Telehealth
AUGUST 2020
What is telehealth?
Telehealth is broadly defined as the use of communications
technologies to provide health care at a distance. Telehealth has
become a valuable tool thanks to combined advances in commu-
nications, computer science, informatics, and medical technolo-
gies.
Telehealth ofen involves remote monitoring of blood pressure,
heart rate, and other measurements obtained by a device worn
by the patient and electronically sent to medical personnel.
Smartphones and other smart personal devices are increasingly
utilized for the collection, dissemination and even analysis of
health status due to their increasing presence around the globe,
even in remote, underserved communities.
In the last several years virtual visits between doctors and
patients have become very common, especially with the onset of
A cell phone with a special module can process cervical
the COVID-19 pandemic. The willingness of physicians, patients, specimens to identify cancerous and precancerous cells.
and insurers to embrace virtual medicine is likely to cause it to Credit: Ralph Weissleder and Hakho Lee/Massachusetts
remain a popular option in healthcare. General Hospital.
How can telehealth technologies improve medical care?
f area
Teleconsultations allow a physician in a remote
to receive advice from a specialist at a distant
f Remote patient monitoring (RPM)
enables patient monitoring outside of clinical
location about special or complex patient conditions. settings, such as in the home. Patients use or wear
Such consultations can be as simple as a phone call. sensors that wirelessly collect and transmit phys-
Increasingly, they involve sophisticated sharing of iological data to health professionals. RPM can
medical information such as CT, MRI or ultrasound significantly improve an individual’s quality of life.
scans. These images can be taken by the local physi- For example, in diabetes management, the real-time
cian, incorporated into an electronic medical record transmission of blood glucose readings enables
and sent to the specialist for diagnosis and treatment healthcare providers to intervene when needed and
recommendations. avoid acute events and hospitalizations.
f Point-of-care (POC) medicine relies on
diagnostic devices that can perform at the time and
f toTelehomecare provides the remote care needed
allow people with chronic conditions, dementia,
place of patient care, which includes at home, in or those at high risk of falling to remain living in their
doctor’s ofices and clinics, and in remote areas with- own homes. The approach focuses on reacting to
out electricity or laboratory equipment. POC devic- emergency events and raising a help response quick-
es can detect micronutrient deficiencies, anemia, ly. Sensors monitor changes in chronic conditions
infectious agents and even some cancers. Combined as well as other risks including floods, fires, and gas
with telehealth, POC technologies allow health care leaks. Sensors can also alert caregivers if a person
workers to test patients and rapidly obtain results with dementia leaves the house. When a sensor
without the need for a complex laboratory setting, is activated, a monitoring center is alerted to take
which can result in significant cost-reduction. appropriate action such as contacting a caregiver or
sending emergency services.
www.nibib.nih.gov
Telehealth AUGUST 2020
What telehealth/POC technologies are researchers creating to improve healthcare?
15-minute paper-based viral diagnostic
Diagnoses of HIV viral load requires RNA amplification from blood in a centralized laboratory, which can delay diagnosis
and treatment for weeks. NIBIB scientists are developing a paper-based diagnostic that can quantify HIV viral load in
whole blood in 15 minutes. A mobile phone is used to power and control the paper-based RNA extraction and reaction;
analyze the fluorescent readout indicating viral load; and store the results in the cloud where they can be accessed by a
physician. The $10 test will be broadly applicable for infectious disease diagnosis at the point-of-care.
Wearable mHealth system to improve therapy for knee osteoarthritis
Knee osteoarthritis (OA) is a leading cause of disability because of
pain, stifness, and decreased range of motion. Studies have shown
that too excessive or too limited levels of clinically recommended
therapy ofen increase pain, suggesting that each individual has an
optimal treatment level. NIBIB-funded engineers have developed
a flexible wearable system with one sensor attached to the knee
sleeve and a second sensor under the foot insole. The system will
gather and assess a patient’s movement biomechanics that afect
pain, quality of life, and rehabilitation progression; this will generate
clinical data that will enable the development of personalized OA
therapy.
Smartphone-based test to diagnose anemia
More than 1.6 billion people have anemia, which increases risk of
maternal and infant mortality and impairs cognition in children and
adults. Inflammation and iron and B vitamin deficiency each cause Smart watches can monitor conditions such as atrial
fibrillation using machine learning. Credit: Gregory
anemia, and incorrect treatments may exacerbate the condition.
Marcus, UCSF
NIBIB-funded researchers are developing AnemiaPhone to assess
inflammation, B vitamin, and iron status in one test. A smartphone
accessory analyzes a drop of blood on a test strip. The phone camera captures and quantitates the results, which are
catalogued so healthcare workers can administer the correct treatment to each individual. The technology is designed to
perform in remote settings where anemia is a persistent, debilitating health problem.
Mobile device to avoid heart congestion hospitalization
Atrial fibrillation (AF) and congestive heart failure (HF) are common conditions that frequently occur together and ofen
result in hospitalizations when patients experience shortness of breath. Early warning of congestion would allow cardiol-
ogists to adjust patient medications and avoid the need for hospitalization. NIBIB scientists are developing smartphone
and smart wearable devices for monitoring patients with AF and HF for early stages of worsening heart congestion. The
technology will consist of a smart wrist band and smart ring that will detect heartbeat frequency and amplitude changes
that are indicative of impending heart congestion. The data will be submitted by smart phone to cardiologists enabling
therapy adjustments to avoid hospitalization and significantly reduce progression to heart failure and the associated
morbidity, mortality, and expense.
Contact
National Institute of Biomedical Imaging and Bioengineering Phone: 301-496-8859
Ofice of Science Policy and Communications Email: [email protected]
6707 Democracy Blvd., Suite 200 Website: www.nibib.nih.gov
Bethesda, MD 20892
~ \ . National Institute of Biomedical Imaging and Bioengineering www.nibib.nih.gov
IM&lf/ Engineering the Future of Health
