Technology has always played a central role in healthcare. From microscopes to medical imaging, and from pacemakers to prosthetics, technological breakthroughs throughout history have improved diagnosis, prevention, treatment, and rehabilitation.

In addition to digital technology, the connected health megatrend owes its adoption and growth to the urgent need for fresh approaches to these persistent challenges. (Credit: Thinkstock Photos)

Today, connected medical devices are transforming the way care is delivered. Wearables, home monitors, and other networked devices that rely on machine-to-machine communication offer compelling solutions to tough healthcare challenges:

  • Improving prevention, early detection and outcomes.

  • Reducing the cost and effort of delivering care.

  • Relieving shortages of primary care and specialist providers.

  • Serving patients in rural, remote or developing areas.

  • Helping the elderly age in place.

  • Managing chronic diseases.

  • Giving patients greater control over their health.

To create the next wave of connected healthcare devices, designers need the right materials. Depending on the type of device and usage scenario, advanced polymers may be required to increase ergonomics and usability, provide an attractive appearance, support miniaturization, ensure biocompatibility, deliver flame retardance and heat resistance, and stand up to chemical cleaners and wear and tear.

Defining Progress

The National Cancer Institute at the National Institutes of Health defines connected health as “the use of technology to facilitate the efficient and effective collection, flow and use of health information.” Technology is transforming care delivery by making it simpler, easier, more collaborative, and more data driven.

Digital technologies that are the foundation of connected health include:

  • Sensors: worn on/adhered to the body or implanted to identify, capture and measure data.

  • Internet of Medical Things (IoMT): connects smart sensors and devices to each other and the cloud. As a subset of the IoT, this connected system of medical devices and applications provides collected data to healthcare IT systems through computer networks.

  • Wireless connectivity: rapidly transmits data over the network.

  • Mobile devices and applications: collect and transmit data for building reports on individuals or public health trends.

  • Videoconferencing platforms: support telehealth systems.

  • Big Data analytics: mines and analyzes data from IoT devices.

  • Cloud computing: scales easily to handle huge data volumes.

BY THE NUMBERS

By 2025, the United States is expected to face a shortage of:

  • 446,300 home health aides

  • 95,000 nursing assistants

  • 29,400 nurse practitioners

Source: Mercer's US Healthcare External Labor Market Analysis. Calculations by Mercer's Workforce Strategy & Analytics practice. here 

Healthcare device manufacturers are feeling competitive pressure to invest in digital health products. (Credit: Thinkstock Photos)

Categories Defined

It's a large universe, but the connected health sector can be divided into just a few manageable categories:

  • On-body segment: Includes consumer wearable devices for tracking health and fitness, and clinical wearables that are typically approved for use by regulators and used under the supervision of a physician.

  • In-home segment: Includes personal emergency response systems, remote patient monitoring and telehealth virtual visits.

  • Community segment: Examples are kiosks that dispense information, point-of-care devices used outside the home or healthcare setting, and mobility services that track a patient's health parameters during transit.

  • In-clinic segment: Includes devices used for administrative or clinical functions in a clinic, via telehealth or remotely.

  • In-hospital segment: Includes wearable devices for patients and facility management applications, such as hand hygiene monitoring for staff and environmental controls.

Tech That Heals

In addition to digital technology, the connected health megatrend owes its adoption and growth to the urgent need for fresh approaches to these persistent challenges:

  • Improving adherence and outcomes. Medical treatment today still relies heavily on qualitative information and doctor/patient conversations. To improve public health, there is a need for vast quantities of data that can be analyzed to identify trends with high confidence and accuracy. On an individual level, nonadherence to prescribed medication is a major contributor to poor outcomes. It can be addressed, in part, through technology that reminds patients to take their meds.

  • Expanding care delivery while controlling costs. Providing in-person healthcare to people in underserved areas, such as rural communities and developing nations, and to home-bound, elderly or disabled patients, is expensive, inefficient and time-consuming. Plus, there's a looming shortage of primary care and specialist physicians and other healthcare professionals — just as demand from the aging population is rising.

  • Helping the elderly age in place. Most older people want to remain in their homes as long as possible. However, dementia, physical frailty, and other health issues can interfere with independent living and lead to costly hospitalizations and nursing home admissions.

  • Managing chronic conditions more effectively. Chronic conditions, such as diabetes, hypertension and chronic obstructive pulmonary disease (COPD), require ongoing monitoring and management that can place a heavy burden on clinicians and patients alike. Inadequate management can lead to patient noncompliance and costly hospital admissions.

  • Increasing patients’ involvement in their health. Although many people still defer to their doctors, the Wall Street Journal reported that quality gaps in U.S. healthcare and rising death rates from many diseases highlight the need for patients to play an active role in getting the best care and avoiding harm. Providers are encouraging patients to manage chronic conditions proactively and help make informed treatment decisions.

PC and PC/ABS with their expected toughness and performance and polymer additives can also boost properties like UV resistance, toughness, or antimicrobial action. (Credit: PolyOne)

FUN FACT

57 percent of Millennials would be interested in cutting-edge devices like pills that can monitor their internal vitals when swallowed.

Source: Salesforce 2015 State of the Connected Patient Report

Depending on the type of device and usage scenario, advanced materials may be required to increase ergonomics and usability. (Credit: Covestro)

Generational Change

Millennials are often called the “C” (for connected) generation. As the largest generation (80 million strong), these young people are helping to advance connected health through their familiarity with technology, including mobile devices and apps. This generation of patients are looking for innovations in how they connect with providers and share information. Millennials tend to choose:

  • Health advice and support from social media vs. institutions, clinicians, or manufacturers.

  • Employers that offer fitness benefits.

  • Alternative therapies, natural foods, and supplements vs. pharmaceuticals.

  • Companies that emphasize sustainability.

Cell Phone Connections

Most people around the world are able to rent or own a cell phone. In countries where access to healthcare is a problem — whether due to lack of clinicians or poor infrastructure — mobile healthcare is bridging the gap. Even where there is no electricity, a cell phone signal can connect patients and providers. Examples include:

  • Sending out SMS messages about health education, appointment and medication reminders, and information about medical services

  • Sending images of patient conditions (skin rashes, tissue samples) for evaluation by experts.

Devices for off-the-grid healthcare. Areas with intermittent or no electricity can benefit from these innovative devices:

  • Cell phone microscope — this addon turns a mobile phone camera into a microscope.

  • Solar blood pressure monitor — this semiautomatic upper-arm blood pressure device uses solar-charged batteries.

  • Smartphone ultrasound — this device uses a transducer plugged into a smartphone, along with a software package, to create an ultrasound machine.

Remote Monitoring

Cell phones are also helping patients in countries with a lack of healthcare resources to tackle those issues seamlessly. Consider the following:

Indonesia's maternal mortality rate is among the highest in Southeast Asia, mainly due to few resources available for the care of expectant mothers. Taking advantage of high mobile phone usage in Asia, Philips recently developed a scalable telehealth platform using a mobile app. Local mid-wives create a health profile of pregnant women by collecting data from physical examinations and tests. Data uploaded from the app allows obstetricians to remotely diagnose and monitor patients who have high-risk pregnancies.

Thermoplastic elastomers provide for softer grips, texture, and comfort. (Credit: Thinkstock Photos).

Clinical or Consumer?

Many consumer electronics companies are entering the healthcare market. At the same time, healthcare device manufacturers are feeling competitive pressure to invest in digital health products. A study by Ernst & Young noted that if medtech companies do not make significant investments in digital health capabilities, long-term growth could be at risk. They may be overtaken by major technology companies, which are already at an advantage over medical device firms.

Cytotoxicity, sensitization, and irritation are all critical factors to consider when selecting polymers to ensure biocompatibility. (Credit: Thinkstock Photos).

Convergence concerns. Blurring of the line between consumer and professional medical devices raises several issues. One concern centers on the expansion of professional medical devices from the hospital or clinic to the home setting, where untrained patients and caregivers may struggle to understand, operate and maintain them.

On the other hand, as OEMs create portable medical devices that mimic the attributes of consumer electronics — ultra-thin profiles, for example — some features and functionality, such as battery life, may be affected.

In fact, some manufacturers of consumer electronics for healthcare are having their products cleared by the U.S. Food and Drug Administration under the “de novo” regulatory pathway. Examples include the Apple Watch Series 4 and the Bose Hearing Aid, a wireless device intended to amplify sound for those over 18 with mild to moderate hearing loss.

Why Connect? So Many Reasons

The technologies powering connected health offer major benefits for patients, clinicians, hospitals, and health systems. Benefits include:

  • Patient empowerment to manage and monitor their own health.

  • Faster detection and diagnosis of medical issues through real-time access to patient health data and images.

  • Increased system efficiency by reducing time spent on administrative tasks and in waiting rooms and emergency departments.

  • Better decision making based on analysis of huge volumes of patient data.

  • Lower costs through more-efficient care delivery, such as virtual visits and remote monitoring instead of in-person office visits or hospital/nursing home admissions.

Polymer Connections

Material developers have worked hard to develop a broad range of medical materials with properties that can satisfy various requirements and deliver the performance that OEMs expect. In other words, they're saying to product developers, “Tell us what you need and we will point you to materials that can deliver what you need.”

Aesthetics: Medical-grade colorants, clear polycarbonate, additives for scratch resistance, “tactile qualities” (either through soft touch elastomers, or micro-patterning the mold in the case of injection-molded parts).

Tele-which?

The Federal Communications Commission defines these terms:

  • Telemedicine: Using telecommunications technologies to support the delivery of all kinds of medical, diagnostic, and treatment-related services, usually by doctors.

  • Telehealth: Similar to telemedicine but includes a wider variety of remote healthcare services beyond the doctor-patient relationship.

  • Telecare: Technology that allows consumers to stay safe and independent in their own homes.

Ergonomics/safety: Thermoplastic elastomers for grip, texture, comfort.

Miniaturization: High melt flow grades of polymers such as PC and PC/ABS for thin-wall molding, complex geometries.

Flame retardance: Non-halogenated PC, polyamides, polypropylene.

Chemical and disinfectant resistance: Chemically resistant PC, PC/ABS, and polyvinyl chloride.

Practical performance: Polymer additives that boost UV resistance, impact resistance, and antimicrobial action.

Biocompatibility (these are the most critical considerations for devices that will be worn against the skin):

  • Cytotoxicity — Does the material cause a negative effect on body cells, such as cell death or inhibition of cell growth?

  • Sensitization — Does the material cause a level of discomfort on contact?

  • Irritation — Does the material cause visible irritation, including redness, itchiness, or swelling of the surrounding skin or membrane?

This article was written by Lauren Zetts, healthcare segment manager, Americas, Covestro, Pittsburgh, PA, and Karen Heroldt, global marketing director, PolyOne Distribution, Avon Lake, OH. For more information about Covestro, visit here . For more information about PolyOne, visit here .


Medical Design Briefs Magazine

This article first appeared in the June, 2019 issue of Medical Design Briefs Magazine.

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