Online banking subscribers can check their financial health at any time from anywhere. New technology for medical patients allows them to check their physical health remotely by using contactless sensors.
Like going into a busy bank and lining up for service, visiting a medical facility to get your vital signs checked can be time‑consuming. Wires, adhesives and Velcro normally connect monitors to equipment that checks your heart rate, temperature, blood pressure and oxygen level. It restricts body movement and limits the number of tests that can be performed at a time. During a pandemic, going for face‑to‑face examinations by professionals may not even be possible.
But this will soon be a thing of the past. The COVID‑19 epidemic has quickly transformed the health system from traditional in‑person diagnosis and treatment to technology‑based alternatives that do much of the work virtually. As part of the National Research Council of Canada's (NRC) Pandemic Response Challenge program, innovative digital care solutions will promote safety and convenience for patients and health‑care providers.
Among these solutions is contactless sensing software that will be integrated into virtual care systems. It will enable both patients and clinicians to track vital signs‑such as heart rate, oxygen saturation, respiratory rate and temperature‑remotely and securely from any device.
"Health‑care professionals are already using computers and cameras for virtual care and patient management, but they need objective data on hand to help them confirm diagnoses and prescribe treatments online," says Di Jiang, Team Lead, Medical Devices Research Centre, NRC. "Innovative contactless sensing technology, using built‑in cameras in laptops, cellphones and other portable devices, will allow clinicians get near real‑time readings of vital signs."
Jiang points out that, while some contactless sensors exist, their reliability, accuracy and robustness need to be confirmed through additional research and validation. "Here at the NRC, we use digital augmentation employing machine learning, computer vision and skin optics to not only enhance the robustness and precision of existing contactless sensing algorithms, but also create new models." The NRC's contactless sensing software will enter a preliminary clinical testing phase in October 2020, when it will go to the University of British Columbia's (UBC) Department of Emergency Medicine for validation and analysis.
Collaboration brings success
"While our lab tests in simulated conditions are important in the development phase, UBC will validate the technology in the emergency room (ER) with actual patients," adds Jiang. For example, to gather data for the oxygen saturation (hypoxia) component of the tool, the NRC examined subjects in a commercial hypoxic training tent filled with reduced‑oxygen air. These tents help athletes such as mountain‑climbers calculate what adjustments their bodies require to perform in high altitudes. "That's how we created essential data without using real patients."
Testing the software on actual patients is the task of Dr. Kendall Ho, Lead, Digital Emergency Medicine Unit, UBC Faculty of Medicine. "One well‑known phenomenon is that patients infected with COVID‑19 could have a dangerously low blood oxygen level without feeling it," he says. "They may report being slightly short of breath but unless we have critical numbers about their oxygen saturation, we cannot confidently advise them whether to stay home or go to the hospital."
Ho explains that in a case such as this, the test scenario is to ask patients in the ER waiting room if they agree to participate in the study. A clinician then puts the computer with the special camera in front of them to detect and record the status of vital signs. To confirm the accuracy of the software, the numbers are compared to standard hospital equipment data.
"Our clinically based analysis of hypoxia and other vital signs will reveal how the system can be integrated into virtual care generally," adds Ho. "We will also determine how it can be applied in different situations such as community care, emergency medicine, contact tracing and patient follow‑up."
The collaboration between the NRC and UBC blends the medical side of technology usage with the technological side of medical device development. "None of us can do this by ourselves, but working together gives us the ability to successfully carry out this digital transformation," says Ho, who is not only a health researcher and academic, but also a practising emergency doctor. "I feel privileged to work with the NRC because they have excellent expertise, especially engineering, computer science and tool design. They can also find technology collaborators to extend the reach of the tool."
Beyond the hospital
The benefits of the vital‑sign assessment software could go far beyond clinics. For example, by using cameras built into any mobile device, Canadians can track their health status by keeping an eye on their vital signs so they know when to contact their doctors. The tool will also be made available to industrial clients for integration into telehealth platforms, and it can help the Public Health Agency of Canada identify disease patterns and severity. And it is an ideal screening device at international borders and airports, since it checks vital signs on the spot while allowing social distancing.
The UBC hospital validation phase is likely to run until July 2021, when patients will be provided access to the NRC's vital‑sign assessment software from their own devices. Clinical trials in various ER departments across Canada will hopefully begin in late 2022. If the testing yields solid data, the NRC will facilitate mechanisms for deployment.
"The COVID‑19 crisis has spurred us to better understand where our health gaps are, and where technology can help redefine our health system," says Ho. "This tool contributes to that system, which not only helps us now, but may well have a lasting legacy to transform the way that health professionals partner with patients to support their wellness at home."