Fighting diabetes – with IT tools

No doubt, spread of diabetes reached an epidemic proportion, with nearly 10% of the adult population suffering from this chronic disease. Better medicine means longer survivor period in this population and translates to self-care fatigue, where pricking the finger eight times a day is no longer a viable alternative.

Advances in technology opened a new field of possibilities in the management of diabetes. With the help of apps, IT devices, patients can manage their condition, so they can live a better life with a better understanding of how their body reacts and processes sugar during the different type of activities.

Free apps for a better life

A lot of free mobile apps provide information, support for the patient, deliver coaching advice for this new lifestyle. For example, behind mySugr Coaching app is the well-known diabetes educator and author Gary Scheiner and his team, who will answer all your questions. The expert team welcomes all inquiries from newly diagnosed patients or from people living with diabetes for years and need a boost to improve their lifestyle. If you are more into tech, the app paired with a compatible device automatically captures the blood glucose history, making it easy for coaches to review your data.

Fooducate educates users on nutrition and helps to eliminate unhealthy foods. Just scan nutrition labels and you’ll see ingredients as well as the health grade assigned to different foods. Or Glucosio is an app for people with type 1 and type 2 diabetes. It monitors important metrics such as weight, hemoglobin A1c, ketones, cholesterol, blood pressure, and more. The app also includes glucose target tools and an HbA1c conversion calculator. The best diabetes apps of 2018 are listed on this website, some of them are free, others offer in-app-purchase or a subscription.

Self-help apps, though, may have their limits unless they also link the patient with a professional health team or if they have „regional” versions to reflect various preferences and options of people living in various parts of the globe. They also often tend to focus one particular element of daily routines or logging and analyzing data input – either monitoring your lab data, nutrition elements/weight control or exercise, being somewhat weaker in other aspects or limiting integration to one particular device (like one type of glucose meter).

These apps are all much smarter and personalized than books or manual data logging, while new solutions emerge day by day, integrating important functions previous versions lacked – either to be „the ultimate” solution or to serve specific groups within the global diabetes community. The new versions also may provide a better integration with new wearable devices for health, to provide smart data monitoring of vital signs.

Painless glucose level monitoring

Continuous Glucose Monitors (CGM) are not available to everyone due to their price, but advances in technology will eventually bring their costs down. A CGM is essentially a sensor that patients place on their body. This sensor continuously measures blood sugar levels, many readings are possible over the 14 days without ever pricking a finger. The sensor is not connected directly to the bloodstream but instead measures interstitial fluid, and then uses an algorithm to predict the blood sugar level. The acquired data shows how levels are changing through the day. CGM can be used by patients using insulin pumps or multiple daily injections.

Henrik Berggren is a loud advocate of CMG’s, publishing a lot of blog post about his experience with the device. He even went further and modified his own sensor, and now it transmits data every 5 minutes, thus making monitoring continuous.

Frequent data allowed him to measure sugar levels when it was previously impossible, during work or sleep. And more frequent data means is easier for him to connect highs and low to specific actions like a meal or workout. For example, using CGM he noticed, that playing basketball raised his sugar significantly, so he developed strategies to mitigate some of its effects.

He processed the data transmitted by CGM with the help of a free app, Spike, which alerts patient of high and low glucose values, displays blood sugar data as a graph over the last 24 hours in 5-minute intervals (used in treatment decisions). The app also allows the input of personal insulin and carb intake. Spike is not an authorized app, but the product of a hacker ecosystem that exists around diabetes management tools.

Smart pens and needles

Approving and testing these IT devices, apps take a lot of energy and time, so no wonder, that the so-called bio-hackers took matters into their own hands by experimenting on themselves. We understand, that waiting is not an alternative for someone living with diabetes, but we recommend a slow and careful approach, and prudent (self)testing for all non-approved apps and tools.

Another very important category is new smartpens and needles, several which are in development. These will capture injection data and send information to a cell phone, the cloud, or a healthcare-provider dashboard. Experts believe these smartpens and needles will be more widely used than artificial pancreas, which is a closed loop system with the insulin pump and CGM, where insulin is delivered based on CGM data reading. No matter what device, technology or app you are using, the goal is to live a better, fulfilled and empowered life as a chronic diabetes patient. To achieve that, a number of factors do matter: your diet, your compliance, your activities and your medical support. IT can help to support all these areas by now.

Author: Eva Lajko

The best time to be a medical student

Excuse my enthusiasm, but there is no better time than the present (except maybe the all-digital future) to be a medical student.

At Stanford University, students are using VR headsets to see inside an infant’s beating heart to explore congenital heart defects. Medical students can walk around inside a beating heart, manipulate it and observe how it impacts normal functions of the organ. Moreover, at St. Mary’s Hospital in London, clinicians tapped a vendors AR technology to overlay CT scan images onto a patient’s leg during reconstructive surgery. Medical experts study how VR tools can be used in pain management.

These are only a few examples of how AR and VR technologies are deeply immersed in many aspects of healthcare. According to studies VR is deployed in four key medical and healthcare segments: therapy, training, surgery-related applications, and medical research. These are relatively new technologies in health education, but their usage is widespread. According to ABI Research, VR services in the medical and healthcare segment will grow to US $285 million business in 2022.

Medical simulation with a long history

AR and VR simulation tools are relatively cheap, effective, properly designed to the needs of millennials born with a smart mobile in their hands. Technology and the digital generation is a match made in heaven. These students, masters of game consoles, can learn using technology. They become better doctors, they use AR, VR simulation, not only to play but to learn how to save our lives.

The recorded history of simulation in health professional education stretches over 1500 years and around the world – according to the book by Harry Owen, Simulation in Healthcare Education. The demand for knowledge of new medical procedures overwhelmed the traditional apprentice-based training system and give rise to courses in which simulation was introduced to help teach students the practical skills and when to use them. Such courses were even advertised in newspapers, these ads explained that students would learn on „a contrivance made on the bones or skeleton of a woman, with an artificial matrix (womb)”.

What is AR and what is VR?

We came a long way from these contrivances and built up the knowledge to develop AR and VR simulation technologies. People get confused easily between the terms of VR and AR, so let’s clarify them. Virtual Reality (VR) means the user could watch and interact through the VR device but all the images displayed are fake, virtual. On the other hand, Augmented Reality (AR) involves a virtual object that is generated by a computer through the real environment seen by a mobile phone, tablet or AR glasses. The AR presents a semi-true and false image, which is the combination of real and virtual.

Research showed that VR and AR could improve the learning effect by the acquisition of skills and knowledge, understanding of spatial relationships and medical concepts, enhancing learning retention and performance on cognitive-psychomotor tasks. They are providing material in a convenient and timely manner that shortens the learning curve, giving subjective attractiveness, and simulating authentic experiences. In short: students learn because it is fun to work in a simulated operating theatre, to get close to a beating heath.

I saved for last my favorite argument: AR and VR technologies allows medical students to make bold errors, and to learn from their mistakes – all without harming a living person. It’s why is no better time, than the present, to learn medicine with the help of technology!

Author: Laszlo Varga

How can we use digital tools for patient education?

It was not too long ago that patients only had one source of information for all of their health care needs – their personal doctor. Once upon a time patients had to rely entirely on their doctors and nurses to manage their diseases, monitor their symptoms, personalize their care and so much more.

However, today’s technologically savvy consumers are playing a more proactive role in managing their own health and as a result, have begun to hold their personal physicians to a higher standard when it comes to patient education.

High expectations of the healthcare industry for patient education

Because of Facebook, Twitter, Instagram, YouTube and other social media platforms we’ve all grown accustomed to consuming daily fast content. In 2019 and beyond our primary way of consuming and learning new information is through our handheld devices (smartphones, tablets, etc.).

Furthermore, search engines such as Google allow us to research anything we want in just a matter of seconds. Because patients have grown accustomed to easy access information in the blink of an eye, they have come to expect the same of their healthcare providers.

Using digital tools for patient education

Because the internet is the most popular way to obtain information it should come as no surprise that there are hundreds if not thousands of health websites dedicated to specific conditions, written in easy-to-read language.

Patients also can join online groups comprised of individuals whom all suffer from the same condition. These individuals can speak with one another, learn from one another’s experiences, and lean on one another for emotional support. The beauty of technology is that it bridges the world together with just the swipe of a finger or the click of a mouse.

Apps tend to provide the greatest convenience for patients. With a simple download to their smartphone or tablet, patients can learn everything they need to know about their condition in minutes and, with the proper app, can even calculate the appropriate doses of medication they should be taking to treat their condition properly.

Some apps even take the form of mobile games that prompt users to engage in health-related tasks in exchange for points. More and more health providers are also turning to YouTube to educate their patients as well.

The need for a collaborative approach to digital healthcare

When it comes to patient education, collaboration is key. While technology empowers patients to educate themselves on their condition, many of these new technologies still need to be linked into the current healthcare system.

For instance, take the heart rate notification feature found on the Apple Watch. Researchers believe this technology can eventually lead to improved stroke prevention efforts and enhanced rates of detection of heart rhythm disorders.

With that being said, what should a patient do when they receive a notification that there’s something potentially wrong with their heart rate? Perhaps they should race directly to the emergency room? Perhaps they should give their doctor a call and ask for advice? Maybe they should just turn to Google for the answer? The downside of easy-to-access medical information (or something which looks like medical information) could be that people with no medical training and knowledge try to do self-diagnostics, which may be entirely misleading.

While the technology is innovative, the main problem lies with the fact that there are still many unanswered questions which means that more research needs to go into figuring out how to integrate many of these digital tools into the healthcare system.

If end users expect lasting change when it comes to patient education, then they can’t just sit back. Patients along with their healthcare providers need to find a way to work with software developers (such as providing feedback) to design applications that meet the ever-growing need for patient education.

Author: Laszlo Varga

Can we trust health IT devices?

Last Christmas I had the idea to give everyone a piece of smart technology: a smart plug, that controls whatever is plugged into it. I thought it would be a nice gesture to my not so techie relatives, to familiarize them with a glimpse of intelligent tech. The idea turned into a terrible one this Christmas, as I spent (again) much time configuring the device.

My mom pressed the reset button accidentally, and everything went back to where it started. She used it to control the iron: one time she forgot to turn it off, and it was pure luck that the house didn’t burn down. With the help of the smart plug, she was sure, that the power was off.  My sister didn’t even bother to try the smart plug; she doesn’t really know a good use for it. I tried to convince her to control the Christmas lights, but she told me she likes to turn them on every day.

However, even if she would use it for the Christmas lights, probably half of the time the outlet would not work for some mysterious reason – as it does in my home. The smart thermostat also has a will of its own; it randomly decides when it is time to turn on the heat or turn it off. I have more of a semi-automated home, with all these smart tools that fail when you least expect. As it turns out, I’m not alone, when I read an article on Medium, about smart home technology that is not smart enough.

How is all that related to health IT technology? I wonder, people with dementia, diabetes or just older people are safe relying on smart devices, that are not smart enough? Can we trust their illness to an alien gadget?

We do not have perfect health IT gadgets. We took only the first steps towards the complete digitalization of healthcare. Compared to the simple bicycle, we are merely discovering that a safety light on the back of the bike would be beneficial, or we are still working on the brakes.

Technological discoveries arrive daily. For example, a company is perfecting a battery-free chip, that helps connect people with products. The paper-thin chip draws its energy from the surrounding Wi-Fi and mobile networks. Use case scenarios are multiple, and to give just one example: at home, elderly patients can communicate with their medication to get instructions and reminders of when and how to use them. Containers equipped with this chip can automatically reorder themselves, when empty.

Yes, there is room for improvement, and yes sometimes these devices drive us crazy. However, they mean freedom, ensure a quality life. So, I say, yes. We can trust them – with professional support from the caregiver, from the health IT specialist or advisor – as we, at NETIS like to think about ourselves.

Author: Laszlo Varga

VR technology for patients with dementia

Technology is here to help us improve in every aspect of our lives. VR solutions are finding their way into the field of medicine: an Australian company developed a VR solution to help people with dementia, and a Dutch development helps hospitalized people stay in touch with their school or loved ones.

Do you fancy a canoe ride? Would you like to experience a scuba dive? Or you would prefer to contemplate architecture from an Italian gondola? If you are old, suffering from dementia, and living in a nursing home these activities might seem impossible. But not if the staff hands over to you a VR headset which makes all the above possible.

VR technology is already deeply immersed in medicine: at Stanford University, students are using VR headsets to see inside an infant’s beating heart to explore congenital heart defects. Medical students can walk around inside a beating heart, manipulate it and observe how a deficiency impacts normal functions of the organ. Moreover, at St. Mary’s Hospital in London, clinicians tapped a vendors AR technology to overlay CT scan images onto a patient’s leg during reconstructive surgery. Medical experts’ studies show VR tools are helping pain management.

An Australian company developed a VR unit solely to enhance the quality of life of people living with dementia in nursing homes. The reason is personal: the developer’s dad (who is also the founder of the company) was diagnosed with dementia. In nursing homes, everything is about comfort and care, with little room for fun and joy. Those with limited mobility have limited options for entertainment. This is where VR can make a difference: technology, the soothing content gives back experiences to those who miss them most. Caregivers can track the VR experience on a tablet, which opens up communication between staff and patients.

A Dutch company took this concept even further by developing VRiend. The company custom built a small toy, that scans and records the environment it is placed in and broadcasts this environment to another location. VRiend then it is connected to a specially designed VR google. The person wearing this glass can be present in the virtual environment the hardware is placed in, outside the nursing home or hospital the patient it is confined. The technology is mainly used to connect sick children with their school or to connect the elderly with limited movement to their loved ones.

Elderly people, patients living with dementia respond very well to this technology. VR technology offers them a unique experience that generates further, real-life interactions. Gives them a reason to call their relatives, to go in the room next door to speak about the experience. And this is what matters.

Authors: Eva Lajko and Laszlo Varga

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