Faculty in the departments of electrical and computer engineering are leading research in mHealth at The University of Alabama in Huntsville. mHealth capitalizes on what Dr. Emil Jovanov, associate dean for graduate education and research in the College of Engineering, calls “major revolutions” in computer informatics, smartphones, and energy-efficient and miniaturized electronics and sensors. It can provide health information to the patient directly, to the physician via the Internet, and to researchers as aggregated databases.
In 2000, Jovanov was the first to propose Wireless Body Area Networks (WBAN) for health monitoring as a sensor system to integrate sensors on or in bodies and communicate through the Internet. “When WBAN is used to monitor diabetes patients using an implanted blood glucose sensor and insulin pump, the system can determine how much insulin should be released, not only based on the blood glucose level, but based on the level of activity and condition of the whole organism,” said Jovanov.
Jovanov said the idea sprang from the Personal Area Network used in wireless computing. “We proposed creating a personal health monitoring network within two to three feet from your body integrating a number of sensors to monitor your vital signs and physical activity.” Individual sensors are controlled by a smartphone that collects information from sensors and communicates with the rest of the system. In collaboration with the Mayo Clinic, the researchers developed the first successful prototypes.
Since then, size and weight have shrunk and sensor and communication technologies have advanced. Through UA Huntsville, the researchers filed two recent patent applications. Both applications use the sensors already embedded in a smartphone.
First is a cardiac health monitor that records the change of heart activity every time a user stands up. A sensor in the smartphone detects when the patient gets up and a wireless heart sensor detects heart activity.
In the second, a university-developed program monitors activity of wheelchair users using sensors embedded in the smartphone. A magnet on the wheel allows the smartphone to detect and record the number of wheel rotations so distance, speed, and duration of activity can be calculated. Moreover, the system can detect if the user propels the wheelchair or if the chair has been pushed.
A Growing Need
“We are desperately in need of changes to the whole health system. Currently, the emphasis is on reactive health care,” Jovanov said. As part of the Affordable Care Act, in 2012 Medicare tightened its hospital readmission rule to decrease payments to acute care hospitals with excessive readmissions. “That has created overnight a multi-billion dollar market for home monitoring and an early intervention system,” Jovanov explained. “What is ultimately needed is a proactive system. You can make small changes and affect your health in a major way over time.”
As health status deteriorates, longterm records and information in the electronic health record can help in diagnosis. Having this long-term information will decrease the amount of needless testing done. It also opens the possibility for rehabilitation use.
High costs have prevented this level of personalized medicine. Hospital-grade monitors typically cost from $5,000 to $15,000 each. Jovanov says that he expects to see an emergence of mHealth monitors in the $50 to $500 price range.
Once mHealth monitors are widespread and generating big data streams, data mining will allow researchers access to information not identified by user, resulting in super-sized studies on topics ranging from heart disease to cancer outcomes.
“We believe that once we have widespread mHealth devices, we will create huge database of records capable of completely changing healthcare,” Jovanov said. “Once you gather enough data, it will tell you how well you are doing for your genetic profile and your age and health, and what to do to improve your health status.”