COVID Opens Door to Comfort With Rise in At-Home Medical Tests

Pulse is pending FDA approval. It is expected to cost around $300, arrive around midyear and initially be available by prescription only, the company says. Data is pushed to a mobile app and back to the health care provider monitoring the patient’s progress.

“There’s an increased opportunity for people to be more in control of their health data,” says Mark Gorelick, chief product officer of Conneqt parent CardieX. “Trend data is what’s really important: Is there a change over time?”

• Testing eyesight. EyeQue in Newark, California, sells the portable FDA-registered EyeQue VisionCheck vision kit. You attach the device to your phone using micro-suction tape and an elastic band. After bringing it up to your face, one eye at a time, you’re guided through a series of refraction tests to take measurements you can use to order eyeglasses online.

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It pairs via Bluetooth with an app on your phone. EyeQue’s vision monitoring kit, including glasses, currently costs $179. The company cautions users that the kit should not replace the need for an eye health exam.

Separately, Visibly in Chicago announced in August 2022 that it became the first company to have an FDA-cleared online visual test.

Are self-tests smart medicine?

Home tests can help you catch problems early and begin treatment. They may keep costs down as well. Moreover, a self-exam at home can calm jitters and reduce the stigma associated with certain tests.

However, some users may experience the opposite. “Oftentimes you have people that are looking for a problem,” Pride says.

Gorelick of CardieX mentions, for example, people who are worried about their sleep habits. They can use an Apple Watch to track their sleep and display detailed information in their iPhone’s included Health app. Users of Android smartwatches such as the Samsung Galaxy Watch 5 can do the same.

“We see individuals who are more nervous because they’re testing their sleep all the time, and now they can’t sleep because of their sleep data,” he says. His company doesn’t currently have its own sleep-focused products.

Here are some important questions to consider about the reliability and validity of home tests:

• Could you mess things up if you don’t follow instructions exactly?

• Are the tests using the latest medical science?

• Is the data kept private and secure?

“To get people to adopt these types of products, … they have to get something in return and understand how data is being used,” says Ray Rosti, chief digital officer at Publicis Health Media, a Philadelphia-based health care marketing company.

Can you trust the results?

Most critically, patients must have confidence that the results of home health tests are accurate — and be able to easily understand them. Patients also need to know when they ought to seek immediate medical attention. And if they have any doubts, they should consult a health care provider.

In general, medical-grade devices that have gone through extensive clinical trials and peer review and have earned the federal government’s blessing are more trustworthy. But lots of devices, even some that may prove beneficial, are categorized under a less well-defined “wellness” umbrella.

What’s more, a positive or negative result is one thing. You presumably have COVID or you don’t. But some tests’ results may be murky or fall into a borderline range.

Tests have “got to be simple to do and simple to interpret,” Pride says. And occasional false positives are inevitable.

“In my experience, every test is an answer to a question,” Abbott’s Rodgers says. “The more tests that are done, the more answers that are out there and the more accessible health care can become.”

Some products are hybrids. The electrocardiogram feature on an Apple Watch or Fitbit that can detect an irregular heartbeat or atrial fibrillation (AFib) required FDA clearance. Other features in these wearables did not.

“We’ve got to work through that balancing act and learn as a community how much we want to do at home without the doctor and when you reconnect with the health system,” says Australian global futurist Bruce McCabe, who focuses on medicine, AI and other technologies.

Be prepared for more in-home tests

What comes next? Pride at UC San Diego says tests will be available for any simple microbiology-related issue you can think of. “All of those sorts of things are kind of out there, and instead of being at the back of the mind, where they were before, they’re really at the front of the mind.”

But not every area of medicine is ripe for an at-home diagnostic test.

“It’s hard for me to imagine it ever will be black and white for cancer,” Pride says.

Even so, in lieu of an invasive colonoscopy, some people choose to take their own stool sample and send it off to a doctor or a lab through a fecal immunochemical test (FIT), guaiac fecal occult blood test (gFOBT) or FIT-DNA test, such as Cologuard. Most require a prescription. You’ll still need a colonoscopy if you get a positive result.

Further health insights from your voice

McCabe envisions more single tests that can detect four or five different conditions at a time. And he sees an increased role for AI-based chatbots and what he refers to as “unobtrusive diagnostics.”

With devices like Google Home, Amazon’s Alexa and Apple’s Siri, “our home is equipped to listen,” he says. “There is a very straight line you can draw between that and offering diagnostic services [based] on your speech patterns, various intonations [and] word choices.”

Indeed, biometrics monitoring is also on the cutting edge, including the use of voice. The AI-powered HearO app, in clinical trials from an Israeli company called Cordio Medical, can predict when a patient suffering from congestive heart failure has a worsening condition based on real-time speech analysis.

A patient establishes a “vocal signature” as a baseline by speaking to the app, which can then detect an early buildup of fluid in the lungs, ahead of any symptoms. Alerts can be dispatched to the clinician monitoring the patient.

CEO Tamir Tal says the app has a more than 80 percent accuracy rate in predicting a heart failure event 18 days in advance. Research into voice biomarkers is being conducted for Alzheimer’s, cancer, cardiology, cognitive impairment, COVID and Parkinson’s disease.

Meanwhile, insights may also be drawn from cameras. At the CES trade show, Samsung demonstrated how a camera connected to a television can measure a person’s heart rate, heart rate variability, oxygen saturation, respiration rate and stress.

“It doesn’t have to be a wearable,” McCabe says. “We can do a lot of background diagnostics in your home by combining [biometric] factors. To me that is one of the most exciting frontiers of all.”