Presented by Presage Technologies

Video is the future of healthcare, and computer vision breakthroughs are the key, says Coryn Ramirez, director of marketing at Presage Technologies. With new cutting-edge signal and image processing methods, it’s now possible for an ordinary phone camera to measure everything from heart beats to electricity, even under the most challenging conditions, including highly variable motion and lighting. Right now Presage Technologies is applying that capability to a broad range of emerging applications in healthcare and beyond.

“We want to increase the equity and the accessibility of healthcare for both provider and patient,” says Ramirez. “We see some of the barriers here where access to remote medicine or vitals shouldn’t be a $400 Apple Watch. We want to tap into the power of video to make it more efficient, more cost-effective, and safer for all parties.”

Presage Technologies has applied these advances in computer vision to a vitals by video platform that can capture and analyze vital signs, no matter where a patient is or what they’re doing. It’s continuous, passive video monitoring that’s also contactless – there’s no need for any type of wearable. Continuous monitoring means all the data is put into context, as a patient moves through their day and various levels of exertion. The technology can currently identify and track heart rate and heart rate variability, respiration rate and respiration quality. They’ve demonstrated the ability to capture oxygen saturation, and they’re working on blood pressure measurement now.

It’s a huge game changer for the healthcare industry in a broad array of applications, addressing industry concerns about safety, cost, equipment, environment and other unique scenarios. Yet it has applications outside the healthcare industry too, says Dr. Aya Eid, director of biomedical imaging at Presage.

“Wherever physiology has informative significance, we can provide value there,” Dr. Eid says. That includes applications that range far outside a doctor’s office.

An expanding number of use cases

Healthcare is composed of multiple settings, Eid says, starting first at home. If you’re acquiring your vitals every time you use your cell phone, those statistics can be integrated with your primary care or hospital management system. Then every time you connect with your physician, they can look at trends instead of single data points acquired once a year. Safety for both the patient and the provider is better served when you’re contactless, as well, and vitals by video make remote medicine more effective.

In the hospital setting, remote monitoring can be used in the emergency room for triage. And when there aren’t enough healthcare providers to care for patients, automatically monitored vitals reduce pressure on healthcare personnel and improve patient care.

In the NICU, where babies are already monitored by video constantly, vitals by video can replace or reduce the amount of cables or electronics that are sitting with and attached to a newborn child.

There’s also a lot of promising work happening around models that can predict patient outcomes, and determine when a patient should be discharged. The more data, the better these models perform, and continuous monitoring can make all the difference. Once the patient gets home, these models can help determine what further care a patient requires, which helps reduce re-admissions.

In longer-term inpatient care situations, such as the elderly population in nursing homes, nurses are often short-staffed, and that’s where constant monitoring can be invaluable. Plus, continuous monitoring of patients with severe disabilities, or following a traumatic event such as stroke or brain injury, can be a literal lifesaver.

In non-traditional healthcare settings where there’s a need to monitor mental and physical well-being, such as prison settings, video-based metrics and video-based analytics can not only measure vitals, but also measure changes in behavior, or erratic activity.

Overall, there’s also a significant cost reduction in both personal protective equipment (PPE), as well as cost for the actual employees who have to take vitals from patients on site.

“Right now vitals take on average five minutes, one second and cost $2.84 million for every 1 million patient visits in nurse time alone, in an industry where there’s a shortage of nurses,” Ramirez says. “With our software and technology we can drive that to a fraction of the cost.”

In battlefield medicine, medical staff refer to the “golden hour,” or the first hour after a traumatic injury occurs. It’s considered the most critical hour to address an injury, before the patient’s prognosis starts to decline. Soldiers often have to step in and handle injuries while they wait for aid. Instead of having to carry health equipment, they can simply carry a phone to take vitals immediately and better address an injury on the battlefield.

Integrated with a drone, the technology can also help triage mass casualties or situations where there are numerous injured people in an area. That gives EMTs the information they need to address the patients who need immediate assistance.

There’s also a huge application in the fitness and wellness industry. The rise in in-home fitness devices such as Peloton and smart mirrors has also increased consumer interest in products and services that monitor vitals while exercising. It can directly impact the bottom line for companies like Peloton, Ramirez notes.

“The company’s heart monitor costs $49, and switching to our software can result in massive savings there,” she says. “That leads to lower prices for consumers while also delivering higher margins for Peloton without any supply chain, shipping, and returns, or need for cleaning between users.”

On the wellness side, there are applications for athletes, and in physical therapy, to monitor and enhance performance. It can be used in biofeedback-based applications to reduce stress, lower anxiety and improve psychological well-being. It could even be embedded in a car monitor to reduce drunk driving or ensure that a truck driver isn’t too fatigued to drive.

Video monitoring under the hood

Presage is committed to ensuring that the technology uses explainable algorithms, says Dr. Jim Winkelmann, Presage’s director of biomedical engineering.

“We believe that developing explainable algorithms allows us to gain a lot more trust with the physician, and also gives us a huge competitive advantage with regulatory bodies,” Winkelmann says. “The FDA isn’t going to like it when you say, ‘We don’t know how this does it, but it does it.’ That won’t fly very well.”

That requires specialized education in medicine and physiology. To that end, the team includes biomedical engineers from top universities. Team members have also explored further education, with classes like biological fluid mechanic classes to help understand blood flow, and advanced light scattering classes to help them understand how light interacts with tissue.

The technology works by sensing minute, nearly invisible changes in the patient’s face. When a heart beats, it sends oxygenated blood into the face. When the heart relaxes, the remaining blood is primarily deoxygenated. Because oxygenated and deoxygenated blood have slightly different colors, faces actually change color as the heart beats.  

From that, they’re able to extract the blood flow trace, which gives up heart rate and variability data. Color analysis can reveal blood oxygenation, and other aspects of that blood flow offer blood pressure data.

“Our robust, explainable algorithms are able to do all this in very dynamic situations,” he says. “We’ve extracted breathing and blood flow traces on treadmills, exercise bikes, and brushing teeth. We’ve even done it in the dark.”

They’re ensuring that the data is as accurate and unbiased as possible by emphasizing diversity in the company’s teams, both with respect to expertise and background, as well as diversity in the data they use. And these video solutions can be tailored to whatever the client’s architecture or use case is.

“We see that video is the future of the healthcare industry, and we want to tap into that to make it more efficient, more cost-effective, and safer for all parties,” Ramirez says. “Vitals by video is safer for both patient and provider, significantly cuts costs, and allows us to collect data that we couldn’t before, in an equity-conscious way, to improve patient outcomes across the board.”

Learn more about how computer vision is unlocking the future of healthcare here.

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