A low-cost digital stethoscope that can attach to a smartphone may represent the future of saving millions of children in Third world countries. StethoCloud is is designed to listen and digitalise a patient’s breathing sounds and patterns. Those patterns are then compared against a medical database via cloud infrastructure. Then an automated report is generated though Algorithmic Artificial Intelligence Decision Support. Such software could potentially allow an earlier diagnosis of pneumonia and reduce the mortality of children in developing countries.
StethoCloud is the Australian entry in the international Imagine Cup 2012. The Australian software design team led by Hon Weng Cheng, a third year medical student at the University of Melbourne, has advanced to the second round and is in the World wide finals. Go Aussies! Oi-oi-oi!!
SteathoCloud at the Imaginecup
Medical devices that combine consumer electronics and apps are revolutionizing chronic disease management. These new breeds of medical devices interface with smartphones to allow patients with chronic diseases, such as diabetes, to monitor their health and share the information with their treating physicians. Mobile disease management has the potential to collect, organize and analyze patient data through evidence-based clinical guidelines, and then give patients feedback when they need it. Furthermore it can connect patients to their health care providers, educators and other people who have the same disease.
Diabetes affects 171 million people worldwide and it is estimated by the year 2030, 366 million people worldwide will have diabetes. There is an increasing burden on primary care physicians and endocrinologists to manage patients with diabetes, and consequently patient care will be compromised. On average a typical patient with diabetes will spend 6 hours a year with their primary care provider. Then they are left to manage a complex and challenging disease on their own. Mobile disease management can fill in this “in-between” time.
One such device is iBGStar, which was developed by Sanofi and AgaMatrix. iBGStar is a glucose meter that can be used on its own, or connected directly to an iPhone or iPod touch. The information stored on the app can be shared with the patient’s healthcare team. When the patient goes to the doctor, she can see pattern of the blood glucose readings and adjust medication or advise behavior changes accordingly.
WellDoc, a Baltimore-based behavioral science and technology company, developed a super-app called DiabetesManager. DiabetesManager collects data on the patient’s blood glucose levels, diet, exercise and medication regime, then uploads information to the cloud-based analytic system. The system provides automated feedback to the patient based on that data in the form of alerts, prompts and positive reinforcement. They recently published their results and showed that there was a statistically significant 1.9% mean decrease in A1c levels for the intervention group who used the DiabetesManager compared to a 0.7% mean decrease for the control group over a 12 month period.
Mobile disease management will provide a more diversified platform that will enable constant connectivity between patients and their doctors. It will not be long before this field expands to multiple therapeutic areas and a number of other chronic diseases such as COPD, heart disease and pain management.
 World Health Organization, “Facts and figures about diabetes,” http://www.who.int/diabetes/facts/world_figures/en/
 Quinn CC, Shardell MD, Terrin ML et al., Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control, Diabetes Care, 2011; 34(9):1934-42.
Human communication contains much information that is not verbalized. Facial expressions, facial micro-expressions, hand gestures and speech patterns are all signals of who we are. There is a new wave of startups and entrepreneurs looking to make an impact in healthcare. Companies such as Cognito and Affectiva are developing innovative mobile technology designed to analyze emotions, studying vocal and visual clues as well as physiological factors. The premise of this new technology measuring human emotion is to focus on how people speak and interact, not what they are saying.
New technology developed by Affectiva began as collaborative research effort at the MIT Media Lab to help people on the autism spectrum who have difficulty reading emotion. Now the Affdex emotion measurement technology, which reads emotional states such as smiling, confusion, dislike, has been commercialized to help businesses understand their customers by quantifying the emotional connection consumers have to brands. Cognito has been developing “Honest Signals” technology that measures patient engagement through vocal clues, either through phone conversations or face-to-face meetings.
Emotional measurement can be beneficial in many areas such as marketing research and clinical research. However, an area that this new technology may have a significant impact is mental health. Mental health disorders affect millions of people worldwide. According to the World Health Organisation1, mental health disorders account for 13% of the global burden of disease, and is poorly recognized. The treatment gap for mental disorders is large all over the world. In low- to middle-income countries, between 76% and 85% of people with severe mental disorders receive no treatment for their mental health conditions. The corresponding figures for high-income countries are also high – between 35% and 50%.
Measuring patients’ emotions allows healthcare professionals to pick up signs that a patient might not recognize or be willing to express. The application of such technology may be useful to diagnose mental health disorders and post-traumatic stress disorders, and even helping occupational healthcare providers to spot stress in employees and preventing burnout.
Emotional measurement technology is still very experimental and much validation work needs to be done before it can be applied to healthcare. There may come the day when a patient’s mood is measured with a psychological sensor that is as reliable as a blood pressure cuff!
1. World Health Organization, Sixty-fifth World Health Assembly, May 12, 2012. http://www.who.int/mental_health/WHA65.4_resolution.pdf