Application of Point of Care Devices, Mobile Apps & Augmented Reality in Cardio Diabetes

Management

~Vinaytosh Mishra

B-Tech (ECE) ,IIT(BHU)MBA,IMNU,Ahmedabad PG Diploma in Statistics & Computing ,Institute of Science ,BHU Specialization in Digital Marketing ,University of Illinois ,Urbana Champaign ,USA

Agenda • Point of Care Devices

– Ecosystem – Trends & Examples

• Glucose Sensors & Insulin Devices • Mobile Application

– Information provider – Keeping Track of goals – Social Sharing

• Future Technologies – Augmented Reality – Technology Adaptation in Healthcare

Living With Diabetes ………Made Easy !

Diabetes Care

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Point of Care Technology • Diabetes is a multisystem disease requiring complex management provided

by a variety health care professionals (HCPs).

• Assessing modifiable risk factors for metabolic and cardiovascular diseases prior to the onset of disease could allow effective prevention initiatives.

• Equally, monitoring in diabetic people glucose, hemoglobin A1c, ketones, lipid profiles, and urinary micro albumin concentrations allows the prevention, early detection, and treatment of diabetes-related acute and chronic complications and has a positive impact on the process of care in the management of patients with diabetes.

• The point-of-care testing (PoCT) technology offers convenient aspects: immediate results, decision-making without the need for repeated visits.

POC Ecosystem

ASSURED Guidelines for POCT

• Affordable – for those at risk of infection• Sensitive – minimal false negatives• Specific – minimal false positives• User-friendly – minimal steps to carry out test• Rapid & Robust – short turnaround time and

no need for refrigerated storage• Equipment-free – no complex equipment• Delivered – to end users

Trends & Common Use

Educational Background of Testing Professionals

Common Use:

•Glucose Monitoring •Activated Clotting time for high dose heparin monitoring •Urine Dipstick •Hemoglobin A1c•Lipid •Cardiac Markers •Drug Toxicology• Coagulation for hemostasis assessment (TEG) •D dimer for thromboembolism

Glucometers Advantages:

– A Blood Glucose Meter comes with the following advantages, portable and convenient, yet inexpensive

– Testing time (only 3 – 60 secs depending on different models) can be a life saver during an emergency

• Disadvantages:

– Accuracy is a concern as it can be false positive to hypoglycemia (low blood glucose)

– Immediate measurement to hypoglycemia may seem higher than hyperglycemia (high blood sugar) which makes it less useful.

– some models cannot perform test without light.

Smart Meter

All in one glucometer

Storage for Strips , no requirement for battery

Easy Integration with mobile, easy share of data

Meter Magic -This is based on Pepex's proprietary Conductive Composite Monofilaments (CCM) for detecting blood glucose levels -- electrochemical biosensors inside the cartridge that are composed of single strands of fiber about the diameter of a human hair

• -Meters will not only be easier to use but will also lead to improved meter accuracy simply because user-error wouldn't be as common with these products

- The company plans to integrate it with insulin reservoir so that it can work as insulin pump also.

Continuous Glucose Monitoring • Advance CGM System is a non-invasive

(needle-free), wireless, continuous glucose monitoring system designed to provide accurate, real-time blood glucose data conveniently and continuously.

• Incorporates a skin permeation device, a transdermal sensor, wireless transceiver and data display technologies.

• All existing FDA-approved continuous glucose monitoring systems are needle-based, requiring insertion of a glucose sensor into the patient's skin, which gives rise to risks of infection, inflammation or bleeding at the insertion site.

• Being non- invasive, new technologies does not give rise to the risks or discomfort associated with needle-based CGM systems.

DIABETIC TEMPORARY TATTOOS

• The devices work using non-invasive technology that’s embedded in the tattoo itself.

• A pair of precisely patterned electrodes are printed onto the temporary tattoo paper, which is applied to the skin and applies a very mild electrical current.

• This process enables tiny sensors on the tattoo to detect glucose levels and output the data.

“A temporary tattoo that could replace pin-prick blood tests for diabetic children”.

Mobile Apps in Diabet

es

Gadget Blindness

MySugar

• MySugr's Companion app acts as a diabetes logbook, but also gamifies the experience.

• Along with feedback and motivation, you win points for every entry, and challenges help you reach personal goals

• Price: Free• Available

or iOS and Android

Glucose Buddy • Glucose Buddy is a data

storage app through which users can track glucose numbers, carbohydrates, insulin dosages and physical activities.

• An added bonus is users can view this data at any time though their online accounts.

• Price: Free• Available

for iOS and Android.

Diabetes Pal• Telcare's second iteration

of its Diabetes Pal app is similar to mySugr and Glucose Buddy as far as tracking features go, but it also allows users to log blood pressure, weight and sleep duration, as well as add notes.

• The redesigned interface provides extremely visual charts and graphs as well.

• Price: Free• Available

for iOS and Android.

Med Simple

• Electronic monitoring identified poor compliers for interventions that improved adherence (61–79%; P < 0.05).

-Diabetes Care May 2004 vol. 27no. 5 1218-1224

• The MedSimple app, helps users track medications and set up reminders

• Price: Free• Available for iOS and Android.

Fitter fitness calculator• The Fitter fitness calculator

helps you stay active, track your weight, calculate your body mass index and set goals – which you can see just by looking the app's icon.

• Your data is stored in the cloud, and you can also share your progress on social media.

• Price: Free• Available on iOS.

FUTU

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Augmented Reality

Augmented Reality (AR) is an area of research that aims to

enhance the real world by overlaying computer-generated

data on top of it. Azuma (Azuma, 1997) identifies three key

characteristics of AR systems:

(1) mixing virtual images with the real world

(2) three-dimensional registration of digital data

(3) interactivity in real time.

AR has been imagined a thousand times in fiction because of its

unparalleled potential in applications ranging from industrial

and commercial projects, to education, to creative storytelling,

to medical imaging. Google discontinued the product in Jan 2015 but files a new application with Federal Communication Department in Dec 2015.

Use of Augmented Reality in Diabetes

• The Google Glass has made it possible to provide integrated health care service using concept of Augmented Reality.

• With the applications for Google Glass, doctors can access patient records, check live patient vitals, collaborate by sharing what they are viewing with other doctors and record video or take pictures (Scientist, 2014).

• The Google Glass based applications can be useful in Pharmacy Benefit Management (PBM). PBM happens to be a part of an integrated healthcare system. Augmented Reality with use of Google Glass based applications can help make PBM more efficient. Patients wearing Google Glass and having an app installed on the device can get reminders on taking drugs.

• The app can also offer information on drug overdose and its effects. What’s more, the app can also recommend a diet depending on a person’s health condition (HealthtechEvent,,2014).

• One more application helps in educate patients in a new way. It uses the camera display for simulating the impact of specific conditions on a person’s vision (HealthtechEvent, 2014). Similar, apps can be used to educate a diabetic patient by simulating effect of specific conditions and their impact on various organ of the body.

• In United States the maker of similar type of Glass based app claims that more than 300 physicians have already opted to use the app. The app is currently available for free, but the company may charge a fee in the near future.

User Readiness for The technologies

“ Are we ready for technologies like Augmented Reality in Healthcare ?”.

“To help me answering this question Bass Diffusion Model comes to rescue”.

Bass Diffusion Model

Technology Adaptation in Healthcare