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Pinky Langat was a finalist in our Fall 2018 essay contest. Langat is a Harvard Medical student and used her experiences in school as the basis for her essay. Langat notices the need for health-related technologies on a global scale. The World Economic Forum is recognizing that wearable technologies have the potential to transform healthcare and increase the global market value on an exponential scale. In her essay, Langat, calls for the cooperation of scientists, engineers, healthcare practitioners, policy makers and businesses to come together to reform health care. Langat notes different reforms that hope to use various technologies to address the global shortage of health workers. Included below is Langat’s essay submission.

In the past decade, increasing demand to conveniently and dependably use technology in daily life has been met with advances in the design and low-cost manufacturing of lightweight, flexible electronics, leading to the rise of wearable technologies. To date, the wearable device market, primarily led by Fitbit, Xiaomi and Apple (1), has mostly been geared toward wellness and fitness applications, providing opportunities for individuals to be empowered to monitor and improve their own activity levels. The success of such wearable technologies has been evident, with the global market value for wearable devices growing from roughly 750 million US dollars in 2012 to a forecasted estimate of six billion US dollars by the end of this year (1). I envision digital health technologies to continue to expand, with exciting developments and challenges in healthcare as devices become increasingly ‘bionic’ and bioelectronic wearables are incorporated to help monitor, diagnose, and treat disease.

Wearable technologies bring the advantages of convenience and comfort that can aid various aspects of healthcare, namely in the diagnosis, treatment, and longitudinal monitoring of health conditions. These applications have been recognized by the World Economic Forum as ways in which wearables are transforming healthcare (2) and several examples of devices in various stages of development exist. At UC Berkley and Stanford Children’s Hospital, flexible electronic cloths are being designed and trialed as “second skins” to detect potentially fatal seizures in pediatric patients by monitoring the skin for electric signals originating in the brain. These lightweight electronic materials aim to substitute for bulky, cumbersome MRI technology and reduce the necessity for frequent hospital visits (3). As therapeutics have extended from chemicals (e.g. small-molecule inhibitors) to biologics (e.g. antibodies, T cells), the integration of technology and biology has also led to novel ‘bioelectronics’ as medical treatments. Various ventures across the US are currently developing implantable devices that aim to treat conditions covering a range of metabolic, inflammatory, and endocrine disorders, by targeting electrical signals in the body (4,5). For example, the Indiana-based company Innovate Health Solutions recently had FDA clearance for their wearable medical device that attaches to the ear and sends electrical pulses to “block the pain of opioid withdrawal” in addition to chronic and acute pain of other causes (4). In chronic disease management, wearable medical technologies can provide valuable information for preventative rather than reactive care (4,6). Sensors that record a continuous flow of data rather than the ‘snapshot’ approach of periodic physician visits aid in continual monitoring and can alert doctors when a patient’s symptoms deteriorate (7). With this information, physicians will be able to make better, personalized decisions about what interventions are needed for individual patients. The efficacy of such initiatives has started to come to light, with a recent study illustrating that symptom recording apps were shown to potentially help increase the lives of cancer patients by an average of five months longer compared to those who did not use them (8).

(It is important to note that PCB Solutions has the engineering capability to create the technology to engineer, design, layout, manufacture and supply wearables mentioned in this essay. As an 18-year veteran of custom fabricated electronics, we have taken many designs from concept through delivery of the product to the end customer. Our team and supply chain offer many of the turnkey capabilities necessary to be a single source for electronics manufacturing. We are technologically proficient in delivering high quality products from ISO9001 and UL registered suppliers from all over the world and the domestically in the USA.)

In order for these various innovations to come to fruition, there are a number of engineering challenges to be addressed. Devices face the challenge of balancing miniaturization while requiring considerable computing power. Additionally, the material of these wearable or implantable devices should not harm or be rejected by the body. Further, with the increased throughput of data, analyses and mining of biological data will require machine learning to help physicians determine and detect changing patterns of medical conditions. These bioelectronics initiatives require an integrative science approach, leading to partnerships not just between biologists and chemists, but also with experts in nanotechnology, manufacturing, and data analytics in order to implement these new medical interventions.

Beyond the technical challenges, several other concerns exist in the incorporation of wearable and integrative bioelectronic technologies. Given the sensitivity of the data collected, clinics may be hesitant to adopt these innovations due to data privacy and accuracy concerns (9). Further, one must be mindful that the complexity of implantable devices, which may be considered a high-risk endeavor, requires considerable regulation and oversight to ensure the safety and well-being of patients (5). It is critical to not rush these developments, otherwise trust in the medical device industry will deteriorate, of which there have been previous examples (10). Another concern is the high cost of developing such products, particularly in countries with public health systems, can be recuperated while providing greater access. From a global perspective, there is reason to believe these advances do not need to be limited to the most resource-rich settings. For example, the startup Feebris focuses on affordable health technologies, connecting wearables and medical devices to detect early signs of pneumonia in children in rural India. The concept is to address the global shortage of health workers, where AI may supplement existing limited resources to better diagnose and monitor health conditions through a community-based diagnosis platform.

Overall, it is clear that in order to safely and effectively move wearable health technologies from the realm of science fiction to beneficial implementation, the combined efforts of scientists, engineers, healthcare practitioners, policy makers, and businesses are required. In this way, we can develop and make use of disruptive and ideally affordable health innovations that will ultimately enhance our ability to maintain health and well-being in the 21st century.

1. Global wearable technology market 2012-2018 | Statistic [Internet]. Statista. [cited 2018 Aug 1].Available from: https://www.statista.com/statistics/302482/wearable-device-market-value/
2. How wearable tech is transforming healthcare [Internet]. World Economic Forum. [cited 2018
Aug 1]. Available from: https://www.weforum.org/agenda/2015/10/how-wearable-tech-istransforming-healthcare/
3. McFarling UL, Branswell H, Swetlitz I, Ross C, Thielking M, Garde D. Electronics “like a
second skin” making MRIs safer and easier for children [Internet]. STAT. 2017 [cited 2018 Aug
1]. Available from: https://www.statnews.com/2017/11/15/safer-mri-printable-electronics/
4. Blau M, Silverman E. FDA clears electronic earpiece to block opioid withdrawal symptoms –
STAT [Internet]. STAT. 2017 [cited 2018 Aug 1]. Available from:https://www.statnews.com/2017/11/15/fda-bridge-opioid/
5. Silverman E. Q&A: Glaxo exec says bioelectronics is “not science fiction” [Internet]. STAT.
2016 [cited 2018 Aug 1]. Available from:
6. Wearable tech: The next big thing in healthcare? [Internet]. Roland Berger. [cited 2018 Aug 1].
Available from: https://www.rolandberger.com/en/Point-of-View/Wearable-tech-The-next-bigthing-in-healthcare.html
7. Murray S. Digital technology pushes out frontiers of healthcare [Internet]. Financial Times.
2016 [cited 2018 Aug 1]. Available from: https://www.ft.com/content/f643993e-e620-11e5-
8. Ram A. Vital-signs monitoring app helps extend cancer patients’ lives [Internet]. Financial
Times. 2018 [cited 2018 Aug 1]. Available from: https://www.ft.com/content/a35550ee-4a3e-
9. Bond-Myatt C. Health Wearables, Apps & Information Protection [Internet]. [cited 2018 Aug
1]. Available from: https://assets.kpmg.com/content/dam/kpmg/pdf/2016/05/Health-
10. Sifferlin A. What the Netflix Documentary “Bleeding Edge” Gets Right About the Dangers of Medical Devices in America [Internet]. Time. [cited 2018 Aug 1]. Available from:

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