemic, the ability to monitor your own health on your own terms and being able to relay this back to healthcare professionals could revolutionise modern diagnostic technology. It would relieve the strain on healthcare environments as appointments may not be needed as frequently with consistent monitoring, it would relieve the strain on shortages of staff and overall, it could reduce healthcare costs significantly.
References:
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Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current and potential use among physicians and students. J Med Internet Res. 2012;14(5):e128. Published 2012 Sep 27. doi:10.2196/jmir.1994
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https://www.gadgetsnow.com/slideshows/these-16-sensors-in-smartwatches-fitness-bands-help-in-measuring-heart-rate-spo2-and-more/magnetometer/photolist/78179724.cms
Gilsenan, K., 2020. How wearable tech is helping consumers take control of their wellbeing - GWI. [online] GWI. Available at: <https://blog.gwi.com/chart-of-the-week/wearable-tech-and-consumer-wellbeing/>
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Abid Haleem, Mohd Javaid, Ravi Pratap Singh, Rajiv Suman, Shanay Rab. Biosensors applications in medical field: A brief review, Sensors International, Volume 2, 2021, 100100, ISSN 2666-3511,https://doi.org/10.1016/j.sintl.2021.100100. (https://www.sciencedirect.com/science/article/pii/S2666351121000218)