MHealth muscles tests more accurate.

Doctors test the strenght of intrinsic hand muscles by letting the patient pull an push at their hand and fingers. Is this an accurate methode? No, a team of bioengineering students from Rice University developed a device to measure thenar, hypothenar, interosseus and lumbrical muscles.

Graduates Caterina Kaffes, Matthew Miller, Neel Shah and Shuai “Steve” Xu invented PRIME, or Peg Restrained Intrinsic Muscle Evaluator, for their senior project. “Twenty percent of all ER admissions are hand-related. Neuromuscular disorders like spinal cord injuries, Lou Gehrig’s, diabetes, multiple sclerosis-all these diseases affect the intrinsic hand muscles,” said Xu. PRIME, was created to replace the common test. The real goal is to quantify finger/muscle strength for a more accurate diagnosis for carpal tunnel syndrome evaluation and other disorders.

“U.S. surgeons perform over 500,000 procedures for carpal tunnel each year. $2 billion per year is spent treating this disease but up to 20 percent of all surgeries need to be redone. Our invention can be used across the spectrum of care from diagnosis to outcome measurements,” said Xu.

The device has three elements: a pegboard restraint, a force transducer enclosure and a PDA custom-programmed to capture measurements. In a five-minute test, a doctor uses pegs to isolate a patient’s individual fingers. “You wouldn’t think it works as well as it does, but once you are pegged in, you can’t move anything but the finger we want you to,” Miller said. A loop is fitted around the finger, and when the patient moves it, the amount of force generated is measured. “PRIME gets the peak force,” Xu said. “Then the doctor can create a patient-specific file with all your information, time-stamped, and record every single measurement.”

Fall detection integrated in your body-area network.

Sensoring your condition and your balance. Not new so why the mentioning? This one is integrated in a wireless body-area network (WBAN).

Halo Monitoring is a Huntsville, AL based company, that is marketing a wearable monitoring strap that can detect falls. This is one of the leading causes of hospitalization and accident-related deaths among senior citizens. Halo Monitoring is demonstrating its myHalo system at the Healthcare Unbound conference in Seattle this week.

The user wears a washable strap with electrodes embedded in the fabric to measure heart rate, skin temperature, calorie expenditure, sleep patterns and other factors critical to the health of frail, elderly people, and is able to detect whether the wearer has fallen or is simply lying down. It transmits readings via the ZigBee standard for wireless devices, to a home “gateway” that looks like a standard wireless Internet router. The gateway connects via an existing ethernet or a standard phone line to Halo’s monitoring center, which can send immediate web, email and text alerts to concerned caregivers, or, in emergency cases, a call-center operator can contact the caregiver directly or dial 911. “If Mom doesn’t answer the phone, you can log onto our website,” President and CEO Chris Otto says.

Monitoring is automatic, so the user doesn’t have to press a panic button. The Halo system costs $65 to $99 a month, and is currently in use only in the Huntsville area, as well as in Chicago and New Jersey, where the company has marketing partners. Expect a national rollout next year, according to Otto.

Watch your baby grow on your mobile.

Pregnancy and the iPhone. We could have seen it coming. Will this become a breaktrough or a gadget? This app will make you see your baby grow.

San Antonio, Texas-based AirStrip Technologies announced that the FDA had granted the company’s iPhone application, AirStrip OB, clearance to market the app to physicians. AirStrip OB enables obstetricians to use their iPhones to remotely access real-time and historical waveform data for both the mother and the baby. The data set includes heart tracings, contraction patterns, nursing notes and exam status. The app pulls the data from the hospitals’ labor and delivery units.

In order to connect the iPhone to the hospitals’ clinics, the hospital needs to purchase the AirStrip system first, which then works along with the hospital’s existing patient monitoring system. Once installed, doctors only need to download the app to their iPhone.

“Labor and delivery is one of the riskiest and most litigious environments in healthcare, and… communication errors lead to a measurable majority of actionable bad outcomes,” AirStrip President and CMO Dr. Cameron Powell stated in a company release. “AirStrip OB aims to mitigate that risk by closing the communication gap among caregivers,” he said.

AirStrip OB is already available on Windows Mobile powered PDAs and smartphones, but the company noted the iPhone app has a different feel because of the phone’s touchscreen.

Wii-Fit in your toilet.

There are dozens of tests that can be performed on human urine. Why do we have to visit a healtprovider to have a check? Toto’s new “Intelligence Toilet” system brings health measurements only a bathroom away.

For $3,500, the Intelligence Toilet system will measure urine sugar, hormone levels, protein levels, blood pressure and body fat on a daily basis. The bodyweight scale is build in around the floor. We already urinate multiple times a day and with this system we can automate the process of analyzing our urine daily to keep an eye out for abnormalities and to accumulate valueble trending data. There is hardly any human intervention required except for the blood pressure sensor. The data is transfert by Bluetooth and the results can be seen on a monitor on the toilet.

It’s the sequel to the original Intelligence Toilet, which has been tracking and graphing the health of 10,000 buyers who have purchased one since 2005, according to the Japanese manufacturer. Like the original, the Intelligence Toilet II takes all kinds of readings from your urine, which are then organized into Wii-Fit style charts and graphs on your PC via Wi-Fi. Sony has announced that they will integrate an interface in there new healtcaresystem. Another feature that makes the Wii into a healthcare platform. I wrote about that before.

Healthcalls in schools.

A child with asthma has difficulty breathing while at school, so his teacher sends him down the hallway where he sits in front of a video screen. Using a special stethoscope, a doctor who is miles away examines the boy’s chest, sends a prescription to his local pharmacy and instructs the student to go back to class. Is this a scene out of a movie? No dream of the future. Reality in Yancey an Mitchell counties USA with a school-based telemedicine network.

“It’s about providing improved coverage for acute issues and better management of chronic issues,” said dr. Steve North, a family physician at the Bakersville Community Medical Clinic. “But while it’s a great idea, it isn’t financially viable to a school of less than 60 kids.”

“In addition there is also the potential to do nutrition counseling and education and also to do teledentistry,” he said. “If we could provide those services you could really have a functioning school-based health center.” The project is being run by the Graham Children’s Health Services of Toe Rive. ,

North’s idea of a school-based telemedicine network is unique, said Jodi Polaha, an assistant professor of psychology at ETSU. Polaha: “If successful, North’s school-based telemedicine network could form the basis for similar networks in other areas of the country”.

Ultime integration of technology + communication + healthcare.

Intelligent medicine integrates in-body computing, sensor and communications technologies into medical existing devices and pharmaceutical products. What if my hip implant and my running shoes worked together? The Raisin system from Proteus Biomedical uses tiny computing devices inside pills to transmit data to doctors.

Raisin is a socalled “ingestible event marker”. It’s a tiny computing device put inside a pill. It reports when it has been swallowed, record information about the body’s response to the drug, and transmit the information. A high-frequency electrical current is send through the body’s tissue. Periodically a receiver, placed on the patient’s skin downloads the information and recorded on the mobile phone. The phone connects to the Internet. The patient can authorise access to the data for example doctors can track a treatment’s impact and a patient’s health in real time.

“This is the most personal computing that has ever been conceived,” says Andrew Thompson, Proteus CEO and co-founder. “It’s a secure system. The technology doesn’t rely on any kind of radio signal, instead using the conductivity of tissue to relay signals, which are thus confined within the body. The device eventually disintegrates and passes safely through the digestive system”.

The technology offers the potential to transform the way heart patients and those with infectious diseases or mental problems are managed. For drug therapy to be effective, patients have to adhere to a prescribed regime, taking required doses at appropriate intervals. But clinical studies show that more than 50% of heart patients do not receive guideline-recommended therapy, and of those who do, only 40% to 60% adhere to the regime.

The initial application of the Raisin system is for the treatment of patients with heart failure. The system senses and records the precise time a patient takes one or more microchip-enabled drugs, providing feedback on its bodily impact. The information is sent to caregivers and clinicians so that decisions can be made about any necessary adjustments. Proteus is also developing “intelligent leads,” or wires connected to defibrillators and pacemakers, which, when used in conjunction with Raisin, will allow doctors to make long-distance adjustments to both the device and a heart patient’s medications.

One of the significant challenges that have prevented widespread use of in-body computing to date is the disintegration of active electronics as they are exposed to bodily fluids. Proteus has developed so-called ChipSkin technology that eliminates this issue with an extremely thin and durable wrapper to protect the leads and preserve performance of the active electronics.

RFID starts up in healthcare.

RFID-enabling functions are tracking, identification and authentication, automatic data collection and transfert and sensing. But what about healthcare? A recent study by Rand Europe’s Health and Health Care, which included 325 state of the art sources, sheds light on the actual applications in use.

We see RFID (Radio Frequency Identification) in healthcare delivery servicing different subjects. In relation to staff and assets, the main enabling function is tracking. When applied to patients , the key objective is identification and authentication. The primary function of RFID, the automatic data collection and transfert, is mostly used in clinical trails.

There are four RFID functional domains in which RFID can be supplemented or complemented by other technologies:

• object/person identification
• data transfert from RFID tags to other tags/ the environment/ back-office applications
• sensing/ telemetry/ diagnosis
• integrating health-information infrastructures.

With respect to the first two functions, the relationship between RFID and the individual technologies performing these functions can be both complementary and substitutive. The relationship between RFID and the technologies performing the latter twe functions is clearly complementary.

The study reveales that not only does a large functional range of RFID applications in healthcare exist. Applications, trials and pilots evaluating RFID are already emerging.

For the full report click here.

You and your medical data collection.

There are multiple ways to interact with a health record. Is all this effort necessary? Questions like where, when and how are crucial for succes. Is there an immediate payoff?

A new personal health application is being designed by T.R.U.E. Research Foundation. It analyzes, summarizes, dispays and makes recommandations on many daily activities. It helps the patient to make decisions. You can conduct “what if” analyses, which will predict the results of choices the user might consider. For example the consumption of specific food for diabetes patients.

At the University of Rochester, George Ferguson and Cecilia Horwitz are working on a computerized “conversational assistant”. It will provide heart patients with a daily checkup via a series of voice-activated questions and responses. The voice activations, using natural language, looks promising because patients are immediately comfortable with it. Ease of use is important for collecting data in daily life cause:

• data collection is incredibly burdensome
• data collection can be embarrassing
• data collection can be emotionally fraught

Patricia Brennan, National Director of the Project HealthDesign, points at the distinction between data that need to be stored in order to analyze trends and data that are immediately usable and then can be discarded. “This could revolutionize the way people relate to their health. Say a person with asthma walks into a meadow that has a high pollen count. A sensor can read the pollen count and send an alert to the user to tell him to take his inhaler and than delete the information. We don’t need to remember what the pollen count was, only that an event triggered a response.”

Patients are an untapped source of medical data.

Mobiles will boost the creation of health-related data. Will we save all of it? What do we do with it? It’s time to rethink the power and potential of Personal Health Records (PHR).

At first health records were originally paper-based files. It’s primary purpose was to assist the provider in the care process. Later on the functionality of records grew. They offered access to test results and were still owned by a health care institution. The new generation of PHR’s is designed for individual users. To help them engage in their own health management.

This introduces the collection of observations of daily living (ODL). Not necessarily collected in a clinical setting but of importance to individuals. Data that can help determining ways to live healthier and not simply to manage an illness.  ODL data can take many forms. From quantitative measures of sleep to qualitative self-reports. These data allow different kinds of insights:

• a fuller/richer picture of the health status;
• analyses of patient’s own trend information;
• relations/comparisons of symptoms with others;
• when combined; location based developments.

ODL data are often subjective and ethically, legally and socially divers. The broader uses are difficult to achieve. Their quality rises when measured and reported more consistently. Abnormalities can be filtered out. James Heywood, co-founder of PatientsLikeMe says: “The challange is to take all the information that patients can offer and compress it into a usable format so others can use it”.

First and foremost, PHR’s remain a tool to engage individuals in their own health management. People will wrestle with decisions about how much data about themselves they want to be collected, stored and shared.

To get some idea of the legal complexaties involved see the Health Care Law Blog of Bob Coffield.

Under-skin sensor for mobile cardiac monitoring.

This is for under your skin. How many devices can we place within our body? Will we end up half human half machinery? Just joking. It’s all for the best.

This is the second time in a week that I stumbled upon a sensor that’s placed under the skin. An other cardiac monitor is lounched by Medtronic. The Reveal XT subcutaneous cardiac monitor is now commercially available in the U.S. In Juli 2007 it was already introduced on the European market.

The device helps physicians diagnose heart arrhythmias by remote monitoring. It also captures an electrocardiogram (ECG) during asymptomatic episodes to better diagnose difficult cases. The Reveal XT communicates wirelessly with a pager-like device that the patient wears. The information is then routed from the device to the physician’s computer.

The monitor is inserted just under the skin of the chest area in a short outpatient procedure. To store an ECG, the patient places a handheld, pager-sized assistant over the device and presses a button. The information is then transferred to a physician’s computer via the Medtronic CareLink Network or the physician can retrieve the data during an in-office visit.

Medtronic says: “Subcutaneous cardiac monitors are intended to put no restrictions on a patient’s daily activities, making the necessary monitoring more comfortable for the patient but also ensures that the data is not being influenced by restrictions in activities”.