Wearable Tech World Feature Article
April 09, 2015

The Lifeguard Internet

The Internet of Things (IoT) is so abstract, it encompasses everything from wearables to connected cars to M2M monitoring of gas pipelines in the middle of nowhere.  What if I told you that IoT could deliver lifesaving results within a decade? It's a radical proposition that could upset medical device manufacturers, but the hardware already exists today in wearable tech.

A typical fitness wearable wristband or smartwatch has the basics of monitoring down cold, tracking movement over time, with many able to record heart rate. Blood oxygen level monitoring is the latest function being rolled into wearable tech, enabling the individual to automatically keep track of vital signs.   Temperature and detailed EKG-style data are likely to become standardized options in the next year or two.

Consider the following scenario:  An "at risk" individual, one with a known or suspected medical problem, is urged by his primary care physician, health insurance company, or employer, to use a fitness or "Wellness" wearable.  Potential and previous cardiac and stroke patients will be among the first to get a wellness wearable.  

During normal activities throughout the course of the day, motion, heart rate, EKG and blood oxygen statistics are monitored.  If parameters are exceeded during an exercise session, a smart watch or smart phone may beep and ask a simple "Are you OK?," prompting the individual to answer "Yes" to dismiss the alert.

During a stroke or heart attack, motion, heart rate, EKG and blood oxygen are likely to dramatically change. Certain types of seizures may be able to be categorized based upon sensed motion or lack thereof.

What actions take place based upon those vital signs collected by a wearable depend on the software involved.   Data sent from the wearable to a smart phone -- and in the future, directly processed on the wearable -- would relay an alert to a monitoring service.  The service would attempt to contact the individual to determine that the alert is an actual medical emergency, while pulling up location information for where the wearable is at.

If the individual is at a public place, the alert service might either try to "ping or ring" others close by to get confirmation of a medical emergency. Upon confirmation, the service would directly contact a public safety access point (PSAP) -- what we call 911 -- to get an ambulance dispatched, if someone on site hasn't already done so.

So far, so good. But what else could we do in the minutes before emergency services arrives on site?

One option is to provide a life safety map function of the immediate area, pointing out the location of the nearest AED.  If the individual is still able to move, better they put energy getting closer to a defibrillator.  AED manufacturers looking for the next big product improvement would be wise to put a Bluetooth or low-power Wi-Fi chip into the device to provide location, status, and usage information.  Pulling out an AED and putting it into operation should send an immediate alert to one or more parties, including the owner, emergency dispatch, and the manufacturer/service manager.

Once emergency personnel arrive on site -- or even in route -- relevant medical data could be transmitted and reviewed by paramedics and doctors at the closest emergency room.  A determination could be made if the individual could go to a regular emergency room setting or be dispatched to a specialized cardiac or stroke care center, resulting in faster, more effective treatment.

Modifications to this basic lifeguard service could be rolled out for the elderly and in hospital care.  A stock visit to the ER may evolve from a tearable paper wristband to an electronic one providing access control and vital sign monitoring. 

How fast this happens depends on the medical device community and the Food and Drug Administration (FDA).  The FDA handles medical device certification, a non-trivial process.  Blending together off-the-shelf wearable tech and software is likely to happen far quicker than the FDA might be used to while device manufacturers might not be keen to see some of their expensive products put out of business by $100 wristbands available at Best Buy.

Edited by Stefania Viscusi

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