Patient monitoring outside the hospital has been a hot topic (and also a not so hot topic) for the past 15 years. Starting back in the late 1990s with companies like Health Hero, a company whose products for patient home monitoring are still in use today, company after company has sought to bring a successful product to market. The holy grail: finding an easy, non-intrusive, and continuously reliable way to predict patients’ potentially serious medical problems when it is early enough to do something about them and prevent an acute and expensive episode of illness. Some of the newer companies are focused more on the wellness and tracking side of the equation, such as helping individuals see progress from an exercise or other preventive/health-inducing regimen.
So far this whole area has been a very tough nut for businesses to crack in the US in particular. While some studies have shown great positive effect, others have not. Insurance payment for these programs has been spotty at best and non-existent at worst; most of the current vendors are stuck in pilot hell without significant long term and widespread commitments from payers. There is a belief, veracity unknown as yet, that the proliferation of risk-based entities such as Accountable Care Organizations will change this and lead to broad adoption of ambulatory patient monitoring tools, angels will sing and a large number of hospitalizations and rehospitalizations will be avoided. That may be true, but remains to be seen.
Yet due to the growing belief (wish?) that the broadening risk base will create massive monitoring market growth, fed by the advent of smart phones and miniaturized, inexpensive mobile sensors, the number of companies focused on this opportunity has grown faster than Rapunzel’s hair. And these patient monitoring tools are showing up everywhere. There are sensors that plug into home appliances that let you know grandma woke up and turned on her coffee pot; sensors in phones that can remind you to take blood pressure and glucose readings and send those readings off to be tracked; sensors in beds that help measure body parameters and whether patients are moving or about to fall. Even sensors in clothing, although none yet that detect hipness.
I saw an article this week in the Wall Street Journal that really made me wonder where this is all going and when and how we will determine when the sensor craze has jumped the shark. The article, entitled “A Car That Takes Your Pulse,” was about a growing trend among auto-makers to create “technology that could feed your heart rate, blood pressure and other biometric responses into the car’s computers, the better to determine when you’re drowsy or overwhelmed with distracting media” among other things.
Car manufacturers such as Mercedes, Lexus and Ford have already begun building biosensors into their vehicles. Experiments are underway there and elsewhere using built-in passive sensors to measure respiration, sweaty palms, pulse rate and other signs of stress and distress that could lead you to have a car accident. I actually test drove a Mercedes that had the sensor to detect driver drowsiness in it. When it perceives you are getting to tired to drive it shows you a cute little coffee pot and suggests you stop for a rest. No word on whether they have done a joint promotion with Starbucks.
Here’s my favorite example from the WSJ story:
Sports car maker Ferrari SpA, for one, has filed a patent application that indicates the company is evaluating technology that would embed wireless electrodes in a car seat’s headrest to monitor drivers’ brain waves for stress as they pilot machines capable of roaring up to 200 miles per hour. Depending on what the sensors detect, the car might try to mitigate the driver’s risk by cutting power to the motor or automatically stabilizing the vehicle. As Ferrari researchers put it in the patent filing: “drivers tend to miscalculateāin particular, overestimateātheir driving skill and, more important, their psychophysical condition.”
I am pretty sure this technology is redundant. As the police and everyone else know without sensors, the Ferrari driver is definitely under extreme stress because their mid-life crisis drove them to buy a Ferrari in the first place, for goodness sake. They are worried no one will ever say they are young and hot again, and keeping up appearances is exhausting. Plus they are