The wearable sensor market is exploding. The associated groundswell of innovation with medical and wellness applications is vast and can be applied to all populations in a variety of settings. However, the validity of generated data is often questioned, therefore research must parallel this expanding frontier to ensure appropriate validation studies and understanding of each device's limitations.
That can be easier said than done. Validation studies are often costly and time-consuming—which is why the pace of research studies seems to be lagging behind the pace of advertising and marketing in the digital health arena.
In addition, peer-reviewed studies remain the gold standard in the medical community, yet the claims of both clinical- and consumer-related health and wellness devices have not been universally held to similar standards.
The result is that the wearable sensor market has become part of the "wild, wild west" of marketing and advertising—often with unsubstantiated claims. That’s why, in a small laboratory on the 5th floor of the old hospital at the University of California-Los Angeles (UCLA), we’re stirring up a little controversy to change all that.
Stepping into the Paradigm Shift
Unfortunately, the university setting is often viewed as an impractical and self-indulgent institution disconnected from society and reality. Many in the academic community feel that "the seduction of academia by the marketplace" has gone too far by inhibiting free-thinking minds in order to meet commercial demands.
But while the controversies of this culture are debated around us, we’re busy embracing the ideology that by marrying academia and industry, we can collectively create advancements in policies and innovations. That’s why we’re working within a different paradigm that aligns with the federal Bayh-Dole Act of the 1980’s.
Bayh-Dole catalyzed "academic commercialization" by supporting the exodus of ideas out of higher education and into the marketplace—which is exactly what we’re doing at UCLA.
Here, we’re creating meaningful collaborations between industry and academia within the digital health arena by leveraging technology to shift the paradigm of the health care system. We’re moving it towards a preventive, patient-centered approach, and enabling validation of new technologies by accepted research standards.
Creating a Unique Collaborative Model
An example of this collaborative model is found in our Digital Health Network (DHN). A byproduct of ongoing research collaboration between the Department of Homeland Security, emergency responders and the Exercise Physiology Research Laboratory housed in the David Geffen School of Medicine at UCLA, the goal of this collaboration is to bring together researchers from engineering, medicine, exercise physiology, industry and the emergency responder community to create state-of-the-art technology solutions for ensuring the health and safety of emergency responders.
Known as PHASER (Physiological Health Assessment System for Emergency Responders)—project results are optimized by our ability to make use of economies of scale to expedite opportunities for system deployment and national rollout.
With industry support, these products are then developed and delivered via PHASER-Net, a networked platform for individualized emergency responder physiological monitoring, risk profiling, risk mitigation and guidance. PHASER-Net enables monitoring of firefighters during baseline data collection and training, as well as during missions (e.g., fire suppression or emergency operations).
Results have been consistent since initial deployment—the platform has proved its value by identifying individuals with high risk of cardiovascular events and providing targeted actionable training guidance for risk mitigation and prevention.
Applying the Platform to Wearables
The DHN system architecture mimics much of the PHASER-Net platform; it is low-cost, secure and private, scalable, supportive of standardization, robust, reliable and amenable to future modifications.
The DHN system employs existing state-of-the-art wireless wearable physiological status monitors and standalone instruments. Durable smartphone platforms are integrated via a novel DHN mobile application for sensor data acquisition, processing and interaction with users.
The data from the app then is securely uploaded to the DHN, implemented with dedicated secure servers at UCLA for archival, processing and development of individualized feedback available to each user via password-protected Web pages. Access to the data on DHN is restricted to the participants and authorized personnel to perform additional over-read of the data and provide further feedback and guidance.
The DHN system is inherently designed to be modular and to support innovative components from collaborators. These components may be wireless wearable sensors, mobile devices, signal processing algorithms, expert or diagnostic systems, secure network protocols or any other elements that can optimize system development. This allows our research team to be open to opportunities that enhance the system through innovations by our collaborators or adopters.
Creating New Products
As an outcome of our collaborative efforts, we recently (soft) launched UC Fit—a reflection of our mission to bridge the gap between laboratory research and real-world application of health-fitness practices by leveraging Digital Health technology.
UC Fit provides an in-depth snapshot of one's health, as well as an action plan to improve upon it. UC Fit also serves as a community hub for translational research and a clinical resource for lifestyle intervention that emphasizes fitness education.
We integrate the DHN and a number of validated wearables with our 10 evidence-based health-fitness assessments. Among them, our sleep and performance tracking assessments have been popular among students, faculty and staff.
Our real-time feedback via a rich visual user interface (smartphone) with further integration on the DHN Web portal allows for intuitive monitoring/tracking of progress over time, actionable feedback, motivation to ensure compliance, and guidance and mitigation strategies addressing the obstacles that prevent adherence.
By making use of unique collaborations between academia and industry, we believe that we can catalyze the development of credible digital health products to optimize outcomes. By leveraging our extensive research and validation experience, we can provide needed credibility to the reliability of wearables—and help to set a new validation standard for the explosion of technologies within the emerging field of digital health.
Dr. Christopher Cooper is Professor of Medicine and Physiology at the David Geffen School of Medicine at UCLA where he is Director of the UCLA Exercise Physiology Research Laboratory. He is also Medical Director of the ULCLA COPD Program and of the Clinical Exercise Physiology Laboratory.
Dr. Brett A. Dolezal received his Ph.D. in Exercise Physiology with a specialization in Strength and Conditioning from the University of Kansas. In 2008, after a seven year stint in the private sector owning his own fitness consulting company, in Beverly Hills, CA, Dr. Dolezal reentered academe and secured a position as Assistant Project Scientist at the David Geffen School of Medicine at UCLA where he’s also the Associate Director of the UCLA Exercise Physiology Research Laboratory.
Dr. David Boland received a doctorate in Physical Therapy from Baylor University in 2009. He is currently a Major in the United States Army and has served as Director of Rehabilitation at the Pentagon from 2011 until entering the MCIP Ph.D. program in 2013. David is now supported by the Army Medical Department to pursue a doctorate in Exercise Physiology.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the authors.