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Smart Watch Heart Monitors

Do Smartwatch ECGs Stand up to Doctor Scrutiny?

The fitness tracker and smartwatch industries are booming — CCS Insight, a research company, estimates that 140 million wearables will be sold every year by 2022.

But what impact does it have on healthcare, both for the individual and for their doctor?

Are companies like Apple, Samsung, and Fitbit angling to replace doctors, ECG machines, and medical computers?

What Are Fitness Wearables and What Can They Do?

Fear not: the trusty stethoscope and the electrocardiogram machine aren’t going anywhere. But, fitness wearables certainly can transform how patients and doctors communicate.

Fitness tracking devices get consumers moving, make them aware of their activity levels, and help them stay healthy and lose weight. And they aren’t just pedometers anymore — companies like Fitbit, Garmin, and Apple are integrating more sensors and fitness software practically every day.

Now that consumers have a constant feed of information about their activity levels, pulse rate, blood pressure — and can even discover if they’re suffering from heart arrhythmia — does that mean patients are healthier? At the moment, there isn’t enough data to tell.

Doctor’s should expect a flood of partially-informed, anxious patients all pointing frantically at their smartwatches. What are the best practices for handling this information, and, is it flooding doctors offices and urgent care units with false-positives?

Examining Wearable Accuracy

As a society, we’ve become more skeptical than ever — and that’s a good thing. So, when the glowing square on our wrist tells us that our heart rate just hit 220 and our ribcage is about to explode, should we trust it? How comparable is it really to a hospital EKG machine?

How can a device sitting on our arm detect that kind of thing with any real accuracy?

How the Sensors Work

Each smartwatch and high-end fitness tracker works a little differently.

At the low end, pedometers use a simple accelerometer to measure approximate step count.

For devices like the Apple Watch and the Fitbit Ionic, they deploy optical and electrical sensors against the skin to read the pulse and even blood oxygen levels, not unlike the same tech used in hospitals. These sensors are located either on the back plate of the watch, on a crown or button jutting out the side of the watchface (to be held while scanning), or in the watchband.

A Look at the Numbers

Studies have found that most fitness wearables are only right about half the time when it comes to step tracking, sleep monitoring, and energy-use estimations like calorie counts. While those features might not be such a big deal, the ECG and heartrate readings in wearables like the Apple Watch could have more dire consequences.

Lucky for consumers and worried doctors, the readings coming from the Apple Watch, the Fitbit Ionic, and the Garmin vivo line (to name a few) seem to be fairly accurate, depending on the model.

A thorough test and comparison by tech zine Tom’s Guide found that the Apple Watch and the Samsung Galaxy watch were the most accurate, with an overall variance of 0.67 for reading accurate heart rates when tested against clinical chest straps. No surprise, considering they’re both pretty much the top-of-the-line when it comes to smartwatches.

Fitbit’s and Garmin’s flagship offerings lagged behind, with their devices rating anywhere from 1 standard variance all the way up to the not-terribly-accurate 5.67.

The ECGs Are Coming

The ECG sensor in the new Apple Watch has physicians and tech experts concerned: are false positives, increased hospital traffic, and the constant anxiety of helpful “health alarms” doing more harm than good? In essence, the question is: should we freak out?

First off, it’s important to remember that the Apple Watch has only been cleared by the FDA, and not approved, which is a much more complicated and rigorous process. “Cleared” essentially means that there is some truth to the claims being made, and that it isn’t actively dangerous to the public. It could be some time before the Apple Watch — and the Samsung Galaxy Watch, and the other alternatives — are fully approved for actual medical use.

Secondly, there’s been no real data to support that an influx of concerned smartwatch users are flooding the ER. The rise of telehealth and patient portals means that while it’s conceivable that doctors may be getting a few more emails than normal because of fitness trackers — “Doc, do I have bradycardia? Should I be worried?” — but an epidemic it ain’t.

Thirdly, having more data — from sources that are at least accurate enough to be a good starting point — is nothing but good news for patient and clinician alike. Smartwatch users will have months (possibly years) of heart rate, blood oxygen, and sleep levels available to send to their doctor at any time.

For home health providers or nurses or aids in settings like an elder care community, they can use their normal computer or medical tablet to upload the data for the patients and send it to their doctor when needed.

Wearables won’t be replacing a good check-up, but they might be able to enhance one.

Giving Patients Better Data

It doesn’t seem fair to give healthcare professionals another responsiblity, but it may be wise to help guide patients toward more accurate solutions. And, for patients, this is a good opportunity to improve the data you’re gathering on your own fitness levels.

Accessories that Can Help

While wearable ECGs seem to be relatively accurate, a study by the Cleveland Clinic found that their sensing capabilities can actually be improved by accessories like the “KardiaBand,” a watch band with built-in sensors that are far superior to the ones in off-the-shelf smartwatches.

In fact, the KardiaBand increased the chance of detecting atrial fibrillation to 99 percent, which is comparable to a physician reading the same ECG data. That’s quite a boon for patients and doctors everywhere, especially considering that an estimated 2.7 million people in the US have regular afib, which can, in turn, lead to heart failure and stroke.

The Watches that Watch You Better

The Apple Watch and the Samsung Galaxy Watch rate the highest for heart rate accuracy, and should be recommended over the alternatives. However, for less expensive variants, the Fitbit Versa and the Garmin Fenix and Forerunner were relatively close in accuracy.

Informing patients of these more accurate options could give them a better sense of security, while at the same time reducing the number of false positives crowding up the waiting room.

An Apple Watch a Day

Whether you’re a patient or a clinician, it’s important to be aware that while consumer wearables can be incredibly useful (and even save lives on occasion), regular check-ups and physicals are far more important for long-term health.

Still, wearables can be treated as an additional tool in a doctor’s toolbelt, with a little planning and organization.

Contact Cybernet to find out more about strategies for implementing patient-gathered fitness data, and to learn about the medical computers and EMR software that can be used to store and process that data.

telemedicine image on phone

Reducing Unnecessary Hospital Visits with Telehealth

It’s no secret that medical facilities are understaffed, overcrowded, and often underfunded. Patients seem to be shipped in by the truckload, and factors like staffing shortages and doctor burnout have many professionals worrying about increased wait times and decreased patient satisfaction.

Unnecessary hospital visits only expound these common problems, choking up emergency departments, urgent care facilities, and even doctor’s offices with patients who would have been just fine at home.

Luckily, the industry of telehealth has made great strides in reducing these visits, especially in the fields of home care, telemonitoring, and chronic illnesses. Add to that the possibility that Centers for Medicare and Medicaid Services (CMS) may be expanding the number of telehealth services covered by Medicare, and you’ve got a full-blown industry boom brewing.

But how can hospitals and medical practices leverage telehealth to save time, money, and mental energy?

Where is telehealth most effective?

Telehealth Reduces Nursing Home Hospitalizations

Nursing homes are only growing more crowded as one of the largest generations — the Baby Boomers — age. And since the elderly are frequently hospitalized for numerous different reasons, nursing homes are a perfect launching point for telehealth services.

Some nursing homes have already partnered with medical groups and vendors to use long-distance doctor’s visits to lighten the load on nearby hospitals.

Central Island Healthcare, a nursing facility in New York, had telemedicine experts train their nurses. These nurses were then able to use medical tablets and medical grade PCs to give their nursing home residents long-distance doctor visits without leaving their rooms. Instead of constantly shuttling nursing home residents to and from hospitals, the nurses were able to help the patients get diagnosed and even prescribed medication over a Skype-style video chat with a doctor.

This reduced hospital visits of nursing home residents from 25 a month to 14. Doctors, over medical computers, were able to see the patients and help them, but without all of the attendant hassle for both parties.

Another added benefit of telehealth for elderly patients — they’re unlikely to contract a nosocomial (hospital-acquired) infection from the comfort of their own rooms. And considering that the elderly are typically at the most risk from common hospital-acquired infections like pneumonia, telehealth could literally save lives.

What About Nursing Hotlines? Do They Work?

Perhaps one of the earliest forms of telehealth is “telephone triage,” more commonly known these days as a “nurse hotline.” Nurse hotlines allow patients to call a number — usually provided by their insurance — to get quick medical advice from a nurse.

There’s little doubt to their efficacy — a study by the University of Southampton in the UK found that a well-staffed nurse hotline can reduce the number of both ambulance dispatches and hospital admissions in the area, with a relatively low error rate.

However, telephone triage lacks the greatest strength of modern telehealth: nurses aren’t allowed to diagnose conditions or prescribe medication. For those procedures, a doctor is required.

Plus, the nurses are only able to talk to the patient over the phone, and can’t see them or be shown symptoms or wounds. And while nurses are incredible at their jobs, that’s a difficult position for any clinician to be in. Modern telehealth devices far surpass the limitations of a simple phone call, and smartphones, tablets and computers can all be used to upgrade the old telephone triage hotlines into full-scale telehealth services.  

Telehealth Monitoring Leads to Fewer Visits to the Emergency Room

Close to 75% of all healthcare expenditures are spent on chronic illnesses. They’re also the cause of 70% of the deaths in the United States.

However, telehealth monitoring may be a highly effective weapon to combat this problem. Telehealth monitoring uses a device to record vitals like heart rate, blood pressure, and blood sugar. A home monitor that is integrated with a medical device computer then sends the information to the doctor, who is able to monitor sudden drops and changes. With doctors receiving real-time updates, it’s far easier to treat flare-ups and complications of a patient’s diagnosed chronic illness.

This monitoring can also take the form of digital doctor’s appointments, where the doctor speaks to the patient over a video call. The appointment then goes much like any regular in-person visit, especially when the doctor already has all the patient’s vitals courtesy of the telemonitoring system.

An exhaustive report of multiple studies from medical groups, universities, and hospitals found a wealth of useful data about how telemedicine, particularly telehealth monitoring, made a huge difference to cost, engagement, hospital admissions, and mortality rates for patients with chronic illnesses like cancer, diabetes, arthritis, pulmonary disease, and heart disease.

Over multiple studies, mortality rates from chronic diseases monitored by telehealth were reduced anywhere from 15% to 56% depending on the study. After having a stroke, patients who used telehealth monitoring had a reduced mortality rate of 25% for the first year after the original stroke.

The study concluded that a massive wealth of evidence points to telehealth “reducing hospitalization and emergency department visits,” “preventing and/or limiting illness severity,” which resulted in “improved health outcomes.”

A separate study of veterans with chronic illnesses found a 19% reduction in hospital admissions and a 25% reduction in the number of bed days. They also found that the telehealth treatment cost less, and produced excellent satisfaction scores from the veterans who used it.

What Does the Future of Medicine Look Like?

The future has already arrived for many telehealth technologies.

Dedicated virtual care centers, facilities whose sole purpose is to provide long-distance care for patients, already exist. Mercy Virtual, a dedicated virtual hospital in Chesterfield, Missouri, doesn’t have a single patient bed on the premises. Instead, nurses, clinicians, and doctors in the facility (or working remotely) communicate solely via medical computers to diagnose and treat patients.

Another sci-fi tech, virtual reality, is already being used to train doctors and perform long-distance surgery. In addition, there is some evidence that virtual reality immersion techniques, used from the safety of home, could be used by psychiatrists and patients to treat disorders like anxiety, depression, PTSD, and even intense phobias.

Obviously, some of these more advanced techniques are in their infancy, but it does show that telehealth is being taken seriously as a treatment style that could have huge positive benefits.

Telehealth Today

It’s clear that healthcare has a problem with rising costs, patient wait times, and clinician burnout. Luckily, cutting-edge telehealth technology like camera-equipped medical tablets and medical computers, along with telehealth training, could take a massive load off of overworked healthcare professionals.

Right now, only 15% of physician practices are using telemedicine. Any new technology takes time to proliferate, but with telehealth showing huge leaps in cost savings, patient health, and reduced hospital visits, it’s a technology that simply can’t be ignored.

How can your practice benefit best from telehealth? Is your medical computer equipment up to the task of the streaming, video-recording, multimedia demands of the burgeoning telehealth future?

To find our more information contact Cybernet here.