Cuffless device delivers clinically accurate blood pressure measurements
embedded.com
embedded.com
Something which absolutely surprised me when I was there a few years ago was the amount of IoT health devices available in other markets outside of the US.
There were blood pressure braclets, tons of smart watches that measure health data, connected scales, connected...everything, and TONS of platforms wanted to warehouse this data. My coworker and I were there looking for exactly those sorts of things, and it was great to see so much.
It was actually a bit depressing to see how much stuff is available, just not available in the US. The connected health revolution is definitely coming. Something I was a bit frustrated about this year is how much of this would have been helpful as a covid19 early warning system. Imagine monitoring population-level SPO2 levels, temperature, and activity level.
As I read your comment, I had a growing expectation that you were about to express horror at the mass gathering and warehousing of individuals' health data. I was very surprised when you expressed such excitement at the prospect.
Good call. It was a mistake for me to post such a once-sided comment.
> And while you might assume that this information is legally protected the same way your hospital and medical records are, that’s not necessarily the case.
https://www.consumerreports.org/health-privacy/are-health-ap...
I don't understand why you think there is a difference between taking a health reading at your doctors office and having it included in your patient chart, or taking a reading at your house and having that included in your patient chart. I'm wondering if I'm missing something that is just being unsaid.
Let's say it is a blood pressure reading taken by your Fitbit and uploaded to Google's servers. That data is not subject to HIPAA regulations. When your doctor takes your blood pressure and records it in your chart, it is subject to those regulations (as you say, it would be wildly unethical for them to sell it).
Separately, even if the two scenarios were subject to the same regulations, I would still expect the doctor's office scenario to be more secure. I think that any given patient's home network/device/security practices are more lax than those of most healthcare organizations.
Perhaps this is not an inherent downside to the data security, but it's a reality with the current medical system and regulation does play a part in how we got here. And there is no financial incentive for hospitals to fix these sort of issues, in fact there is a disincentive (I'm doing another EEG now...). So I just don't see how it gets fixed without some outside disruption.
It may not be a popular opinion on HN but I'm much more concerned with having access to my own medical information than how secure it is.
For the most part security for healthcare systems is like security for government systems. A lot of checkbox marking and little real security. Just look at the large number of successful ransomware attacks against healthcare organizations. Having at one time worked in health informatics and from observing the practices at my healthcare providers I am not confident my data is anymore protected at a doctor's office.
If I needed to get one person’s medical information, I think I’d I have a higher likelihood of getting it from their medicine cabinet or snooping on their devices or search history.
If I needed the information of many people, I’d target the doctor. But even then, the goal typically isn’t to leak anyone’s information, it’s to get money from the healthcare provider and the information stays secret, theoretically.
Not really disagreeing with you just rambling.
You can be HIPAA compliant and on Google servers.
They key thing is, as always, ensuring that your data remains your property. Europe is bigger on that than the US.
So if your doctor is part of a larger health system or uses an EMR system odds are that all your data is bundled up and sold. It’s not identifiable easily, but is still sold and used.
One reason for this is strict regulations. U.S. FDA Title 21 CFR Part 11 is very strict as to what a medical device company needs to do, and it's not easy to meet those requirements. Most people do not realize that even in the early startup stage, if you build something that is a medical device, there are rules to follow (mostly about traceability: you have to know what you've built, using what parts, and where those came from).
Shameless plug: I am the solo founder of PartsBox (https://partsbox.com/), which helps a lot with managing traceability when building electronics.
Similar restrictions exist in the EU, Canada and Japan — I'm not familiar with the rest of the world. I suspect developing new products in China is much easier, and you can showcase them anywhere.
So the pressure is just measured with a MEMS (microelectromechanical) device, the temperature with a different one, and there's also a pulse oximeter (optical).
(This at least was one of the major hurdles we faced. Maybe the regulations have changed in the last 4 years or so. I'm not in that space anymore. The recommendation to go check out medica is still valid though. It's really cool!)
We were trying to bring connected health/predictive analytics to a larger, existing healthcare company.
In situations where it actually matters ( patients with abnormally low or high BP, patients with low peripheral perfusion, patients with peripheral vasoconstriction, critically ill patients ) this will be measuring something with little or no correlation with the brachial BP.
Theranos made similar promises...
I wouldn't call the claims Theranos-level, but at the same time I don't see how this is any more useful for the general population than the standard automated blood pressure cuffs. Maybe that will change as things evolve!
This article has a nice review of the history-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312947/.
I guess it might have value if you calibrate it against a good measurement in both arms and then only compare it to historical measurements with the same device. That's to say, it can show you change, which isn't unimportant.
All this to say, I hate measuring my BP and follow this space closely. It's a chore that takes minimum 10 minutes twice a day and I have to largely stop what I'm doing.
I would give so much to a device that could measure my BP as easily as O2, but this device is not it. That picture does not inspire confidence.
All the current "continuous" measurement devices are bulky and inaccurate compared to their larger non-"continuous" counterparts. One day I hope the apple watch can do it, but given the physics of BP doesn't seem realistic.
10 minutes sounds like a lot, I have a pretty common OMRON automatic pressure measuring device[0], and it takes about a minute to do the actual measuring, plus, say, another two to take off my sweater and put it back on.
I suppose I am missing something, how come it takes much longer for you?
EDIT: have you tried meditation? As a fellow person with genetic disposition for HBP, it was somewhat helpful for me, when I could do it regularly.
[0] something like this, but older https://omronhealthcare.com/products/5-series-wireless-upper...
Not the OP, but at a guess (one of my relatives has kidney disease and take their blood pressure twice a day every day), it takes about 5' to relax, then another 5' to take two readings and combine the results. My relative takes three readings and keeps the last. From my understanding this is common with electronic devices, where the measured BP changes between readings.
Again from my relative's experience (I helped them with a bit of code to keep track of their BP and plot it etc) the trend is usually monotonic, i.e. either it starts low and goes up a bit, or it starts high and goes down a bit. Sometimes more than "a bit", like from 130/80 to 120/70 (i.e. from hypertensive to normotensive range), etc. Manual sphygmomanometers don't seem to have the same variance in their readings. From my understanding, the digital devices have some kind of model that estimates BP from the readings of an oscillometric sensor and are less accurate than the hand-operated ones. The table-top mercury ones are the most reliable of the bunch. And as to finger-cuff devices, you might as well read tea leaves.
I used to take multiple readings too, but then concluded it was somewhat pointless: my measurements seem to be pretty consistent, and I would only be alerted when I noticed a shift over multiple days, but I understand how this can vary by person.
Wrist usually gives a higher reading than upper arm, but if you use both for a while to get a good idea of what is good on the wrist one you should be able to do most of your daily monitoring by wrist, only needing to do arm when wrist is unexpectedly off.
https://omronhealthcare.com/products/heartguide-wearable-blo...
As it does all of us.
My BP monitor takes 3 reading and reports the average and takes about 2 minutes to do this. What are you doing that takes so long?
Fitness is pretty low these days given COVID, but I used to be quite fit (former Fitness company). That didn't really move my BP much.
My biggest levers for BP are salt intake and work stress. Currently a co-founder so work stress is rather high handled with a bit of mitigation practices like meditation, but definitely not enough.
Overall I'm on borrowed time of sorts and do my best to be thankful for each day... doesn't always come through.
Speaking of cheese and bread, most of the internet will say it's impossible, but I've found some evidence online (reddit threads and blog posts and the like) of people who actually make both bread and cheese without salt at all (because of hypertension) and they seemed to be doing fine. This was about half a year ago so I can't find the sources again, but in any case salt-free cheese and bread making is possible. I've made a few loaves of bread without salt myself and they're OK, though they taste a lot better when they're made wth sourdough (which is a pain to maintain) rather than dried yeast, because the sourdough adds taste and the dried yeast only air!
What's the problem with butter? I can find both salt-free and salt-full in most countries in the EU that I've visited.
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[1] well... I cook for the entire household :)
I can find salt-free bread from local bakeries in Greece. Also, salt-free rusks (popular in Greece) seem to be a trend, there's three or four different brands that sell them in supermarkets.
Not a GP, not giving advice.
Reading around, health standards vary by economy. Maybe australia has a different cutoff bp to the USA. The nih say you need five visits to be assessed on 140/100.
Many people with hypertension have comorbidities. Diabetes for instance, which also causes neuropathy.
Is it ideal? No. Far from it. I wish I could get mine lower. I see my health professional regularly, I am taking my prescribed medication, and I exercise. I have had no signal that I am facing imminent demise. Far from it.
That's all I meant really: if there is no other problem, I think treated 140/100 could be sustained for some time.
I ask because the word "clinical", used repeatedly in the article, means... in a clinic. And devices like this have an unfortunate habit of failing to perform in the real world.
WuQi does RISC-V BLE chips. I don't know if this product is using that or an ARM.
Someone with better Chinese skills than mine will have to dig at this.
Unfortunately, when you tell me "clinically accurate" but then I see BLE by "super cheap Chinese only" supplier, my skepticism alarm bells start ringing.
It's probably not super common and obviously psychosomatic, I doubt my blood pressure would drop if I were unconscious, but I imagine if I can make my blood pressure go down that fast, other people might do it less extreme and fool the device.
Anyway I'd be happy to use a less invasive device for sure.
(The gold standard, which all other methods are compared to, is a direct measurement taken by sticking a needle in your artery and putting a pressure gauge on it. For obvious reasons this is avoided as much as possible.)
Effects of untreated high blood pressure: loss of mental function, atherosclerosis (so heart attacks and strokes), and vision loss are some of the big ones.[2] It's probably the leading cause of death these days.
So the market for a cheap, reliable and convenient diagnostic device is very large, and wide open at this point.
1. https://health.howstuffworks.com/diseases-conditions/cardiov...
2. https://health.howstuffworks.com/diseases-conditions/cardiov...
A digital blood pressure monitor effectively does the same thing, but without the need for a trained professional. It still has the cuff and the pump. To measure the blood pressure it has to pump and cut off the blood flow to some extent. This obviously makes it inconvenient - it's uncomfortable, it's fairly large, you have to put it around your arm (or wrist or finger), and the pump is usually noisy. The new device seems to be an improvement in these categories.
The main improvement here is size though. Blood pressure monitors usually go around your upper arm and the machine that houses the pump and the electronics is even larger than the cuff. This makes taking frequent measurements difficult. There are smaller devices that go on your wrist, but their accuracy tends to not be great. Even the standard digital blood pressure monitors suffer from inaccuracy.
If the device in the article does what it says and is actually close to as accurate as a regular digital blood pressure monitor, then hopefully we will get more blood pressure data on more people. This should hopefully allow doctors to figure out better treatment plans. However, I find it unlikely that it will match the accuracy of the commonly used digital blood pressure monitors.