Technologies for Healthy Independent Living for Heart, Lung, Blood and Sleep Disorders (R43 - Clinical Trial Not Allowed)

The average age of the U.S. population is climbing because people living longer. Chronic health conditions related to heart, lung, blood, and sleep (HLBS) disorders are becoming more prevalent as part of natural aging. Technological advances and the needs of older adults create an opportunity for the design and development of home digital health technologies that could enable functional independence for aging adults, people with disabilities, and those with chronic HLBS conditions, including mild impairments associated with aging. Home-health and mobile-health technologies are expected to function not only as monitoring devices, but also as essential components in the delivery of healthcare.

This Funding Opportunity Announcement (FOA) seeks research applications for the development of technologies that monitor health or deliver care for aging adults with HLBS disorders and persons with disabilities in a real-time, accessible, effective, and minimally obtrusive way. These systems are expected to integrate, process, analyze, communicate, and present data so that the individuals are engaged and empowered in their own healthcare with reduced burden to care providers. These may be novel sensors, including wearables, or monitoring systems related to the NHLBI mission, home-use point-of-care devices, home or mobile therapy or rehabilitation tools, or information systems and should have the goal of fostering healthy and independent living for people with HLBS disorders.  The development of these technology systems has the potential to improve the quality of life for people with disabilities, aging adults with mild impairments, as well as individuals with chronic conditions, including HLBS disorders, and remain at home for a longer time. 

Technologies that detect significant acute events or signals of declining function in the home or wherever the person goes may create a meaningful improvement over the current method of monitoring through a provider visit thus reducing time to intervention. These technologies have the potential to capture rare, irregular, or transient events; symptoms that are difficult for a patient to report; and changes in HLBS conditions that evolve slowly over time. The technologies should also be reliable, robust, safe, and simple (four traits also found as technical features); be aesthetically acceptable and unobtrusive; uphold the patient's privacy preferences; be easy to use and have intuitive user interfaces with consideration for user disability or impairment; provide feedback in meaningful forms, whether auditory, visual, or tactile; maintain or promote social engagement; and address heterogeneous populations and regions of the country (e.g., rural vs. urban) in which one size does not fit all.

Examples of health technologies that are expected to achieve wider adoption by older adults include remote patient monitoring tools that connect blood pressure cuffs, blood glucose meters, and heart rate monitors to the Internet to support self-monitoring and ongoing monitoring by clinicians and care teams; telehealth and secure messaging tools that support care delivery to and from remote locations; and online tools that help individuals access educational and health information and connect with social networks through online communities.

There are barriers that prevent effective use of technologies by older adults, including: access to technology on a fixed income, slower recall and forgetting or losing the technology, physical challenges in using technology, uncertainty about how technology may provide benefits, and difficulty learning to use modern technologies. Currently, the design of digital technologies does not consider the unique challenges older adults face such as poor vision, poor hearing, poor sensory perception or mobility, and thus often results in poor adoption by this population. This FOA is intended to support the development of new technologies and adaptation of existing technologies to meaningfully accommodate the needs of older adults and address their unique problems and challenges.

See Section VIII. Other Information for award authorities and regulations.