Digital healthcare solutions deliver progress. What sounds trite on the one hand deserves a more differentiated consideration on the other. On each day of the fair, the MEDICA CONNECTED HEALTHCARE FORUM – to be staged within the scope of MEDICA 2016, the world's leading trade fair for the medical sector, which will be taking place in Düsseldorf from 14 – 17 November – will be looking at what the networked future of healthcare will look like. Current developments have thrown up exciting questions that demand answers. For example, how can the countless apps and wearables in the different market segments deliver the most benefits – in private and preventive healthcare through therapy and rehabilitation to the inter-sectoral and interdisciplinary fields? And how can networking be used to deliver benefits to patients?
One example for the variety that is to be more specifically illuminated during the MEDICA CONNECTED HEALTHCARE FORUM is diabetes. Many digital solutions that may be used to prevent and treat diabetes currently exist on the market. These will be the focus of the forum that will be taking place in Hall 15 on Thursday, 17 November. It will be revealed here that: Digital change is affecting systems designed to improve prevention through exercise and appropriate nutrition, through measuring and an awareness of one's own physical status and through solutions intended to make everyday living with diabetes easier.
One important step on the way to automatic and correct insulin dosage is to determine blood-sugar levels without the need for taking blood: Wearables such as the ‘Freestyle Libre’ smart patch are already making it possible for blood-sugar levels to be measured without pricking. The devices thus allow users to query their values whenever required, which is useful to diabetics because being aware of their own blood-sugar levels can help them protect themselves from high or low blood sugar.
Health insurance companies have demonstrated that they are open to digital innovations
Particularly where diabetic children are concerned, these solutions make life easier for families. That is because young sufferers do not have to be woken up in the late evening or early morning to have their blood-sugar levels measured. The wearables allow the levels to be read out by simply moving a scanner – or an Android smartphone with the corresponding app installed on it – across an arm patch that houses the sensor. The scanner detects the glucose level contained in the interstitial cell fluid. Besides the current glucose level, additional values may also be displayed, including the history over the last eight hours and a trend arrow indicating the direction in which glucose levels are moving. The child does not have to be woken up if no insulin is required. The physician needs the corresponding software along with the appropriate devices to read the data. They will provide the physician with the measured glucose levels in a structured layout across a standard 24-hour day. The patch may be worn on the upper arm for around two weeks after which it will need to be replaced with a new one. Two of Germany's largest health insurance companies – the Techniker Krankenkasse (TK) and DAK-Gesundheit (DAK) – are already paying for these innovative ‘Smart Patches’ in the form of voluntary coverage for adults and children from the age of four. It is consequently also being assumed that new wearables – including patches – will be developed to replace insulin pumps in order to administer insulin automatically and in the correct dosages to patients. The session of the forum that will be taking place in Düsseldorf on 17 November will be revealing what solutions are currently being developed across the world.
Wearables designed for prevention
Many wearable technologies are being developed to usefully accompany preventive lifestyles and help people with such common diseases as type 2 diabetes. A few exciting examples are going to be presented in the ‘Wearables’ session on Monday, 14 November. Smart watches and fitness straps, for instance, are able to precisely measure heart rates and heart-rate variabilities (HRV), which may, for example, be used to determine maximum oxygen intake, regeneration and stress levels in users.
One example is Firstbeat, which, among other things, supplies solutions to professional teams, athletes and the wellness sector. Firstbeat is not looking for approval as a medical product, the company’s representative, Dr Christoph Rottensteiner, reports: "However it is important for us to generate a physiologically precise, digital model of the respective person." To this end, science-based algorithms analyse the constantly fluctuating heart-rate variabilities, i.e. varying time intervals between two heartbeats. The quantification of these variations produces the HRV. Firstbeat's algorithms permit an exact insight into the wearer's physiological condition, including stress and fitness levels, along with the quality of their sleep and regeneration patterns. The ‘Firstbeat Bodyguard’ is usually worn for 72 hours straight and may also be used to provide valuable information to physicians. The company is intending to focus its future efforts on consumer markets and to help in reproducing physiological data in an even more user-friendly fashion. But is a separate, specialised device really needed here? "It is imperative to precisely analyse the HRV data. Only then they can indicate, for example, when a break would be required during the day with wearers returning reinvigorated to their activities afterwards," explains Christoph Rottensteiner.
From early-warning systems for asthma to ‘all-rounder’ chest straps
Another example is the Automated Device for Asthma Monitoring and Management (ADAMM) by Health Care Originals, which is a wearable for people who suffer from asthma. It is an early-warning system that detects when an attack is imminent – many hours before the patients themselves may realise this. Thus it can help prevent attacks. A smart patch worn on the chest monitors cough frequencies, breathing behaviour, temperature and other parameters and, in the event of irregularities, the patient is warned. Recognition by the FDA, the regulatory authority in the USA, is being sought.
The ‘QardioArm’ blood-pressure monitor by Qardio, on the other hand, has already been approved and clinically validated by the FDA to meet US and European standards. The device makes it possible for patients to measure their own blood pressure without Velcro straps or pumps. The ‘QardioCore’ is a chest strap that precisely measures body temperature, breathing and heart frequencies without the need for cables and plasters. Qardio is advertising the benefit that graphic charts may indicate certain developments, which patients are able to easily share with their physicians. This could provide additional information about patients' vital data over time and also present a growing challenge for physicians.
"Physicians and patients will have to work together more closely. We should utilise such technologies as online systems and apps to maintain and deepen the dialogue between visits to the physician," says Horst Merkle, Director of Diabetes Management Solutions at Roche Diagnostics and President of the Continua Health Alliance. This would make improved standardisation of interfaces useful so that physicians could be able to read out and analyse the data provided by different devices. This not only applies in the field of diabetes.
The second ‘Wearables’ session, which will be taking place on the afternoon of Tuesday, 15 November, will, among other things, be presenting such examples as sleep tracking, sensors designed to help the regeneration of top athletes, a medically certified multi-sensor platform for measuring body and vital data on the upper arm and an intelligent insole for motion analysis.
MEDICA APP COMPETITION 2016
Many developers from such countries as Bangladesh, Bulgaria, France, Ghana, Switzerland and the USA as well as Germany have already taken the opportunity to win a chance to participate in the MEDICA APP COMPETITION 2016 (application closing date: 30 September 2016). Developers from across the world were asked to submit their ‘Medical Mobile Solution’ for the contest. They may win the chance to take part in the live competition for the best mobile solution to be employed in the everyday work of physicians and clinics. This competition will be held at MEDICA 2016 in Düsseldorf on Wednesday, 16 November (Hall 15, on stage at the MEDICA CONNECTED HEALTHCARE FORUM).
Lots of data and one question mark – the electronic patient file
The Monday afternoon on 14 November will within the scope of the MEDICA CONNECTED HEALTHCARE FORUM be revealing how far digitisation in healthcare can go. From wearables through apps to the digitisation of the entire healthcare system: The focus here will be on how the data quantities generated within the scope of the care process can be utilised in the shape of an electronic patient file – and how it will fit into the telematics-infrastructure environment. While the introduction of the electronic health card with the corresponding infrastructure has been the subject of many years of discussion in Germany, it is already being practically implemented in many other countries, e.g. in Scandinavia, Switzerland and Austria.
The all-day programme at the international MEDICA CONNECTED HEALTHCARE FORUM in Hall 15 (Stand C24) will provide visitors with insights into a broad range of relevant digital developments that will seriously change all aspects of future healthcare.
For more information about the forum, please visit:
Author reference: Dr Lutz Retzlaff, freelance medical journalist (Neuss)