Paraplegics walk with the help of robotic exoskeletons. Refugees from a natural disaster given remote care in a temporary health center. Patients with multiple chronic diseases are warned before they suffer a heart attack. Potentially deadly drug interactions prevented.
These are just some of the ways in which digital health can save lives, attendees at the Digital Health Summit at International CES heard last week in Las Vegas.
Ideal Life, a Toronto-based vendor of remote monitoring technology, flew in Author Tyson, a 70-year-old heart attack survivor living with heart failure and diabetes, from rural North Carolina, as living proof of the life-saving potential of telehealth.
A patient at Vidant Health, a nine-hospital system covering 29 counties in the eastern part of the state, Tyson was selected to participate in the organization's remote monitoring program for people at risk of hospitalization. Nurses at Vidant Medical Center in Greenville, N.C., monitored his weight, oxygen saturation and blood pressure with Ideal Life technology.
One morning, Tyson woke up with a nosebleed. After he took his vitals readings, a telehealth nurse rang his phone and advised Tyson to call 911 immediately. Although Tyson reported feeling fine, his heart rate had fallen below 40 beats per minute and his blood pressure had spiked to a dangerous level. It turned out his heart was blocked, and Tyson received a life-saving pacemaker.
Although he is healthy today, he continues to monitor his health daily. In a case study reported by the Washington-based LeadingAge Center for Aging Services Technologies, Vidant Health was able to reduce bed days, admissions and hospitalization costs by two-thirds.
Tyson's story was inspirational, but lives also be saved in more mundane ways.
"I'd argue that the greatest promise of digital technology isn't in the heroic," said Dr. Saroj Misra, director of clinical clerkships for Michigan State University College of Osteopathic Medicine. It's in preventing the errors that occur daily in healthcare facilities all over the country, according to Misra, a family practitioner whose practice has thrived with technology as basic as the free Epocrates Pill ID service or even the public internet.
Misra told the story of seeing a patient with both lupus and diabetes who had been put on a new blood-pressure medication by her cardiologist. The patient could not remember the name of the drug, so Misra asked her to describe the shape, size, color and markings on the pill. The pill finder and related interaction checker led Misra to discover that the new drug could interact with one of her lupus meds and cause renal failire, so he called the cardiologist, who agreed to change the prescription.
Digital health also saved the life of Misra's daughter when she was an infant, he said. When being weaned from breast feeding, the baby would not tolerate the formula she was given, and was becoming emaciated from not being able to eat. At 6 months old, she was too young to test for allergies in the traditional manner, so Misra looked up literature on new allergen testing methods and discovered that she was allergic to dairy products as well as soy. "I was able to ensure the health of my daughter through digital technology," Misra said.
Another speaker, Claudia Graham, vice president of global access for Dexcom, a San Diego-based maker of continuous blood-glucose monitors, has had Type 1 diabetes for 35 years, and needs to keep close watch on blood sugar so she knows when to take the insulin she needs to stay alive. She started wearing a Dexcom glucometer about five years ago.
"It's the only device that I will absolutely insist that I wear every day," Graham said. "It's really quite simple, but it's life-saving."
Less simple was the response to the March 11, 2011, earthquake and tsunami in Japan that, among other things, led to the accident at the Fukushima nuclear plant. More than 15,000 people died from the quake and tsunami, but Masatake Eto, managing executive officer of A&D Co., the Japanese parent company of wireless healthcare device maker A&D Medical, is convinced that more could have lost their lives if not for an ad-hoc system known as the Disaster Cardiovascular Prevention Network, or D-CAP.
After a disaster on the scale of that one, cardiovascular risk goes up among the survivors, largely due to stress perhaps trauma over losing loved ones and worldly possessions.
"Cardiovascular risk is one of the biggest risks leading to disaster-related death," said Eto. He said that 14 percent of the 6,402 who died in a 1995 temblor known as the Great Hanshin Earthquake did so after surviving the disaster, mostly because of cardiovascular disease.
"The environmental and lifestyle changes brought by the disaster have a cumulative effect on one’s blood pressure, which makes blood pressure a great indicator of the individual's health and physical state," Eto explained.
One survivor of that 1995 disaster was Dr. Kazuomi Kario of Jichi Medical University in Tokyo. He worked with A&D and the Continua Health Alliance to deploy a D-CAP, following Continua standards, to a refugee camp near the hard-hit resort town of Minamisanriku-cho, within two weeks of the quake. In Minamisanriku-cho, 70 percent of patients and staff in a hospital died when the tsunami flooded the building, and Miyagi prefecture, where Minamisanriku-cho is located, saw more than 106,000 homes destroyed.
This, according to Eto, was one of the first deployments of a Continua ecosystem. Seven companies, including A&D, an early adopter of Continua standards, donated devices, software and communications services to the effort.
From the makeshift hospital set up at the camp, a 3G signal sent patient-identified BP readings from the evacuation camp to a cloud server, so clinicians at Jichi, 150 miles away from the disaster zone, could monitor patients and give instructions to medical staff at the camp. Patients were given ID cards with near-field communications chips for quick retrieval of personal and health data.
"It helps identify high-risk evacuees in the early stages. Thus, we can respond to evacuees' needs individually depending on their risks, which can be a pioneering effort for order-made medicine in a community," Eto quoted Kario as saying. It also takes some of the workload off the overextended medical staff on site and eliminate unnecessary doctor visits, according to Kario.
Eto said the technology motivated evacuees to participate in their own health. Ultimately, Minamisanriku-cho had one-third the disaster-related death rate as the national average.
Eto called it "a very real and moving example of the power of connected health, which saved the lives of many people."