Finding technology solutions to diagnose and manage chronic conditions is critical to the future of healthcare. Half of Americans currently suffer from chronic conditions, and 25% of Americans have two or more chronic diseases, according to the CDC. This number is expected to skyrocket as the Baby Boomer population ages.
“Technology has made inroads into the patient consult and clinical work flow in ways physicians could have scarcely imagined just a decade ago,” says Edward I. Ginns, MD, PhD, DABCC, neurology franchise medical director at Quest Diagnostics. “Today, physicians can access clinical, prescribing and other patient data at their fingertips using electronic medical records and associated technologies, such as clinical analytics and mobile devices.”
Quest Diagnostics is just one of many companies working to find solutions to help patients be more accountable for their healthcare, while being cost effective and interoperable for health systems. It’s a challenge to balance multiple healthcare goals, Ginns says.
“While these technologies have yet to fulfill their potential to contribute to good medical practice, it is evident that they afford opportunities to better manage patient care, improve efficiency, and consider population-health insights in medical decision-making,” he says.
Below is a snapshot of upcoming technology solutions that aim at making chronic conditions more manageable.
Non-invasive blood glucose monitors promise accuracy
Up to 67% of patients with diabetes say finger-pricking and other glucose testing is invasive and painful. Researchers have worked for years to find easier, less painful methods.
Ronny Priefer, PhD, professor of medicinal chemistry; and Michael Rust, PhD, associate professor of biomedical engineering; both of Western New England University, presented a handheld device that measures blood glucose levels based on a patient’s breath at the 2016 American Association of Pharmaceutical Scientists Annual Meeting and Exposition. Currently, the device is the size of a small book, but Priefer says that once it hits the market, it will be the size of a smartphone.
“A technology that is non-invasive will improve the compliance levels of blood glucose monitoring for the diabetic population,” says Priefer. “Improved compliance equals decreased diabetic complications. Diabetic complications are a $250 billion annual problem within the United States.”
The device detects a correlation between blood glucose levels and breath acetone in people with type 1 and type 2 diabetes. “It has been tested against a common blood-glucose monitoring finger-prick device, which has a reported accuracy of ±15%,” Priefer says.
The researchers say they hope the device will be on the market by 2020. Priefer adds that it will have Bluetooth technology and be available to both patients and clinicians.
Artificial pancreas makes monitoring diabetes easier
Type 1 diabetics will be able to monitor insulin levels without checking blood sugar and administering insulin multiple times per day thanks to a new wearable pump called an artificial pancreas.
The Medtronic MiniMed 670G system uses algorithms to deliver insulin to patients on a continuous loop. The system can be programmed by the user to deliver insulin at a predetermined rate, or can be programmed to automatically adjust based on insulin need. A glucose sensor is inserted into the skin near the abdomen to monitor glucose levels and administer medicine. A separate, handheld device displays alerts and tracks glucose trends.
“The system delivers a variable rate of insulin 24 hours a day based on the personalized needs of the individual, maximizing the time glucose levels are within the target range. It is designed to learn what an individual’s insulin needs are and to take action to minimize both high and low glucose levels,” says Hooman Hakami, executive vice president and group president of Medtronic Diabetes. “As a result, the system requires minimal input. Users only need to enter mealtime carbohydrates, accept bolus correction recommendations, and periodically calibrate the sensor.”
The device was approved by the FDA in September 2016, and will be available to purchase this spring, according to Hakami.
Dementia testing helps clinicians identify, track symptoms
Most dementia and cognitive impairment testing is paper-based, but that could change soon. Quest Diagnostics developed CogniSense, a digital dementia assessment test that can be downloaded on iPads and other tablets, and aligns with nearly 600 electronic health records.
“CogniSense was piloted by Primary PartnerCare, which is the largest ACO focused on primary care in Long Island, New York,” Ginns says. “Over the four-month pilot, CogniSense helped identify numerous cases of cognitive impairment due to a number of causes, and may have reduced referrals to neurologists.”
The app is currently available in the iTunes store and costs $15 per patient assessment, but Ginns says most health plans reimburse the cost.
COPD testing leads to earlier diagnoses
There are nearly 12 million undiagnosed people with COPD. That’s why diagnostic tests that can diagnose COPD earlier, while also working with existing medical office technology and other pulmonary function tests, are most valuable to health care providers, says Georg Harnoncourt, CEO of ndd Medical Technologies, Inc.
“Pulmonary function tests have drastically changed over the years. In the past, the vast majority of diagnostic tests for COPD have only taken place in lung function labs,” Harnoncourt says. “Conventional lab equipment requires specialized personnel, who are primarily trained to maintain the equipment and to coach the patients through a series of tests—not to provide the level of care and attention that a patient would receive from their primary care physicians. Many lung function labs are overwhelmed and incredibly busy and primarily focus on maintaining the equipment rather than ongoing patient care.”
Harnoncourt says that ndd has two portable COPD testing devices: the EasyOne measures how much air and how quickly the patient inhales and exhales, with a direct connection to a printer, computer or electronic health records system; the EasyOne Pro performs diffusion capacity testing, spirometry and full lung volumes in 20 minutes at the point of care.
“In addition to being able to quickly test patients at the point of care, [the devices] can reduce wait times, increase the accuracy of diagnosis and decrease patient transport costs,” Harnoncourt says. “Since these devices are simplified and user-friendly, there is less need for training, which can improve work flow and drastically increase the efficiency of the health system.”