David Kerr: Medical underwear

David KerrCould the e-bra save the NHS? Recently researchers at the University of Arkansas announced that they had developed a remote monitoring system that could be integrated with an individual’s underwear. The “e-bra” consists of a series of nanostructured, textile sensors integrated into clothing using a wireless module that communicates wirelessly with a smartphone, which then can transfer data to the appropriate hospital or clinic anywhere in the world. The researchers claim that the device will be able to monitor blood pressure, temperature, respiratory rate, oxygen consumption, an ECG and neural activity among other parameters. As well as the potential for improving health, the e-bra concept could be of value to athletes and the military.

In fashion-speak, wearable devices have the potential to be the “new black”. They are no longer the stuff of spies and alien superheroes but are becoming mainstream. For example, the sportswear company, Nike has already produced a wristband that senses movement and converts this into a “fuel,” which is then made available to help people with their training. An individual’s data can also be shared with fellow athletes to add a competitive element. Apparently Nokia has also recently filed a patent application for a “vibrating tattoo” that alerts an individual when someone calls or sends a text message. In the future this could be connected with a range of biosensors and medical monitoring devices  alerting families, friends, and professionals if, for example,  a glucose level or heart rate is falling or a blood pressure becomes too high.

These technological developments came at the same time as publication of yet another depressing assessment about the state of the NHS in the UK. According to a report on the BBC news service, the UK health system is currently struggling to cope with the number of under-65s living with multiple long-term medical conditions, describing their care as coordinated poorly and inefficient. It is also very costly to a healthcare system.

One futuristic vision for managing people living with multiple chronic medical conditions is the “Quantified Self”. A simple definition is “tracking of daily activities (including blood glucose monitoring, blood pressure checks, exercise, weight, medication, symptoms, side effects, mood, sleep etc) through technologies, delivering back to the user performance analytics with the data and metrics helping the user to change behaviour in order to self-improve” (http://quantifiedself.com/). Making some of the data “social” will encourage peer support and perhaps result in positive changes in behaviour. In a nutshell, people with many chronic medical conditions would not need to be reviewed “face to face” in the traditional manner and they would have the option of deciding on the timing and frequency of collecting self-monitoring information.

However, for this to happen, it will require a revolution in attitudes of both patients and clinicians. The current hierarchical and dependent approach to managing chronic medical conditions would be disrupted by allowing patients to collect and own their own data and share it with whom they wish. The use of technology in chronic disease management would also have the potential to cause a seismic change in determining remuneration – in other words could e-bras become more cost-effective than QoF points?

David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes and Mylyfe.me a service for women surviving breast cancer. He also believes that social media has the potential to be of huge benefit in improving medical care and practice. He also holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.