Healthcare wearables development is accelerating and we’re unlocking the insights the devices provide to help resilience against pandemics like COVID-19.
We are in the midst of what, for many of us, is the first global pandemic we have experienced, and it has completely changed the way we live. The virus named SARS-CoV‑2 by the World Health Authority (WHO) that causes the medical condition entitled COVID-19 is invisible, highly infectious and for about 2% of infected people it is deadly. For those of us who are unlucky enough to contract this disease, there are also unknown long-term consequences with some who recover reporting blood clots or inflammatory complications. It is therefore of the upmost importance to reduce the spread of the disease to not only save lives but to reduce the financial burden this virus is having on the world economy.
A key strategy employed by public health authorities worldwide is to maintain social distance to reduce the transmission of the virus coupled with testing to understand the spread of the disease. However, there are a number of companies and researchers worldwide who are turning to wearable technologies to measure monitor and curb the spread of COVID-19
Wearable technology or wearables are a class of electronic device that can be worn on the body, often on, or close to the skin. Typically, they form part of a system using sensors to analyse signals from the body or from the user’s environment and transmit this information to the cloud for data aggregation, detailed analysis and to provide insights. If we consider healthcare wearables, they form a continuum from simple activity trackers at one end, though to complex medical devices at the other. They can perform a myriad of functions supporting lifestyle improvements through feedback on steps counted and activity levels as well as to measure factors such as body temperature, heart rate, blood pressure and even blood analysis.
COVID-19 and wearable technologies
As wearables are able to measure signals from the body, a number of companies and researchers are modifying their existing wearable tech or developing new wearable devices to support the detection of COVID related symptoms and potentially gather large volumes of real-time data to track the prevalence and course of the disease.
Temperature tracking labels
In May 2020, Identiv, Inc, in partnership with NXP Semiconductors, announced the development of a number of Body Temperature Measurement Patches. These devices which deploys flexible hybrid electronics they have skin friendly adhesives and are intended to be worn, on the skin, under a person’s upper arm. The first version which has an embedded temperature sensor and wireless near field communication (NFC) will measure temperature instantaneously when an NFC enabled mobile phone is placed in close proximity to the device. This will allow the wearer to get a quick measurement of their temperature but also allow others, such as those managing public venues, to get a simple, contactless, reading of temperature. The second device they have developed is for clinical-grade applications and it enables longer term body temperature tracking through the integration of a flexible battery. This data can be stored in the cloud through interaction with an NFC enabled connected mobile phone and can be used to rapidly measure if a person’s temperature increases signalling a potential infection and alerting them, and/or public health to take the appropriate next steps, such as isolating that person to prevent further transmission.
The US company, Blue Spark Technologies have developed a disposable self-adhesive temperature tracking label. It is adhered to the skin and measures and records body temperature for up to 72 hours. This data can be wirelessly transmitted in real-time over this period through a Bluetooth connection to a mobile phone or Bluetooth hub. It was originally developed to measure the temperate of patients within hospitals enabling easy aggregation of data across a healthcare setting and reducing the need to take measurements directly from the patient. Deployed already in hospitals worldwide for this purpose, Blue Spark announced recently that they are using this wearable system to also support frontline care workers within healthcare settings. The patch is being trilled one of Ohio’s health care systems, University Hospitals (UI), and can remotely monitor caregivers’ temperatures through a dashboard with little-to-no direct contact so clinicians can deliver care to patients without interruption. Any spikes in temperature can be an indication that the caregiver could be suffering from an infection and can be therefore isolated or given care as appropriate, reducing the risk of further transmission and also enabling the clinician to receive support more rapidly.
These two devices both rely on the under-arm position of the patch providing reasonably accurate body temperature, however measuring a core body temperature is difficult to achieve. The Swiss company greenTEG is taking another approach, using a combination of temperature and thermal flux. These measurements are sensitive to not only the skin temperature but also the heat flow out of the body. By modelling the thermal properties of the body, from these two measurements and accurate core body temperature can be calculated. This measurement method has significant industrial applications in addition to human body measurements.
The New York (US) based start-up Estimote develops Bluetooth location beacons and have adapted their technology to reduce the spread of COVID-19 within a workplace environment. They have produced a series of wearables that they are calling “Proof of Health” wearables that aim to provide contact tracing to monitor the potential spread of COVID from person to person. Using GPS technology that works indoors coupled with Bluetooth beacons in the building and on each of the wearables, their technology is able to measure where a person is and how close they are with others. They also claim to be able to identify how long people have been in close proximity. If a member of the team is found to be COVID positive it should be a simple matter to look at the data and identify which individuals have been in contact with the infected person and take action as required.
A study published in the Lancet in January 2020 gives evidence that identifying deviations in a person’s resting heart rate can be used to indicate infections such as influenzas. The study employed the data from Fitbit wrist worn heart rate sensors for over 200,000 people in the USA and has paved the way for wearable devices to provide an early warning sign of infection. Building on this, researchers at West Virginia University Rockefeller Neuroscience Institute have announced that they have developed an AI enabled digital platform that can detect COVID symptoms up to three days before they appear as a fever, cough etc. They do this by using data obtained by the Oura ring which is a finger worn wearable fitness and activity tracker. Separately, Scripps Research has started a study entitled “DETECT” to analyse participants’ wearable health data, including heart rates, sleep and activity to more quickly detect the emergence of viruses such as SARS-CoV‑2 (COVID). They can aggregate data from smartwatches such as Apple Watch, Fitbit, Amazfit or Garmin watches to enable early illness detection enhancing the ability to track and respond to disease outbreaks.
According to the Financial Times, in Lichtenstein, they are currently testing wearable bracelets on 1 in 20 of their citizens with the bracelets offered to the whole population by the Autumn. The bracelet is provided by Ava, a Swiss medtech company with the original use of accurately monitoring fertility cycles in women. As with the solutions described above, the data from these bands such as heart rate etc will be used to predict infection as early as possible enabling action by the authorities if needed.
A very unexpected symptom of COVID-19 has been patients presenting with extremely low blood oxygen levels, even without other symptoms like fever or cough. Measurement of saturated oxygen is an extremely routine measurement, typically done through a finger clip. Several companies are now looking at the possibility of wearables for the continuous O2 SAT measurements for outpatients and the general public, for early detection of these extraordinary low levels.
Development of wearables for healthcare
At CPI we have broad expertise in the technology required to develop wearables for healthcare including those which would be classed a regulated medical device. We have expertise in printed and flexible hybrid electronics, a method of combing printed components such as sensors, conductive traces or antennas alongside rigid components such as silicon chips and batteries onto a flexible substrate. We can even work with textiles to produce smart fabrics and clothing. This enables significant freedoms of design as well as imparting light weighting thinness and flexibility which is not possible with conventional electronics. Sensing is also one of our areas of expertise and we have worked with companies to develop printed pressure and strain sensors as well as some types of biosensors, when coupled with a wearable device this could enable significant information to be derived from biomarkers. For optical sensing, we have expertise in developing (light-based) photonic solutions to enable measurements such as heart rate, blood pressure and blood oxidation.
Wearables offer a way to give us more information about our bodies and through modern data aggregation techniques coupled with AI, we are learning more about ways to get insights from this data, we at CPI are here to support the development of your next wearable device, or components within that device to enable additional measurements to be taken or make that wearable more lightweight or unobtrusive.
The world of wearables is accelerating at a high rate and their value is really starting to be unlocked. If we embrace wearables en-masse, as they are doing in Lichtenstein. Early detection of COVID-19 coupled with track and trace systems is key to stopping this global pandemic, wearables clearly have a part they can play in this.
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