A pair of headphones hang in the wrecked hull of a bus, involved in the crash that killed four members of the North Central Texas College (NCTC) softball team, in a garage at P&M Wrecker in Davis, Oklahoma, U.S., on Tuesday, Oct. 7, 2014. Trucker Russell Staley's rig, traveling at 72 miles per hour, sideswiped a southbound bus carrying 15 softball players from NCTC and their coach. The Oklahoma crash claimed the lives of Jaiden Pelton, 19; Brooke Deckard, 20; Meagan Richardson, 19; and Katelynn Woodlee, 18. Regulators and the industry are working to find solutions to reduce the death toll of almost 4,000 every year, including mandatory electronic recorders to enforce duty-time limits and stiffer metal bars beneath heavy-duty trailer trucks to prevent cars from sliding underneath in accidents. Photographer: Victor J. Blue/Bloomberg
Developing health monitoring technologies requires looking at what people can and will readily adopt, like wearing things in their ears.

As ultra-low-power chips, smart sensors and signal processing make possible tiny wearable and implantable monitoring devices, the old system of periodic health checks will move to one where patients can generate and transmit a constant flow of data. The challenge for medical professionals will be making sense of this data and ensuring their patients act on it.

An astonishing range of devices is emerging. In the process, companies outside the healthcare sector – such as Google and Microsoft – are entering the field to develop monitoring software or advance the miniaturisation of medical electronic devices.

Some products – such as the Fitbit and Jawbone range of wearable trackers – allow healthy individuals to monitor things such as diet, exercise and sleep patterns, helping them fend off illness. Smart fabric sensors mean clothing and footwear can capture data on things such as breathing patterns, body temperature and gait.

Other devices monitor certain conditions, from congestive heart disease to diabetes. Sensors – surgically implanted inside the human body, inserted under the skin or swallowed on a pill – take constant readings of different indicators and transmit that information to their doctor.

The good news for both patients and healthcare providers is that real-time information flows cut costs and hospital visits. For those with congestive heart failure, for example, changes in heart rate or cardiac output (the volume of blood the heart pumps with each beat) provide advanced warning of a problem.

“It’s getting that identified early enough so that an intervention can happen before the person has to come to the emergency room,” says Charles Sodini, professor of electrical engineering at Massachusetts Institute of Technology.

Given rates at which global populations are ageing, the need to manage individuals living with one or more long-term conditions will grow – creating demand for health monitoring devices.

Yet technology alone is not the answer. Standards and common platforms will also be needed so that information can be exchanged between everyone from patients and healthcare providers to insurers. “Technologically this is simple,” says Prof Sodini. “The hard part is that we have a lot of players in the game.”

Equally important is the development of technologies that people will readily adopt. For this reason, devices worn in the ear may prove most effective, says Frazer Bennett, a healthcare technology expert at PA Consulting.

First, he says, people are used to wearing things in their ears, from hearing aids to in-ear headphones. “And if you think about the pathway between the outside of your ear and your brain, there’s not a lot in the way,” he says. “So the ear is a brilliant anchor point for measuring things about you.”

The ability to monitor health indicators constantly – rather than episodically, during health checks and doctor visits – raises challenges of its own, however. Constant data flows may yield insights that force physicians to rethink the way they treat their patients.

“This is new medicine,” says Prof Sodini. “It’s going to take gathering the data, learning what it means and building up empirical knowledge.”

It also means tackling an old problem – getting patients to act on the information. And often the advice of friends and family, rather than medical results or doctors’ instructions, proves more effective in persuading someone to take their medicine or change their diet.

“Managing long-term conditions and preventive care is about changing people’s behaviour,” says Mr Bennett. “And unless you keep a person in the loop, you’re not going to be successful.”

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