Assistant Professor Lehigh University Easton, PA, United States
Digital measures offer an unparalleled opportunity to create a more holistic picture of how people who are patients behave in their real-world environments, thereby establishing a better connection between patients, caregivers, and the clinical evidence used to drive drug development and disease management. Reaching this vision will require achieving a new level of co-creation between the stakeholders who design, develop, use, and make decisions using evidence from digital measures. A confluence of advances in biosensor technologies, enhancements in health care delivery mechanisms, and improvements in machine learning, together with an increased awareness of remote patient monitoring, has accelerated the impact of digital health across nearly every medical discipline. Medical grade wearables—noninvasive, on-body sensors operating with clinical accuracy—are playing an increasingly central role in medicine by providing continuous, cost-effective measurement and interpretation of physiological data relevant to patient status and disease trajectory, both inside and outside of established health care settings. Although wearable device technologies have improved over the past 15 years, there are many unaddressed translational gaps. Nearly 30% of users abandon smartwatches over time because of motivational loss, routine disruption, perceived measurement inaccuracy, discomfort, and battery charging. Furthermore, skin intolerance of adhesives required for prescription medical wearables is an under appreciated limitation of current devices. Thus, the continued growth and clinical impact of medical wearables will require advances to overcome persistent translational gaps in both measurement capabilities to drive broader utility and form factors and mounting strategies to improve patient tolerability. Key innovations in the field of wearable technology to circumvent the aforementioned issues include but are not limited to: 1) wireless, ultrathin, flexible, skin-like engineering design with a miniaturized physical footprint, compromising neither measurement accuracy nor comprehensiveness, 2) in-sensor data analytics and real-time continuous data streaming provide access to pertinent biomarkers such as heart rate, respiratory rate, pulse oxygenation, skin temperature, workload, and blood pressure, 3) skin-friendly adhesives to mitigate iatrogenic skin injuries posed by current medical-grade adhesives today thereby enabling long-term wear over clinically-relevant durations, 4) interoperability of data towards integration of the acquired digital biomarkers into software platforms employed by medical personnel, and 5) the generation of "proactive analytics" which translate the measured biomarkers into actionable means for clinical utility. Building off of these needs, this presentation will highlight our groups work in applications relating to atopic dermatitis, neonatology, human performance, and dysphagia. We will present engineering developments in flexible electronics, elastomeric nanocomposites, and flexible materials and how their integration into devices adds value towards addressing the clinical questions at hand. A key takeaway from this talk is the integration of the end user (patient), medical personnel, nurses, and engineers into the laboratory towards engineering devices to improve patient outcomes.