Healthwatch: Remote monitoring and the future of post-pandemic medicine

In the vast list of changes COVID-19 has made to our everyday lives, one you may not think about often is the growing need for medical professionals or caregivers to be able to monitor patients while keeping (social) distance.

Then again, maybe you do think about it. There are 40.4 million unpaid caregivers of adults ages 65 and older in the United States, and 29% of the adult population cares for an ill or disabled relative.

Managing a pandemic, and a patient, isn’t an easy thing.

Watching Those in Need

This week, Amazon released an Alexa adjunct called Care Hub, which is designed to help families monitor loved ones who need oversight but still want to lead independent lives. It can trigger Alexa to contact designated caregivers, and allow the caregivers to view activity on their smartphones.

This isn’t Amazon’s first foray into healthcare; earlier this year they launched Halo, and in 2018 they acquired a prescription delivery company.

They’re not the only ones. A Seattle startup called Optimize.health sells an end-to-end monitoring service used not by family caregivers but by independent medical clinics and hospitals. Its primary function is allowing doctors to connect with patients via text or video, and according to the company, revenue has increased 800% since last year.

Not surprisingly.

Oh, and there’s Biofourmis, who announced on September 3rd that they had raised $100 million to help advance products in the fields of cardiology, respiratory, oncology, and pain management.

And really, those were just the only two we found while writing this. Undoubtedly there are another dozen either at bat or on deck, waiting to capitalize on crisis. We don’t even mean that pejoratively; innovation is where you find it. And in the end, patients will get better care.

Watching Yourself

We deliberately didn’t start this piece by talking about the Apple Watch, because every time Apple does anything, we go into fits about it. But...they’re just so good at stuff.

Apple Watch Series 6 greatly increased its hardware power, and that power underpins some spectacular new features. The Blood Oxygen app lets users measure their blood-oxygen saturation in a crazy 15 seconds. It also takes readings periodically throughout your day (and night). This can help users keep track of their respiratory and cardiac health, and monitor asthma symptoms and potential heart problems.

And if you opt in, the data isn’t just for you: Apple has partnered with Anthem, UC Irvine, and Seattle Flu Study to develop 3 research studies that help patients and doctors use data to prevent heart failure, and determine how changes in blood oxygen and heart rate can indicate early signs of health problems.

Like, critically, the onset of COVID-19.

Watching the Progression

In some ways, the Watch has changed the way we as a society are able to collect and collate medical data. And that could improve the care we give one another and the skill with which we treat disease.

A standard medical study might test, say, 1,000 people. An Apple Watch test? Researchers can access an exponentially wider pool of subjects. In fact, the 2019 Apple Heart Study had 419,000 participants. Not only that, it ran that test with arguably better accuracy than human-managed tests. The 68th American College of Cardiology Scientific Session and Exposition opened with a study that suggested the Apple Watch can detect atrial fibrillation with a “reasonable degree of accuracy,” giving people an opportunity to seek medical care before a serious event like a stroke.

Each year, more than 795,000 people in the U.S. experience a stroke. This is no small thing.

And the convenience cannot be overstated. It’s a lot easier to participate in a trial if all you do is say “yes” to a prompt and let the Watch do the rest instead of drive to the office, fill out some forms, wait for a call, have an interview… It corrects for the problem of access.

Sort of.

Unless researchers are providing the Watch themselves, resulting figures might be skewed to more affluent test subjects who can afford to spend $400 on a watch. And because health and income are inextricably linked (residents of impoverished neighborhoods are at vastly higher risk of chronic disease and decreased life span), crucial data can be lost when the poor are left out.

It is imperfect. But it’s a start. And the more conditions we can actually, reliably measure from the Watch, the better we do in health monitoring and clinical trials.

Future Watch

Earlier this month, the Taskforce on Telehealth Policy (bet you didn’t even know there was such a thing) released its report on the current state of telehealth, and its future moving forward through, and beyond, the COVID-19 pandemic.

The pandemic has been a catalyst for change that was, perhaps, needed all along. Previously, telehealth and remote monitoring were “nice to haves” but not widely adopted. There were regulatory issues, tech issues, and a general sense of hesitation to take the leap. But when the world was suddenly on lockdown, there was no more waiting.

It happened.

So now, startups, giants, and groups like NCQA are rapidly innovating to make it work for everyone, and not just until the coronavirus has faded away. Issues like patient safety, HIPAA laws, telecommunications access, and geographic restrictions still plague (sorry) the systems, but progress is never without its pains.

We’ll keep watching.

#Apple #Apple Watch #COVID19 #innovation