Bench Talk

Health care faces a dilemma: Medical equipment, treatment, and drugs are increasingly expensive, the global population continues to head north, and in the developed world at least, people are living longer. (A Canadian born today, for example, can reasonably expect to witness the turn of the century.) The result is skyrocketing healthcare budgets.

In the United States (US), the Centers for Medicare & Medicaid Services reported that healthcare spending to rise 19.4 percent of the U.S. economy and reach $6 trillion (USD) by 2027. The government health agency cited the rise to the aging baby-boom population that will increase enrollment in the Medicare health insurance program for elderly and disabled Americans. The agency released its data before the COVID-19 outbreak.

A big part of the medical budget is spent on accommodating the poorly monitored and managed health of baby boomers who are consequently admitted into hospitals. According to the United Kingdom’s (UK’s) Department of Health, to keep a patient in a hospital bed for 24 hours costs £400 (i.e., $525 in U.S. currency)—just to cover the bed, food, staff, and the building to house the patient and these services. Blood tests, scans, and drugs cost much more. This expense is multiplied because the time that these seniors’ spend in hospitals is primarily due to treatments for complications of chronic afflictions, such as diabetes, cardiovascular (heart) disease, respiratory (lung) ailments, and kidney disorders. Apart from the obvious distress to the patients and their families, what these insidious illnesses have in common is that if they are poorly managed they cause years of suffering and frequent hospitalizations before the patients succumb.

Type 2 diabetes, for example, occurring when a patient’s tolerance to insulin increases so much that the hormone becomes less effective at controlling blood glucose, is strongly linked to aging and obesity. Poor control of this disease results in high, long-term blood glucose levels causing kidney and heart disease, among other ailments.

Diabetic patient numbers are sobering. Diabetes UK reports that in Britain, one in seven men over 65 have the disease; for women, the number is one in 10. Compared with the general population, says the organization, diabetics are twice as likely to be admitted into a hospital, and once there, stays are prolonged by the complications of the disease.

Poorly managed diabetics costs the British healthcare budget £32 million ($42 million, USD) per year, in addition to other medical costs. Assuming the proportion of diabetics within the U.S. population is about the same as that in Britain, their pull on the US healthcare budget is $210 million. Although $210 million is a relatively small proportion of the overall health bill, it is just for those with diabetes—add in the sufferers of other chronic diseases who need repeated lengthy hospitalizations and the sum becomes significant.

The key to good diabetes management is maintaining a blood glucose level in the healthy range (such as 72mg/dl to 126mg/dl), thus eliminating the complications of the disease that cause hospitalization. Yet, this is much easier said than done, as blood glucose levels are constantly changing in response to food intake, exercise, stress, illness, and fatigue, among other factors. Diabetics must monitor blood glucose by taking frequent small samples of blood for testing, via a finger prick, and then injecting an appropriate amount of insulin to keep their levels in check, while simultaneously considering all the factors that influence their blood glucose levels. This level of health management is an almost impossible task for a medical practitioner, let alone a seventy-something who could be suffering from the early stages of dementia.

However, wireless technology is easing the complexity of blood-glucose control. Today, diabetics can affix a small (subcutaneous) sensor to their arm, which will constantly monitor (over a period of weeks) blood-glucose levels and wirelessly transmit the data via low-power radio frequency (RF) protocols, such as near-field communication (NFC) or Bluetooth low energy (BLE), to a reader or a smartphone. The result is a much clearer picture of blood-glucose variations and the effect of the influences on these variations. A diabetic working out in the gym, for example, can instantly see when his or her blood glucose starts to drop and can then consume some carbohydrates to boost it back to normal before returning to the treadmill. It’s a technology that’s also triggering the interest of non-diabetics who desire to maintain a healthy lifestyle.

Already, some pharmaceutical companies offer what is essentially “the artificial pancreas”. A wireless sensor communicates directly with an insulin pump to instruct the device to inject precise volumes of insulin into the blood to keep levels in the normal range—mimicking a human’s natural closed-loop system—without the diabetic’s intervention. And if action is necessary—because, for example, food is required to boost levels—the wireless sensor sends a notification to the diabetic’s smartphone to alert them to act. Such control don’t come cheap, but it will be considerably less expensive than the bill for keeping poorly controlled diabetics in hospitals.

While diabetes is a kind of poster child for wireless medical technology, it’s far from the only medical issue to address. Commercial products employing BLE, Wi-Fi, Zigbee, and Thread are already on the market and serve to monitor a range of vital signs, such as heart rate, blood pressure, and temperature. Aberrations in these signs from normal levels are indicators of the onset of poor health, but early intervention minimizes hospitalizations. These wireless devices all forward critical information (via a cellular network) to remote medical staff members and family members. Some wirelessly powered products even go so far as to monitor a patient’s every move and pass the information in near-real time to remote artificial intelligence (AI)-powered servers. This process is important because it ensures that any deviations from the patient’s normal routine, which shows to be an early indicator of illness or deterioration in mental health, is rapidly flagged to trigger an investigation.

Wireless technology has gained significant traction among medical applications, but this is just the start of something much bigger. The Bluetooth Special Interest Group (SIG), which is the custodian of what was once a low-power wireless technology targeted squarely at the consumer electronics sector, quantifies the promise of wireless technology for medical applications in its Bluetooth market update 2018 report. In the document, Bluetooth SIG reports that shipments of Bluetooth chips for health and wellness devices will grow from 362 million this year to 670 million by 2022, and that’s just one technology variant. The industry groupings representing Zigbee, Wi-Fi, and Thread report similar dramatic growth as well.