S2E5 COVID Unites Us All: Remote Pulmonary Monitoring

By collecting and utilizing multiple sources of information, Ginsburg and the COVIdentify team are working to discover how wearable technology can play a role in the early identification of infection with COVID-19. Right now, the study has over 5,000 participants, but the goal is to conduct the study in hundreds of thousands of people, in order to collect broader population data and subsequently draw generalizable conclusions.

The second panelist, Dr. Steven LaBeouf, shared his perspective from the commercial side of wearable devices. LaBeouf is the Co-Founder and President at Valencell, a leading maker of biometric sensors headquartered in Raleigh, NC. LaBeouf discussed the considerable changes to the digital marketplace over recent years, and recalled a time in 2008 when bluetooth earbuds were used to track biometric data. According to LaBoeuf, there was a pattern of users experiencing dramatic changes in heart rate variability. Researchers ultimately determined that this persistently elevated heart rate corresponded with swine flu infection; these dramatic changes in heart rate variability were visible two days prior to users becoming symptomatic. However, this realization was not enough to generate widespread use and acceptance of similar wearable technologies.

Today, we are seeing an increased acceptance of and demand for remote monitoring technologies, especially in the face of COVID-19. Nonetheless, characteristics of today’s pandemic pose obstacles to identifying at-risk individuals:

“In the case of COVID, what makes it more complicated is that the symptoms aren’t so universal. Some people don’t have any symptoms at all, so it would be interesting to find out how heart rate variability comes into play for these individuals over the course of their illness.”

As articulated by LeBoeuf, a lack of specificity in the symptom profile of COVID-19 presents a unique challenge to the utilization of wearable technologies. Other issues in the domain of remote monitoring include: a lack of standardization, concerns about accuracy, and insufficient battery life. Ultimately, the goal is to create and deploy technology that an individual can forget that they’re wearing; this would ensure the most continuous, uninterrupted collection of biometric data possible.

The third and final panelist on Friday’s webinar was Dr. Alper Bozkurt, ASSIST HET Testbed Leader at North Carolina State University. Bozkurt shared the work being done at the ASSIST Center as it relates to pulmonary health. The first medical application area explored by the ASSIST Center was asthma; researchers on Bozkurt’s team sought to identify important variables that might predict and thus prevent asthma attacks. According to Bozkurt, environmental context is as important as an individual’s biometric data; air quality, ozone concentration, and the concentration of other organic compounds in the air we breathe can play a significant role in triggering asthmatic symptoms. Today, the ASSIST Center is utilizing data previously collected on asthma and respiratory health to inform studies of COVID-19, which can cause significant pulmonary difficulties. According to Bozkurt, “Pulmonary health has a lot of information embedded inside it. Whether you are healthy or you have some sickness, there are some signatures there. The question is whether we can track this.” As insight into pulmonary health becomes increasingly important, Bozkurt identifies one possibility for new wearable technology:

“With COVID-19, we are entering uncharted territory with a new form of wearable — the mask. Now, everyone is requiring masks, so there is potential for using the mask to monitor breathing rate and other metrics, as well as using energy generated by breathing to power a device.”

While such technology has yet to be developed, the concept of a “smart mask” represents one way in which COVID-19 has changed the conversation surrounding remote pulmonary monitoring.

As the world continues to respond to the COVID-19 pandemic, important questions are raised about the usage of wearable devices for remote monitoring. Consumers, caregivers, and payers alike must consider issues of efficacy, accuracy, and standardization of devices moving forward. Ginsburg grants readers a useful summary of the challenges we face:

“Providers and clinicians will only want to use devices with FDA approval or similar credentials. To develop a product that will be useful for patient care, we’ll need clinician input as well as regulatory input early on…I hope to see a direct path from medical need identification to product development, testing, and payer reimbursement in the future.”

While COVID-19 has proven to be a catalyst for bringing digital health to the forefront of medical care, clinical utility, proven accuracy, and payer approval will be critical moving forward.

DHIT thanks its guests for serving on the panel, and everyone who tuned in! If you were not able to catch last week’s webinar, check out DHIT’s Media page to see what you missed. DHIT and ASSIST would also like to give a special shout out to our Program and Innovation Champions: Pfizer Digital, RIoT, Excelerate Health Ventures, and Duke MEDx.

We are excited to announce DHIT’s partnership with the ASSIST Center to launch an ongoing focus on remote care. DHIT and the ASSIST Center are partnering to launch a Virtual Incubator using Crowdicity to collect crowdsourced ideas from the digital health community. This innovation engine will serve to advance remote care by sourcing ideas from the ecosystem and nurturing them from inception to implementation. For more information, see our landing page for the Incubator and mark your calendar for Friday, June 12th for the next installment of the DHIT Frequency Webinar Series, which will focus on remote cardiac monitoring. Until then, stay safe, everyone!