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This is the second of a two part series exploring wearable medical devices. In part 1, IDTechEx discussed trends indicating that "the future of wearable is medical". In part 2, we explore the question in reverse, asking to what extent "the future of wearables is medical".
Wearable devices may provide a convenient, ambulatory option for monitoring particular conditions over a period of time, and have found a particular home where the sensor device requires contact with the body. However, many medical futurists will point to potential in remote monitoring of several medical conditions. Whilst the origins of this may be rooted in science fiction, there have been many examples of companies pushing towards remote monitoring of different health conditions, and dedicated funding for such projects from some technology companies.
As a sample of the industry, we can consider some of the speakers at IDTechEx's upcoming event: Healthcare Sensor Innovations. This event is taking place on September 25-26 in Cambridge, UK, and brings together many examples of innovative companies bringing new and established technology in the medical area. There are several groups of companies which can be arranged by the data they are collecting (e.g. which disease vertical), the nature of the sensor/transducer (e.g. optical, chemical biosensor, electrodes for biopotential, etc.) and their proposed sensor positioning. The variety, or lack thereof, shows a good cross section of various spaces and the proposed strategies for each area.
The first example is the use of optical sensors to measure properties of the body, with example speakers coming from companies such as Maxim Integrated, cosinuss° and Delektre. This is a clear candidate for potentially moving to "remote" sensing, but the majority of solutions still tend to require some kind of contact to be made. This is usually to help to manage error with the sensor, where additional separation can lead to challenges with noise. This said, some studies have demonstrated the use of remote optical sensors (e.g. cameras) that can be used to infer various physiological measurements. However, few of these have progressed commercially towards any kind of medical approval, and wearable or portable devices used up against the skin are the preferred option.
A second prominent example is the use of electrodes to measure biopotential, most commonly looking at the heart via ECG, but also potentially measuring other properties such as muscular activity, eye tracking, brain activity and so on. Here, combinations of wearable and implantable options are common, with speakers at the conference including companies like Quad Industries, Henkel, and others having worked in a skin patch format, and others working in apparel (e.g. Sensing Tex), chest strap, or other device formats. Here, close contact between the electrodes and the subject helps with managing noise associated with changes in impedance, so direct attachment onto the skin or even more deeply into the tissue via an implant is the most common approach. Contactless solutions are an option, particularly over short distances (e.g. ECG deployed in a car seat), but much less common and not medically validated yet. This idea also works in reverse, with electrodes used to apply specific electrical signals to the body in order to gain a desired effect. This is best illustrated by the keynote presentation from Boston Scientific Corporation showcasing their work in cardiac and neuromodulation medical devices.
The final example we will consider is the use of a chemical biosensor to detect specific chemical species, with examples including speakers from Lifescan, PKvitality, BioMed X and more. These sensors typically involve monitoring a reaction between an analyte and a specific biological agent (e.g. antibody, enzyme or similar). As such, the sensors need to be in contact with the source of the analytes, whether this be blood, sweat, or another sample fluid. Therefore, these analytes either need to be sampled at source (e.g. blood via an implant or wearable device with a needle, sweat via a skin patch, and so on), or extracted for sampling (e.g. finger prick or larger blood sample, urine test, etc.). There is some case for moving to wearable options over discrete, individual sampling, particularly in the context of diabetes management, for more information, see the IDTechEx report on the topic Technologies for Diabetes Management 2019-2029: Technology, Players and Forecasts. However, remote monitoring of chemical species is more challenging. Whilst many ideas have been proposed (from gas sensors to optical chemical tests), there are still few commercial examples.
There are several other assorted examples throughout the conference that could be interesting discussions in their own right. These include examples of wearable products to monitor body temperature (e.g. from Blue Spark), various systems monitoring stress levels via sweat and other metrics from skin patches (e.g. Maxim Integrated, Fraunhofer IISB), options for wearable, ambulatory blood pressure measurement (Tarilian Laser Technologies) and companies developing solutions for specific disease verticals such as asthma (ItoM Medical), hearing loss (Plextek), respiratory diseases (AMD, BreathDX, etc.) and more.
From each of these examples, it is clear that wearables have a prominent overlap with both the present and future of medical devices. Contactless monitoring may be the ultimate goal, but practical challenges with this mean that wearable solutions will be part of the future of medical devices for the foreseeable future. IDTechEx recently completed their latest status report covering the wearable technology sector, finding that the total market is worth over $50bn in 2019. Around one third of this revenue comes from products that are already approved as medical devices. On top of this, many of the sectors that are not currently medical devices, from prominent products like smartwatches, to emerging areas such as smart clothing, are being strongly investigated for their potential use in the context of healthcare. As such, the close link between these two areas will only get stronger as time goes on.
By: James Hayward