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From HealthKit to AirStrip: Apple's gimmick, is the beginning of a mobile medical revolution?

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2018/09/28 17:11
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As early as June 2014, Apple Watch launched the "wearable device + healthy cloud platform" model with HealthKit, revealing Apple's ambition to build a complete solution for mobile health and mobile healthcare.
 
This year, Apple Watch used the mobile health application AirStrip to extend the heart rate monitoring target to the fetus and directly cut into the maternal and child health field, which has caused great concern in the mobile medical community.
 
Under normal circumstances, pregnant women can not be self-monitoring 15 weeks before pregnancy. For pregnant women aged 15 to 28 weeks, 3 times a day, 1 minute is safe. For pregnant women after 28 weeks of gestation, the fetal differentiation is complete and the length and frequency of monitoring can be lengthened. For high-risk pregnant women after 35 weeks of pregnancy (for example, pregnant women with pregnancy-induced hypertension, hyperthyroidism, etc.), the fetal heart rate monitor should be used for continuous monitoring of the fetal heart, and if necessary, continuous monitoring for more than 1 hour.
 
In the past, the medical community used Doppler and other medical prescription equipment to monitor the safety of the fetus. As for the long-term continuous monitoring, it will have no effect on the fetus. The introduction of this application means that pregnant women wearing Apple Watch can monitor the heartbeat frequency of the baby in the belly at any time to understand whether the baby's condition is safe and avoid the hard work of the pregnant woman during the pregnancy.
 
Home healthcare devices are being replaced by some smart wearable hardware and will become more miniaturized in the future. Not long ago, the germination of fetal monitors focused on fetal monitoring was posted on the Indiegogo website (US crowdfunding website), bringing a completely different monitoring approach to the US watch to the US market.
 
The germination fetus monitor can simultaneously detect two data of fetal movement and fetal heart rate. It consists of two parts. One is a wearable device, which is specially designed for pregnant women. It looks like a diameter of about 40mm, a thickness of 6mm, a weight of 15g, and a 3M medical grade. Silicone stickers, low-energy batteries can be used continuously for seven days; second, the mobile APP connected to it, used to record the data detected by the device, generate a real fetal heartbeat, and also include the mother's heart rate, exercise, sleep and respiratory rate, etc. .
 
The team of this product comes from China's handed down future. Its founder, Ma Yuliang, graduated from Madison University in Wisconsin with a degree in Industrial Systems Engineering. He is a founding member of the “Going Out” question and was responsible for the voice search products for wearable devices.
 
It is understood that the fetal heart rate monitoring adopted by Apple uses the principle of ultrasound to monitor the condition of the fetus in the uterus. The fetal heart rate is regulated by the sympathetic and parasympathetic nerves. The curve of the monitoring pattern formed by the instantaneous fetal heart rate changes can be used to understand the fetal heart reaction during fetal movement and contractions to predict whether the intrauterine fetus is hypoxic.
 
When the fetal heart was taken care of, there was an abnormality in the fetal heart pattern, which was also often used to indicate abnormal fetal heart. Abnormal fetal heart rate in most cases means that the fetus has hypoxia in the uterus. The more severe the abnormal fetal heart rate, the more severe the fetal hypoxia is, but not all fetal heart abnormalities are caused by hypoxia.
 
In the future, it will adopt the "passive monitoring" technology - without signal transmission, the high fetal sensor and intelligent algorithm can obtain the fetal heart rate and the mother heart rate, thus ensuring the safety and non-harm of monitoring. The technical principle is that by detecting the micro-vibration of the sound emitted by the fetus in the air, and the baby fetal movement pattern recognition algorithm, Ma Yuliang said that the product has been clinically tested, the national standard error is 2BPM, and the germination error is 1BPM. From the way of wearing, the sprout is closer to the fetal heart than the Apple Watch, making it easier to get accurate data. The “passive monitoring” technology allows users to receive instant reminders of changes in fetal heart rate in advance through the APP.
 
Try to combine with traditional medicine
 
However, the same bottleneck faced by Apple in the future is how to break through the combination with traditional medicine. A small hardware attached to the mother's stomach can generate a large amount of data by continuously recording the baby's fetal movement data in the mother's stomach. The clinician makes a judgment. Even in the future, data can be used to build models to provide early warning of abnormal conditions and reduce the rate of fetal death.
 
In China, most mobile medical companies currently on the market have not solved one of the most core problems: whether it is the management of chronic diseases or the provision of telemedicine for customers, the final receiving end of all data should be doctors, but currently because Chinese public hospital doctors have not yet With fundamental liberation, doctors (especially doctors in the top three hospitals) have difficulty providing detailed and adequate professional advice to customers through these mobile medical devices and apps.
 
If medical-grade wearable devices are to be formally used, the manufacturer must first pass the examination, but in the face of such completely innovative medical technology, the regulatory authorities often behave very cautiously. Currently, they are only in the experimental stage and far from being used clinically. stage.
 
With the continuous deepening of product functions, can Apple make wearable medical devices move from “always” to a true mobile health revolution? Malay Gandhi, president of the famous digital medical incubator in the United States, believes that only Apple’s Apple Watch Products can truly open the digital health app market, encourage consumers to trust and participate in wearables, and use HealthKit to bridge the gap between personal data and medical treatment.
 
HealthKit integrates seven categories of information on body data, fitness, personal, nutrition, results, sleep, and organs to fully display the user's personal health data. Among them, "Health Data" displays health data measured by wearable devices such as body mass index, body fat percentage, walking distance, calorie consumption, and sleep. "Medical ID" mainly stores user information, including name, past medical history, allergy history, medication, and emergency contact information. It can be used as a medical record in an emergency to provide the doctor with basic information.
 
The industry generally believes that in accordance with Apple's consistent development path, Apple Watch will stimulate and establish a set of standards for fitness and medical monitoring on wearable electronic devices; Apple will develop medical systems with medical institutions, hospitals can be read and saved in Health Health data to monitor the patient's physical condition and further use the data for treatment as necessary.
 
This is also the key point for a truly breakthrough for wearable medical devices: first, the maturity of the sensor, which will affect the accuracy of the collected data; secondly, whether the collected data can be compared with the doctor's diagnosis and medical services in the hospital. Combine.
 
Joshua Landy, chief medical officer of Figure 1 of the health care startup in Canada, said he would look at the patient data displayed on the Apple Watch. “I need to see if its data is useful before I buy or recommend this smart watch to my colleagues. "The accuracy of Apple Watch heart rate monitoring can be described as exciting," said Molly Maloof, an expert in digital health. Heart rate monitoring is important for the treatment of many diseases. It gives doctors a better picture about the patient's condition. Intuitive display.
 
In order to find a breakthrough at the hospital level, Apple is working with many health application providers in the United States to establish contacts and services for healthcare organizations and mobile phones or tablets with iOS 8 systems, including HealthKit. At present, there are more than a dozen top medical companies in the United States to launch the HealthKit service pilot project to establish a patient health information database for the hospital. At the same time, more than 600 developers have integrated HealthKit into their health and fitness applications.
 
It is reported that Stanford University Hospital and Duke University Hospital have begun to combine medical equipment and HealthKi platform to track the health of patients.
 
Stanford University Hospital uses HealthKit to record blood sugar levels in children with diabetes, while Duke uses HealthKitw to record blood pressure and weight and other vital signs to aid in the treatment of more serious conditions such as heart disease and cancer. HealthKit collects data from medical monitoring devices and provides feedback, and user data can be shared with doctors. In addition, HealthKit can automatically determine whether the patient's blood pressure and other vital signs are within the normal range, and inform the hospital whether the patient needs further testing.
 
If you say, HealthKit is just a healthy data platform for ordinary users and medical institutions and developers. The significance of ResearchKit launched by Apple in March this year is even more profound. It has really launched a mobile medical mechanism that allows doctors and medical researchers to truly solve patient-related problems or propose treatment options through mobile apps. The significance of ResearchKit comes from its huge number of users and open source. It welcomes any medical institution in the world to use the data collected by ResearchKit to conduct research and provide medical services.
 
This may be just the beginning of a revolution. (Jilin Qijian Biotechnology Co., Ltd. www.qjbio.com.cn)