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Several Telemedicine and Remote-Patient Monitoring Solutions Cutting Through the COVID-19 Clutter

In a time of social distancing and isolation, technology is enabling patients, caregivers, and clinicians to communicate and monitor health remotely.

  • There isn’t any doubt that COVID-19 is transforming our society and healthcare. Cities are under stay-at-home orders. The global pandemic is bringing an air of uncertainty to everyone’s lives and causing a shift in the way medicine is practiced. Telehealth and remote-patient monitoring technologies are gaining more traction and importance as they are becoming crucial to ease the strain from healthcare facilities. MD+DI has compiled a list of several solutions cutting through the COVID-19 clutter.

  • Fast Pathway Inc.

    Fast Pathway Inc. has developed the DocClocker app for reporting wait times for doctor visits, which could help patients limit waiting time and exposure in medical waiting rooms.

    “It is important that people are not sitting in sick waiting rooms during the coronavirus outbreak when there are delays in the office. DocClocker providers value their patients' time and are engaged in technology efficiencies that mitigate long wait times," said Dr. Eric Carter, Co-CEO and Co-Founder of DocClocker, in a news release.

    Added Dr. Kevin Makati, Co-CEO and Co-Founder of DocClocker: "As governments and communities around the globe are doing everything in their power to prevent the spread of coronavirus, it is our obligation as medical providers to do the same for the safety of our patients. By providing real-time wait times to your patients with DocClocker, you are demonstrating your commitment and true care for their wellbeing.”

    The app could also be used to manage future appointments and reminders. The company reported that providers who use DocClocker receive an increase in new patient bookings, as prospective, in-network patients could locate and select providers through the app.

    Image courtesy of Fast Pathway Inc.
  • BioIntelliSense

    Tabula Rasa HealthCare Inc. (TRHC) is distributing BioSticker (shown above) from BioIntelliSense for continuously monitoring patients' vital signs. MD+DI recently reported that the wearable sensor can also measure the frequency of a patient's coughing and sneezing, which could be among the symptoms associated with COVID-19.

    “BioSticker remote monitoring devices will add an additional layer of patient safety to MedWise and to the other software solutions we currently offer,” shared TRHC Co-founder, Chairman and CEO Calvin H. Knowlton, PhD, in a news release. “Our board-certified pharmacists and the medical teams at our client sites across the country will be able to monitor medication therapy along with vital signs, multi-parameter biometrics and symptomatic events for early detection. More informed medical care can only lead to better health outcomes.”

    Added BioIntelliSense CEO James Mault in the release: “As TRHC serves a variety of healthcare clients, including the majority of PACE organizations in the United States, they are an outstanding partner for introduction of remote patient monitoring into the PACE market and beyond." (PACE is described as a federal program providing comprehensive medical and social services to individuals 55 and older who are nursing-home eligible.) Mault described the BioIntelliSense BioSticker device and data services as "ideal for older adults with complex care needs. Tabula Rasa and its PACE clients will be able to more effectively monitor these complex patients through an effortless patient experience, enabling better care at a fraction of the cost of traditional remote patient monitoring.”

    Image courtesy of BioIntelliSense
  • CluePoints

    CluePoints is reporting increased demand for remote and centralized clinical trial site monitoring amid the ongoing coronavirus outbreak. The company offers Risk-Based Trial Execution (RBx) and Data Quality Oversight Software, which employ statistical algorithms to determine the quality, accuracy, and integrity of clinical trial data both during and after trial conduct, the company reported in an news release. CluePoints is helping its clients overcome some of the blanket travel bans impacting trial management through its Central Monitoring Platform, which interrogates the data and suggests site follow-up by web, phone, and email wherever risks are detected.

    “The industry has been steadily moving towards a new paradigm of Central Monitoring, yet the current crisis is forcing more rapid change now," explained Patrick Hughes, Co-Founder and Chief Commercial Officer of CluePoints, in the release. "We have an important opportunity to play our part in supporting all patients and stakeholders involved in clinical trials to ensure safety and integrity. As pioneers in the field of RBQM, we continually respond to industry demand, to ensure sponsors, CROs, and Clinical Technology Partners benefit from constant innovation and transparency. We’re passionate about maximizing clinical trial data quality, and remote monitoring is one such area that can have a real impact. We’re all worried about the potential effect of COVID-19, on both a business and personal level, but there are simple, easy-to-deploy solutions that remove the need for on-site human intervention that can also help to ensure business continuity.”

    The company has launched a complimentary COVID-19 risk management package available to all at no cost. The package could help companies meet new recommendations from the U.S. FDA, EMA, PMDA, and MHRA, which have each issued specific guidelines as a result of the coronavirus, the company reports.

    Image courtesy of CluePoints
  • Strados Labs

    Strados Labs has developed the RESP System, a wearable "stethoscope" that records patient lung sounds for later remote playback or transmission to clinicians and nurses. Not yet cleared or approved by FDA or any regulatory agency, the RESP platform is currently available for investigational use only, a company spokesperson told MD+DI.

    “With the Strados device we can provide a more objective measurement of the success of acute treatment and we can store this information for future visits. I believe that this will be revolutionary to the respiratory health field and will be a significant cost savings measure for emergency room level care,” explained Gregory Almond, MD Chief of Service of Emergency Medicine at the New York Metropolitan Hospital, in a news release.

    Monitoring lung sounds could prove useful during the COVID-19 pandemic, as cough is a key symptom in more than 70% of patients diagnosed with COVID-19, the company reported in the release. "Our goal is to remotely capture and quantify these symptoms for early detection, treatment, and interventions," the company stated. It is working with telehealth companies to deploy devices for remote care and triage settings as well as clinical research organizations currently working on novel respiratory vaccines for COVID-19.

    A potential proprietary algorithm is being explored for processing and extracting respiratory acoustics to highlight any changes in respiratory patterns for physician analysis, Strados reported.

     

    Image courtesy of Strados Labs
  • CardiacSense

    CardiacSense has developed a wearable for continuously monitoring  vital signs of either inpatients or outpatients. The CardiacSense watch and wristband can measure core temperature, heart rate, respiratory rate, SpO2, and cuff-less blood pressure and detect arrythmia, the company reported in a news release. Such monitoring could monitor isolated patients as well as those recovering at home.

    "We have aleady submitted the files for FDA and CE and [are] now waiting for the review," Eyal Copitt, chief commercial officer for CardiacSense, told MD+DI. "The first submission was for HR, HRV, Spot ECG, A-fib detection. Submission for respiratory rate is expected to be submitted by July, and submission for SpO2 and blood pressure for December."

    Featuring wireless communication, the CardiacSense device can send real-time measurements to medical staff and receive back written instructions through the device screen whether the patient being in the hospital or at home, the company reported.

    Image courtesy of CardiacSense
  • AMC Health

    AMC Health offers kits and a virtual care platform to enable at-home patient monitoring. The kits can either be distributed to patients at hospitals from localized consignment inventory or be shipped directly to them via UPS. Patient biometric and self-reported symptom alerts are accessible to remote care managers via the cloud in near real-time, the company reported in a news release. AMC Health can also provide full or supplemental care management triage services through its national nurse call center.

    Jon Shankman, EVP Clinical Innovation for AMC Health, told MD+DI that “all kits are composed of a cellular transmission hub and pre-Bluetooth-paired peripheral monitoring devices. Monitoring devices can include (but are not limited to) weight scales, blood pressure monitors, glucose meter adapters, pulse-oximeters, digital thermometers, and inhaler monitors. The cellular transmission hub, which sends biometric and medication access information from the wirelessly connected peripherals to cloud, automatically, in near real time, can either take the form of a small cellular modem or a tablet (with a cellular SIM) pre-loaded with the AMC Health mobile app. If the latter, the patient can also conduct secure messaging and secure televideo with care team members on the same device. All devices are ready-to-use out of the box, with no set-up required other than plugging the hub into a power source.”

    The kits can be standardized or customized to patient conditions. “We can arrange for kits to bear a default configuration of devices by program (e.g., heart failure kit has a weight scale and blood pressure monitor as standard),” Shankman said. “However, additional devices can be added to accommodate comorbidities such as diabetes (glucose meter adapter) or COPD (inhaler monitors). Likewise, devices can be removed from default kit configurations (e.g. weight scale removed from a heart failure kit is the patient is not weight bearing).”

    AMC's virtual care platform is supporting COVID-19 triage capacity and response. "From hospitals, health organizations, and ACOs to their patients, AMC is providing immediate solutions to help during this crisis in every way,” said Nesim Bildirici, CEO of AMC Health, in the release. “We are working around the clock to ensure our IVR (interactive voice response) and seamless RPM tools, video-conferencing, easy assessment templates, and mobile solutions are ready to deploy and scale to help fight the best fight against Coronavirus and serving all our clients and their patients."

    AMC Health’s data integration, analysis, and clinical decision support platform called CareConsole (which is device agnostic) is itself an FDA Class II-cleared solution (it is software and not hardware), explained Donna Geringer, EVP Business Development. “That Class II status, however, mandates that any integrated 3rd-party peripheral monitoring devices must themselves be Class II-cleared where applicable. Indeed, we have integrated over 130 such 3rd-party monitoring technologies to date.”

    AMC Health’s solutions allow for collection and analysis of and automated alerts on several data typologies from the home, such as biometric data from vitals monitors, patient self-reported information (on symptoms, environment, behavior and access to care) via automated surveys, medication access information from smart dispensers, service data from 3rd-party remote services (e.g. PERS), and data on patient history from bidirectional exchanges with electronic health records and claims systems, Geringer said. “All these disparate data elements coalesce into a single web record for a patient, which, when AMC Health’s proprietary analytics are applied, alert remote care managers to pre-acute patterns of concern, allowing for the timeliest interventions to prevent hospitalization or worse,” she said. “Synchronous televideo can be supplied to enable these remote care managers to conduct virtual visits for remote assessment and coaching and to supplement in-person encounters to dramatically extend the reach of overtaxed clinical assets. Lastly, automated, interactive surveys (delivered either through telephonic IVR or visually via the mobile app) also serve to impart focused health education in a capacity that no clinician has the time to replicate verbally.”

    Image courtesy of AMC Health
  • VitalConnect

    VitalPatch from VitalConnect is an FDA-cleared, clinical-standard wearable biosensor that continuously monitors eight vital signs in real-time and updates caregivers through the VistaTablet and Vista Solution. These vital signs include heart rate, heart rate variability, respiration rate, body temperature, live ECG, posture, activity, and fall detection.

    VitalPatch uses an internationally recognized standard to attribute a score to a patient's current health state, NEWS (National Early Warning Score), which uses a 0-20 numerical indicator to help preempt issues and health decline during a patient’s hospital stay, according to Peter Van Haur, CEO of VitalConnect. Patients can also be monitored from the comfort of their own home, Van Haur told MD+DI.

    “Physicians have the ability to set and receive text notifications for patients that are outside their current threshold for any of their vitals. Clinicians also have the ability to immediately connect with patients through the VistaTablet to visit the patient virtually and determine next steps in their course of treatment,” Van Haur said.

    For monitoring during the COVID-19 crisis, clinicians are using VitalPatch to measure and monitor respiratory rate, heart rate, and body temperature. “Clinicians can set customized thresholds and be alerted in real-time if a patient crosses a threshold,” Van Haur told MD+DI. “The VitalPatch communicates data to the VistaTablet, which can also display blood oxygen levels (SPO2) and blood pressure when paired with a compatible 3rd party device. This provides clinicians with vitals continuously, through a tablet or through a secure url, limiting the need for spot checks and thereby, limiting caregiver exposure.”

    VitalPatch relays patient data back to Vista Solution for caregivers to review. Historical data for each patient is provided so that caregivers can understand trends and inform treatment decisions.

    Image courtesy of VitalConnect
  • Somatix

    Somatix’s SafeBeing solution consists of four components that work together for remote patient monitoring and telehealth: an enterprise dashboard, caregiver app, user app, and a smartband.

    “Data is collected and filtered at the level of the wearable device through proprietary mechanisms that enable the system to work in real-time and conserve battery power and is then transferred to the cloud and subsequently [to] the dashboard and SafeBeing Caretaker application,” Eran Ofir, CEO of Somatix told MD+DI. “SafeBeing currently supports BLE connection between the band and the patients’ phones. Later this year, the Somatix smartband will have the capability to directly connect to the cloud-based servers of Somatix through wireless internet.”

    The cloud-based platform translates data in real-time from commercially available sensors installed in smartwatches or smartbands, Ofir said. “This data turns into clinical insights and predictive analytics that keep patients safe, monitor their health and wellbeing, and enable healthcare providers to observe the most at-risk patients.” SafeBeing also communicates with PointClickCare EHR platform through its marketplace API, allowing the exchange of a user’s health data between systems, he said. “The passive collection of data via a wearable band is automatically entered into the EHR via PointClickCare’s API without the need for human entry and providing real-time access,” he said. “Also, the patient’s specific data from the PointClickCare EHR platform is enabling better insights and predictive analytics for every patient being monitored, given special conditions, medication administered, history of treatment etc.”

    Somatix offers its own low-cost smartband, which Ofir describes as a “a light, durable silicone band with a 4- to 6-day battery life, but it can work on several other commercially available wearables as well.” He pointed out that “the events and gestures that are captured have less to do with the device and more to do with the unique and patented gesture detection algorithms that we run on the device.”

    SafeBeing could play a role in the response to the COVID-19 pandemic. “We are working with nursing homes, sub-acute short-term care, and other facilities that are in lockdown and quarantined situations,” Ofir said. “Especially as these care organizations are short-staffed and following isolation protocols, technology plays a critical role in both simplifying the workflows of the staff and in providing valuable remote insights.” He shared a couple scenarios here:

    “People (at all ages) who were identified as COVID-19 carriers and need to stay quarantined at home are currently unmonitored. Their health and wellbeing can be monitored with SafeBeing and those at-risk for decline can be identified earlier and at-scale,” he explained. “SafeBeing can also be integrated with Bluetooth-enabled blood pressure cuffs, pulse oximeters, thermometers, and blood glucose monitors to add even more value to the monitoring of patients’ health.

    “We see every day now that other patients with non-COVID-19 related conditions are being sent home to free up the healthcare system (beds) to deal with the emergency COVID-19 response,” he continued. “However, these people (discharged patients) still need to be monitored. SafeBeing can monitor them at scale with no installations or complicated setup and it can identify those that need provider attention.”

    Finally, “seniors are in need of monitoring now more than ever,” Ofir said. “To date, seniors have relied on healthcare professionals, family caregivers, and senior day care centers to oversee their health and wellbeing. Yet, both at home and at care facilities, seniors are left unprotected because of the isolation and social distancing protocols that are currently in place due to the coronavirus. In practice, families are keeping their distance from their loved elderlies to avoid risk of exposing them to the disease, healthcare professionals are unable to provide the same levels of care and seniors are staying home, missing both medical appointments and other day-to-day interactions that provided them a layer of protection. These seniors need a new, simple way of monitoring their health and wellbeing. SafeBeing remotely connect both caregivers and family members, identifying falls, emergencies, deviations from normal, risks for hospitalization and overall decline. Family members can be provided with SafeBeing’s family app to access to their loved one’s insights and alerts.”

    Ofir said that SafeBeing is already live in the market and has met HIPAA, certification, and compliance requirements at several health systems and elder care facilities. “In the United States, the SafeBeing technology falls under the category of a Clinical Decision Support System, which is not subject to regulation under FDA,” he said.

    Image courtesy of Somatix
  • PMD Healthcare

    To help hospitals and home health agencies care for patients during the COVID-19 crisis, PMD Healthcare is providing kits for remote patient monitoring (RPM) and offering a telehealth platform.

    “More and more providers are beginning to drive non-urgent patients to telehealth services to help limit further spread of the virus; but these services are often not equipped with the technology to monitor vital health statistics. PMD Healthcare’s kits enable providers to track these critical biometrics in real time, and better manage the massive influx of COVID-19 patients who may not need a hospital admission but who need to be carefully monitored,” Wayne Meng, CEO and founder of PMD Healthcare, said in a press release.

    Meng told MD+DI that PMD Healthcare ships the kits as requested by the medical facility, and often this is directly to patient’s homes. "The RPM kits are comprised of Bluetooth-enabled, patient-friendly medical devices that capture biometric data (oximetry, spirometry, temperature, blood pressure, heart rate, and weight). The Biometric Devices can be selected based on individual patient conditions and care plans," he explained. "All kits also include a 4G tablet with cellular service, video telehealth, symptom-monitoring tools, electronic care plans, patient education, and ongoing customer care and support," he added.

    Once "patients use the biometric devices, the devices (wirelessly) transmit all data to PMD Healthcare’s HIPAA-compliant Web Portal through the tablet’s cellular connection," Meng explained. "Healthcare professionals have access to the portal where they can view all data/trends and can initiate a video call to a patient’s tablet at any time."

    PMD Healthcare stated in the release that the RPM kits are "particularly important for patients in 'high-risk' groups for severe illness due to COVID-19 such as those with chronic lung disease, serious heart conditions, immunocompromised health status, diabetes, or other underlying medical conditions."

    Image courtesy of PMD Healthcare
  • Cochlear Limited

    Cochlear Limited, a provider of cochlear implants, bone conduction implants, and acoustic implants, has earned U.S. FDA approval for its Remote Check at-home testing tool. Patients with a Cochlear Nucleus 7 Sound Processor can use the tool to complete a series of hearing tests from their compatible iOS device using the Nucleus Smart App.

    "The FDA's expedited approval of our Remote Check offering during the COVID-19 crisis underscores that at-home hearing healthcare support needs to be prioritized, more accessible and convenient for patients now more than ever," explained Patricia Trautwein, Au.D., Vice President, Marketing & Product Management, Cochlear Americas, in a news release. "When elective surgeries become available again after the COVID-19 crisis, clinicians are going to see a wave of patients coming in to seek hearing implant treatment. Having a solution like Remote Check will help clinicians prioritize their case load, so they can reduce unnecessary visits for patients progressing well, spend more quality time with patients who have complex needs, and help more patients seeking initial cochlear implant candidacy assessment." The approval is the first step in commercializing the product offering, which is anticipated by the end of 2020, the company stated.

    As part of the Remote Check testing, clinicians can have patients photograph the implant site and the area behind the ear, take an audiogram test and a listening-in-noise test, run an impedance check, and complete other assessments, all of which can be completed in 15 minutes. Remote Check test results are then sent remotely to the clinician.

    Image courtesy of Cochlear Limited
  • Spire Health

    Spire Health offers the Spire Health Tag for remote continuous respiratory monitoring. 

    Jonathan Palley, CEO of Spire Health, told MD+DI that the "Health Tags are used under the general wellness exemption policy of the FDA. They are intended to give a user information about their pulse, activity, sleep and respiration rate, but not intended to mitigate, prevent, treat, cure or diagnose any specific disease or condition. Like many products of this type, however, physicians often use them to gain insight into their patients’ general wellness."

    Patients can enroll in remote patient monitoring, and Spire Health will ship them their Health Tags, Palley explained. "The Health Tags are all preconfigured so they just need to plug in the Home Hub and adhere the Health Tags to their garments. The entire setup takes less than 10 minutes and can be done at home." The Health Tags adhere to a patient’s existing clothing and require no daily interaction or change in behavior, the company reported in a news release. Patient data and notifications are reviewed by a patient’s care team through a healthcare provider dashboard.

    Spire Health just announced a collaborative partnership with Pulmonary, Critical Care & Sleep Disorders Institute of South Florida (PCSI), a large outpatient pulmonary group in the Palm Beach area of Florida, to remotely monitor chronic respiratory disease patients from home in an effort to help PCSI healthcare providers detect early signs of COVID-19 and limit exposure for healthy patients.

    “As medical professionals in the field of pulmonary/critical care, we are on the frontlines in the fight against COVID-19 and are looking for innovative solutions to help us protect our most vulnerable patients. We have partnered with Spire Health to deploy remote patient monitoring (RPM) for our 3,500 highest-risk patients, allowing us to triage and support them if they need care due to the COVID-19 virus,” explained Dr. Carlos Sanchez, MD, FCCP, a physician partner at PCSI, in a news release.  “The Spire RPM solution enables us to keep a close eye on our patients allowing them to remain in their homes safe in the knowledge that if we detect any changes in their health we can reach out through telehealth. We’ve already seen rapid adoption and interest from our patients knowing that we will continue to provide the highest level of care and safety during these difficult times.”

    Spire Health has received a grant from the U.S. Department of Health and Human Services.

    Image courtesy of Spire Health
  • GN Hearing

    GN Hearing has introduced ReSound Assist Live, a real-time video-enabled hearing care service that enables patients to connect with their hearing care professional for new hearing aids and care remotely. The telehealth service offers people who use hearing aids a remote means of working with their hearing care professional during stricter social distancing measures because of COVID-19.

    "ReSound Assist Live (also accessed via the ReSound Smart 3D app) is a new service/feature that allows real-time video consultations and the ability for hearing care professionals to make remote “fine-tuning” adjustments to ReSound hearing aids without the patient having to visit the clinic," Laurel Christensen, chief audiology officer, GN Hearing, told MD+DI. "It is the only service that offers both real-time live video (synchronous) and remote adjustment (a-synchronous) options." ReSound Assist Live is now available to iOS device users (iPhones, iPads, and iPod touch running on iOS 12 operating system or newer), and the company hopes to increase the number of compatible devices in the future.  

    Christensen said that "the existing ReSound Smart 3D app offers hearing aid users a number of features, including ability to personalize or control their devices while in varied environments and situations. The ReSound Smart 3D App is available to download for both iOS and Android devices. The ReSound Smart 3D App works with ReSound LiNX Quattro, ReSound ENZO Q, ReSound LiNX 3D, and ReSound ENZO 3D hearing aids."

    Virtual appointments take place during a ReSound Live Assist video call over a secure connection. "During that call, if sound adjustments are needed to the hearing aids, the patient listens as adjustments are being made, providing feedback in real time," explained Christensen. "Once the call has ended, the hearing aid will 'reboot' and new settings will be saved."

    ReSound Assist Remote Fine-tuning can happen with or without the virtual appointment, and after a patient submits a request, the hearing care professional reviews the request and then sends updated program settings, said Christensen. The patient receives the setting on the app and downloads wirelessly to hearing aids. The patient can then send a rating of the new settings back to the hearing care professional.

    ReSound is also working with hearing care professionals to establish “curbside” services that will enable remote hearing tests/audiograms and the initial hearing aid fitting, Christensen said.
     

    Image courtesy of GN Hearing
  • physIQ

    PhysIQ’s continuous remote monitoring system, pinpointIQ, could be used to provide continuous physiologic remote monitoring of homebound or quarantined patients with confirmed or suspected COVID-19, thanks to labeling recently sanctioned by FDA, the company reported in a news release. Such use also includes application of pinpointIQ's proprietary Multivariate Change Index. The solution may also be used for patients with a high-risk profile, such as those with heart failure, COPD, or hypertension.

    “Our entire healthcare infrastructure is about to become completely overwhelmed by COVID-19,” said Gary Conkright, CEO of physIQ, in the release. “We will have more patients than hospital beds and our only option is to find ways to better care for patients at home. With clinical grade wearable sensors and our proprietary, FDA-cleared analytics, we are providing hospitals with personalized physiologic visibility into their homebound high-risk COVID-19 patients. We believe this will not only free up hospital capacity, but also reduce clinician exposure to this highly virulent disease.”

    The results of a VA-sponsored clinical study published in Circulation – Heart Failure showed that the artificial intelligence (AI)-powered devices could detect subtle physiologic changes in patients with congestive heart failure that were predictive of hospitalization one week in advance. This study demonstrates the technology's potential for detecting similar cardiovascular changes that may emerge in COVID-19 cases, the company reported in the release.

    PhysIQ sends kits to patients with all the components required for continuous remote monitoring including FDA-cleared clinical-grade wearable sensors and a phone for data transmission with data plan. Data then continuously streams to the cloud where physIQ’s proprietary FDA-cleared analytics look for subtle changes in physiology, the company reported.

    Image courtesy of physIQ
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