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Introduction
Pain Technologies in the Pipeline: Doctors' Rounds at CES 2020

Pain Technologies in the Pipeline: Doctors' Rounds at CES 2020

The time-honored tradition of medical rounds once again took on new meaning at the annual Consumer Electronics Show (CES), held in Las Vegas in January. For the more than 1,500 estimated clinicians attending this year’s meeting, of great interest was the show’s veritable “Doctor’s Digital Rounds” where participants were encouraged to make rounds among the more than 2.9 million square feet of exhibition space to observe and examine emerging state-of-the-art technology.
 

In addition to lectures and courses on digital medicine, technologic breakthroughs in diagnostic solutions, remote patient monitoring products, as well as pain management strategies were on display. Here, a few highlights from a pain clinician’s perspective.

Artificial Intelligence (AI)

Next-generation AI software diagnostic technologies are emerging that can be deployed in clinics and at the bedside to monitor patients’ pain patterns, based on facial pattern recognition. Camera images are analyzed through specialized software to detect and track pain progression.

Portable Diagnostics and Monitors

A blood glucose monitoring wristwatch called Glutrac is non-invasive and incorporates a variety of physiologic functions, including electrocardiography, dynamic metabolic heat monitoring, photoelectric plethysmography, and absorption spectroscopy. Such devices can help to monitor glycemic control and potentially avert future end-organ pain-related complications of diabetes, such as peripheral neuropathy.

The blood pressure monitor HeartGuide is a wearable that utilizes FDA cleared oscillometric methods. Complete is a tabletop blood pressure and EKG monitor being touted as the first such commercially available device. Both devices are from Omron and may play a point-of-service role in vital sign monitoring in pain clinics as well as in post-procedure tracking. Data can be shared in a HIPAA-compliant fashion automatically.

Focus KneeTENS, a wearable customized pain relief option for the knee that incorporates a digital component. Unlike traditional or classical TENS, this device is controllaed by an app.

Pria provides an automated medication manager and home health assistant that can be controlled by voice. Using smartphone app integration, it allows caregivers to monitor a family member’s medication and healthcare schedule remotely.

A novel handheld ultrasound probe system called Lumify attaches to a tablet or smartphone. Software for the device resides on the smart-technology platform, allowing optimal ultrasound wave penetration and image quality. The device can be deployed in pain clinics for a variety of anatomical applications including MSK structures and used for diagnostics or needle localization.

An electrical stimulation device called Clear Up offers a form of portable, microcurrent neuromodulation for pain associated with allergic rhinitis.

An innovative handheld, “breathalyzer style,” non-invasive device that claims to automatically and synchronously measure vital health parameters such as pulse rate, respiratory rate, O2 saturation, blood pressure, and heart-rate variability. Known as Mouthlab, this portable is not yet FDA approved.

Virtual Reality (VR) Programs

VR headsets that display peaceful imagery may help to adjunctively optimize pain management with no side effects. Companies such as AppliedVR market a device that has the potential to wean patients off opioids using distraction techniques. By capturing the patient’s attention, there is a putative dampening of the nervous system’s ability to process pain signaling.

In the clinic, special VR modules allow pre-op pain patients to experience a “virtual” injection and/or procedure through the lens of a VR headset. This allows for better understanding of the procedure and, ultimately, a higher level of patient satisfaction.

Other Emerging Technologies

Smart home devices: For patients with chronic painful, disabling conditions, such devices provide security and remotely control appliances.

Sleep-aid technology: For those suffering from sleep-altering pain conditions (eg, fibromyalgia) or those experiencing insomnia or other sleep disturbance, there are novel devices such as Smart Sleep, a wearable chest strap that enhances the quality of sleep by measuring snoring and providing a subtle vibratory stimulus to change positions.

Accessibility: State-of-the-art technology that makes the world more accessible to patients with disabling conditions including pain-related movement restrictions can be a therapeutic “game changer.” Operating system adaptations performed within common OS platforms such as Windows and iOS both offer built-in support for eye control, potentially allowing pain patients with crippling hand and arm arthritis to bypass the use of a typical computer mouse. This, in turn, may create opportunities to improve learning, communication, and mobility and enhance quality of life for those with pain-related disabilities.

Infection control for clinics: a newly minted clinically proven portable device called PhoneSoap is a compact chamber the size of a paperback book. It is equipped with an ultraviolet C generator that has been clinically tested to neutralize common household and clinical bacteria. (See related material on coronavirus and sanitation).

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