A new generation of apps and wearables is emerging with the ability to monitor vital signs crucial to spotting heart problems, giving us and our doctors powerful new weapons to fight stroke and heart disease.
Just last week, Apple revealed it would be testing, along with Stanford Medicine, an Apple Watch app to help spot irregular heart rhythms that could lead to serious illness. And the same day, Silicon Valley startup AliveCor announced it received FDA clearance for a connected wristband for the Apple Watch. Together, AliveCor’s hardware and software monitor for irregularities, and they produce medical-grade results for physicians to evaluate.
Efforts like these and others could save lots of lives. And, in this time of spiraling healthcare costs, they could also save money. Heart disease is the number one killer of Americans, outnumbering all forms of cancer combined, according to the Centers for Disease Control and Prevention. Together with strokes, they account for nearly three of every 10 deaths in the country. And as the nation ages, that ratio likely will increase.
These new devices aren’t your everyday fitness trackers, which is good, because many doctors dismiss those as inaccurate. They’re clinically accurate: most either are going through the FDA approval process or, like AliveCor’s SmartRhythm software and companion KardiaBand, already have clearance.
And second, they’re familiar: the devices crank out the same data physicians already record when you visit their offices.
The benefit these devices have over systems in the doctor’s office is they can record data every day – even around the clock, in some cases. That affords so much more insight than readings logged at the doctor’s office once or twice a year.
What’s making this union of wearables and healthcare possible? It’s a mix of some old tech. And some new. Some borrowed. And some, well, red.
Both red and infrared, to be exact. As opposed to flashing green LEDs on the underside of the Apple Watch, the new Fitbit Ionic and most other heart-rate-monitoring wearables today, these medically-oriented fitness trackers use red light.
The LEDs flash the light into the skin, while companion sensors use changes in light reflecting back to calculate pulse rate and other metrics. Like green, red has its own set of benefits and shortcomings. But its key advantage is it penetrates much deeper into the body than green, so it can be used to derive a much richer set of vitals.
SensoGram is using red and infrared light to build a compact, wireless vital-signs monitor that perches on your finger. The Plano, Texas, startup turned heads at the Connected Health Conference in Boston in late October with its new SensoScan, which measures blood pressure continuously, as well as heart rate, oxygenation and respiration.
The SensoScan looks like the pulse oximeter they clip to your finger at the doctor’s office, only without the cable and cart attached. It’s now under review by the FDA.
I’ve been evaluating SensoScan for more than a month now. There are a few kinks to be worked out in the software and user interface, as with any new product. But it works. I got sick at the digital health show, of all places, and brought the SensoScan with me when I went to the doctor. We compared it to the office"s big, wall-mounted equipment as well as to the gold standard: the old-school kind, which measures with a stethoscope. It passed!
SensoGram is building a follow-on product that shrinks the same vitals into a ring. That’s scheduled to roll out midyear, though blood pressure may not be available at introduction.
Like startup Sensogram, Omron – a household name in blood pressure measurement – is also navigating a new line of wearable blood pressure monitors through the FDA approval process. But Omron is taking a different approach. Omron borrowed the tried-and-true pressure cuff, and miniaturized it to fit on your wrist like a smartwatch. Impressive. You should be able to buy Omron’s Project Zero 2.0 blood-pressure watch late next year, FDA willing.
On the heart monitoring front, startups like AliveCor are focusing on detecting irregular heartbeats, or arrhythmia, like atrial fibrillation, which can lead to stroke. AliveCor’s KardiaBand features an embedded electrocardiogram, or ECG, which is what doctors use to monitor heart activity. Kardia’s SmartRhythm software leans on the Apple Watch’s heart monitor as a first line of defense. If the app sees something suspicious, it sends an alert, telling you to record an ECG rhythm for the doc.
I’ve been testing the KardiaBand for more than a week, and guess what? I got an alert. My pesky cold may also have helped me put the KardiaBand through its paces. The day after Thanksgiving, the Kardia app blinked and beeped, with a message to record an ECG, like right away. The resulting test called out possible atrial fibrillation.
If you have physicians as relatives, then you know how they hate being asked to examine you during the holidays. So you can appreciate why I held off asking my uncle, a retired cardiologist, to check out the rhythm strip printout.
Of course, I eventually did ask him. He looked at the file, and said the underlying sinus rhythm looked normal. He said the symptoms likely were the result of all the cold medication I’d been swilling to chase my bug. But go see my cardiologist anyway, he said. Which, I will. I will!
Another startup, CardiacSense, is also tackling heart arrhythmia with its own wrist-worn device. The Israeli company says it’s found a way to produce heart data from the green LEDs and optical sensors on today’s smartwatches that’s as accurate as old-school ECG. To make its case, the company is now presenting clinical trial data to the FDA.
Even so, the CardiacSense watch includes built-in ECG for reporting to physicians, because it’s what doctors are used to evaluating. So like the KardiaBand, the CardiacSense device alerts you to record an ECG rhythm at the first sign of trouble. Over time, CardiacSense founders are hopeful they can build up caregiver trust and shed the old altogether.
In the meantime, I expect 2018 to be a watershed year for tackling heart conditions and other chronic diseases with continual monitoring - during the more-than-99% of the time we’re not at the doctor’s office. That’s exciting to me. It should be for you, too.