By Dr. Andrew Dent

Thanks to the rise of social networking and the rapidly increasing amount of time spent online, where our movements are tracked as carefully as a cheetah tracks game, the amount of information about us and our internet activity is growing at an amazing rate. Most of this is related to purchases and predilections, and is tracked so we can be advertised to more effectively. The same methods are also being applied to our more basic daily movements, with our health and wellness as the main targets. The two areas most likely to benefit from these types of advances are medicine for managed care, and professional sports. As you can imagine, the pace of innovation and development in this field is not hampered by funding. In addition, as the focus on healthcare shifts from centralized hospital-based treatment to home-based management, there are growing needs for developing reliable, wearable healthcare monitoring systems...

Surveying the range of health monitoring systems available on the market today, it would seem that the majority are devoted to basic life signs such as heart rate. Of course these types of monitors have been available for some time, some for use in patient monitoring, others for assessing workout regimens and the optimal zone for improved fitness. All of the current systems however require some form of close and constant contact with the skin close to the heart. This is necessary because heart rate monitors work by picking up the electrical signals through the skin that the heart puts out when it pumps. The better the contact with the skin, the better and more accurate the reading. For medical use, there is an acceptance that pads can be placed on the skin to obtain readings, and some of the solutions on the market are simply close fitting shirts that allow for multiple devices to be incorporated. The Bio Nomadix shirt from Biopac is an example. The sports versions use tight fitting bands, either as a separate part, or incorporated into a shirt or sports bra. Textronics (NuMetrex) has been a leader in this field.  However, if this monitoring is to become more mainstream, and potentially worn continuously, then less intrusive and cumbersome solutions need to be developed.

Beyond simple electrical pulses from the heart, newer systems are also attempting to provide data on other aspects of human health. These have included perspiration rate, pH level and electrolyte balance, oxygen saturation and blood flow, brain waves (to prevent truck drivers from falling asleep at the wheel), and the speed and movement of a body during physical exercise.

BIOTEX is a project from a consortium of European development companies that have created a shirt that is able to assess the chemistry of sweat ‘real time’ as it is created by the wearer. Using a textile based colorimetric sensor with a pH sensitive dye, accurate results on the ‘health’ of the sweat being produced can be obtained, taking readings for conductivity, sodium concentration and temperature.

The ‘Smart Cap’ that has been prototyped by mining haulage truckers in Australia uses simple EEG (brain wave) measuring sensors that are incorporated in the cap to assess fatigue, and to display warning signs on an in-cab monitor or a call to the driver’s cell phone. It has had success, and the technology has proven robust enough to be used in such noisy, vibration heavy, dirty environments.

New developments in sports monitoring are also looking to provide real time information on player’s movements, not with just GPS, but also accelerometers. Underarmor has pioneered this innovation with the E39 shirt to be worn by football players. Embedded in the center of the chest section of the shirt is a triaxial accelerometer that measures the left and right side of the body separately, showing how the two work synergistically or not. The sensor allows measurement of each individual stride in its acceleration and braking, which can help a player make minor adjustments to maximize speed. The E39 shirt was used by selected NFL prospects at this year's NFL Combine, a week-long Underarmor sponsored exhibition held recently showcasing some of the nation's best prospective football talents.

But perhaps some of the best solutions to the needs of regular or even constant health monitoring – at least in the managed care field – is no worn sensors at all. Solutions such as the non-contact SleepMinder™ that provides sleep and respiration monitoring with no active participation from the user show a future where we can be monitored with no need for special shirts or connections. There also exist complete systems already that use an army of sensors built into your home that keep track of speed, frequency, intensity and  duration of all normal tasks and operations that are done in our daily lives (WellAWARE® Systems). These track the patient’s movements against an established norm, and if irregularities occur (staggered steps, non-movement, wild fluctuations in temperature, increased visits to bathroom etc.) it can notify a care-giver, who can then either contact the patient to check on them, or intervene directly if more urgent care is needed.

Big Brother? Maybe, but this type of passive monitoring will become more prevalent as the boomers age, want to age in their own homes, and are therefore willing to accept less privacy for that privilege. As for the range of monitors that are being used to track the myriad movements and secretions of professional athletes, weekend warriors and contracted high risk workers, let’s just say it’s the equivalent of assessing and protecting a sometimes very large investment.