These devices are aimed at providing patients with the convenience of monitoring their health status at home, reducing the costs of care as well as increasing the quality of life.
Nevertheless, problems may rise from poor use due to lack of user training, device issues and other external factors. Under these circumstances, the utilisation of these devices can present several issues concerning their efficacy, safety and user privacy.
Evidence lacking on efficacy of devices
One of the prevailing concerns regarding the utilisation of home monitors and other wearable health devices is the validity of measurement and data. Researchers from Peking University Third Hospital, Beijing observed the reliability of several current mainstream devices for monitoring physical activity.
The study found that although the devices were reliable in measuring the number of steps taken and the distance travelled, daily measurements by the different devices fluctuated greatly. The researchers concluded that there was inadequate consistency in the measurement of activity duration, energy expenditure, and sleep quality.
A 2010 study also showed that wearable systems used to monitor movement in patients with chronic conditions, as well as evidence-based clinical applications of such devices, required further development.
Another study examined the outcome of remote patient telemonitoring for those with heart failure. Michael K. Ong from the Department of Medicine in University of California together with several other researchers found that it was unclear whether this form of monitoring provided significant benefits after hospitalisation.
More specifically, the study results that were published last year showed that hospitalisations were not reduced with the intervention.
Improper use poses potential safety hazards
Another issue that revolves around the use of home monitoring devices is the lack of sufficient training to use such devices. This poses different technical concerns, along with environmental and safety hazards.
Jeffrey Shuren, Director of the US Food and Drug Administration (FDA) Devices and Radiological Health, said that using complex medical devices at home carries unique challenges such as caregivers may lack sufficient training, product instructions may be inadequate or overly technical, or the home environment itself may pose environmental or safety hazards.
These factors had potential to affect the product’s functioning. In fact, the US FDA has received about 20,000 reports of adverse events from the use of home medical devices since 1997.
To further illustrate the potential hazards of home health monitors, an article published in 2009 drew attention to the risk of false reassurance and the likelihood of delaying treatment, particularly for women who used home foetal heart monitors.
Home foetal heart monitors are often widely advertised, and while mothers may see them as entertaining and fun, they should not be used as an alternative to medical advice and consultation, according to the article.
Devices may threaten health data privacy
Many devices are integrated into Big Data digital health and marketing networks, which poses threats to individual data privacy. Data obtained by biosensors, such as heart rate, body temperature, physical activity and so on can be combined with users’ personal information from other sources, namely healthcare providers and pharmaceutical companies.
This in turn would raise concerns of unfavorable practices, including discriminatory profiling and manipulative marketing. In addition, there will be greater opportunities for data security breaches, where hackers will be able to access medical and health information from various institutions.
It may be concluded that there needs to be increased public awareness on the appropriate use of home health monitoring devices. It would also be highly beneficial to have an effective regulatory framework concerning the future use and development of these devices.
Needless to say, regular communication between patients and healthcare providers continues to be significant despite the use of such devices. Prior to suggesting home health monitoring to patients, healthcare practitioners should consider the feasibility of those devices and have clear goals in mind, to enable them to gain credible information and achieve the desired outcomes. MIMS
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