Despite predictions for the ECG monitor market to grow, the current products available typically provide limited recording and intermittent monitoring resulting in inaccurate data captured, while also not adequately addressing wearer comfort.

How can product designers create an accurate, discrete and non-invasive solution for monitoring the heart over extended periods?

This problem was at the core of the solution for PA Consulting when Chief Design Officer Cormac Ó Conaire personally experienced the impracticality of a Holter monitor. The idea for Viscero - a non-intrusive, non-invasive solution designed for users to wear independently for everyday monitoring - was created when the team recognised a gap in the market for a more comfortable yet discreet wearable device.

Heart health issues are on the rise

According to the British Heart Foundation, as of June 2023, there are approximately 200 million people globally living with heart disease. Conditions linked to heart disease can cause arrhythmia, an abnormal heartbeat ranging from harmless to life-threatening, with atrial fibrillation (AFib) being the most common type.

AFib involves irregular contractions in the upper heart chambers, potentially leading to severe complications like blood clots, stroke, and heart failure.

The Centers for Disease Control and Prevention estimate that by 2030, approximately 12.1 million people in the United States will experience AFib annually. This projection highlights a looming need for increased electrocardiograms (ECGs) to effectively monitor heart conditions in the coming years.

While an ECG is a simple yet crucial test for checking heart rhythm and electrical activity, current tools used by doctors present consistent challenges across the board.

The best example of this is the widely used Holter Monitor. However, as a piece of equipment, its bulky inconvenience acts as an inadvertent reminder to users of their health, something many don’t want to experience. Holter Monitors restrict natural movement, making everyday activities awkward, while its data collection is often unrepresentative and thus unhelpful.

Other alternative long-term solutions like Implantable Loop Recorders (ILRs) can be intrusive, requiring anaesthesia during insertion which in itself introduces a host of potential complications.

Marrying practicality with comfort

The Viscero prototype took shape in the PA wearables lab, with a clear initial aesthetic goal – a lightweight vest easily worn under clothing. The technicalities, however, demanded a rigorous prototyping process to ensure the practicality of the device didn’t outweigh its purpose.

Viscero records heart rate signals through printed electrodes strategically placed beneath the fabric around the arm and waist. The innovative use of electronic ink creates a pattern along tailored compression points. These points - integrated with precision through lamination - are positioned away from the chest to ensure consistent compression points are maintained.

This design diverges from the traditional use of "wet electrodes," which rely on a gel applied to the skin which often slips off over the monitoring period. The electronic ink in Viscero ensures monitoring follows necessary compression points using "dry electrodes."

Cross-sector collaboration

PA Consulting collaborated with clinicians throughout the design process to determine the best way to collect and filter data. The ECG circuit system combined with a small pod device - referred to as the “brain” - incorporates an accelerometer and gyroscope to provide a fuller picture of recorded heart signals, including highlighting changes caused by activities like exercise.

Being the size of a matchbox, the “brain” comfortably sits in a shirt pocket designed to be easily removed for recharging, while the shirt itself is machine washable.

The circuit system links to the healthcare professional's dashboard, utilising AI to segment recordings into pre-arrhythmia and post-arrhythmia, with leading cardiologists commending the signal quality of Viscero's ECG waveforms as "diagnostic quality data". The data can be triaged for cardiologists to review, with the AI layer facilitating the identification of irregular patterns, saving hours of scrolling through ECG recordings.

The patient's app is designed for effortless interaction and direct connection with their healthcare consultant, giving the user peace of mind.

The concept of Viscero underscores the importance of innovation in health tech and the future of wearables. Our clothing has the potential to become pieces of smart technology that can dramatically improve lives. Designers and entrepreneurs shoulder the responsibility of conceiving purposeful applications of technology for people, transcending the mere embedding of novel technology into our daily wear.

Creating the next generation of wearable devices necessitates cross-disciplinary skills in soft textiles, hard goods, electronic components, UX, UI, and system design. Most importantly, the person wearing and using the device needs to be comfortable and feel as though it's part of their everyday wear, a key component at the heart of the design process for Viscero.

The future of health monitoring

With the increased focus on health and fitness apps available on smartwatches and wearable devices, 'digital wellness' is playing an increasingly significant role in our lives. The rise in demand for digital wellness - highlighted in a report earlier this year on Connected Wearable Devices in Healthcare - is driven by better R&D and enhanced functionality for remote monitoring. This surge in demand doesn't just point to a burgeoning market for wearable health tech but also signifies an industry-wide response to a growing need.

It is clear that healthcare is shifting from a reactive response towards more proactive interventions.

How data is garnered is equally shifting. From data fragmentation where health is measured in a narrow timeframe using hospital equipment to continuous monitoring by small, portable devices in the comfort of people’s homes; the demand for wearables in health monitoring is a mutually beneficial advancement for both patients and healthcare professionals.

The continuous, real-time nature of the data provided by wearables, like Viscero, revolutionises healthcare by enabling early detection, personalised interventions, and a more engaged approach to individual health management.

But, most importantly, health tech wearables like Viscero enable patients to reclaim autonomy over their health, a core principle that designers in the field should ensure is central when creating future wearable devices.

Author details: Sara Urasini is Head of Wearables at PA Consulting