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High-Tech Health Breakthroughs

Popular Mechanics

From Magnetic Brian Stimulation to Implantable Nanowire ...

Sensors to measure electrolyte levels

"Swiss company Biotex is developing a garment with wireless sensors embedded in the lower back to provide real-time values for similar metrics. Hydrophilic and hydrophobic material draws the sweat into flexible sensors just two millimeters thick and a few square centimeters.

Monitoring levels of sodium, potassium, sweat rates and sweat pH is all within reach. Understanding how to interpret and adjust per the data is still to be determined. Medical applications for diabetics and obese children are also being pursued."

Popular Science

Cell Phone Microscope

"The goal of the project, named CellScope, is to make clinical quality microscopes accessible to patients in developing countries. Clinical quality microscopes are necessary for even the most basic medical evaluations, and in developing countries the scarcity of medical equipment is exacerbated by the lack of qualified medical personnel, especially in rural areas. The new cell-phone telemicroscope will allow people with very little means to receive diagnosis and appropriate treatments according to the remotely interpreted microscopy data. "

The Future of Things

The Networked Pill

"In the Raisin system, each pill contains an "ingestible event marker" (IEM). The IEM consists of a sand-grain-size microchip with a thin-film battery that is activated on ingestion, as it is exposed to water. The battery, Proteus says, is nontoxic because it is made from materials similar to those in a vitamin pill. Once swallowed, the IEM sends through the body's tissues a high-frequency electrical current that's modulated in such a way that it provides a unique marker of the pill. It's not an RFID technology: it uses the conductive tissues of the body to conduct the signal, rather than a radio, and the signal is confined within the body...

The electrical current is picked up and logged by a receiver on a patch placed on the patient's chest or abdomen, or placed underneath the skin as a subcutaneous insert. The receiver also contains sensors that monitor physiological parameters such as heart rate, respiration, and bodily movement. Heart rate is monitored by detecting the electrical activity of the heart; respiration is monitored by detecting changes in the impedance of the electrodes as the chest expands and contracts; activity is monitored with a miniature accelerometer, similar to the ones in iPhones. Combining the parameters can reveal behavioral measures such as sleep patterns...

Once collected, the data are uploaded to a server via a cell phone or a PC for a caregiver's scrutiny. The patient can then be advised to adjust dosages or change medications."

MIT Technology Review

Healthcare - Three way matching

At the HiMSS conference a couple of weeks ago, I had the privilege of having an industry veteran - Dave Watson - as a tour guide through the exhibit hall. He has years of experience at Baxter, Kaiser and is now CTO at MedeFinance and it was a joy to hear his commentary on the technologies on display.

But at one point, he mentioned "three way matching" and I had to do a double take. Why was he talking about an age-old accounts payable concept of matching invoice with purchase order and receiving report?

Because the concept has been adapted in healthcare to reduce medication error with some slick new technology. The three-way match is across patient, prescription and care giver (whether certified to administer the medication) information. And involves all kinds of RFID and other sensors, bar codes, software to check on conflicts, and drug dispensers with their own controls built in.

How bad is the medication error problem? A recent study reported "One in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes"

So we saw the Motion C5 tablet.

Look at all the capture and communication technology it integrates:

wireless connectivity: to access patient information and physician’s order. 

RFID: to identify patients, medications and assets 

integrated bar code reader: to manage medicines or costly supplies 

integrated digital camera : to take pictures and capture video for patient education and sealed design: wipeable for quick cleaning and disinfecting 

bluetooth: to help capture patient vital signs 

security: integrated fingerprint reader, hardware based encryption 

Then on to smart pumps like Hospira's Symbiq which delivers precise amounts of fluids, medications, blood, and blood products.

More safety checks - this time between the patient code, the IV bag bar code and the pump bar code. A wireless link connects both the pump and the bar-code scanner to the main database, which matches patient, order, and pump. If correct, the order is checked against the hospital drug library that contains formulation and dosing guidelines. Once verified, the pump is automatically programmed and the infusion can begin.

For pills, there are other smart dispensers such as this Medicine Cabinet developed by Accenture

At the show we also saw various voice recognition products from Nuance. Doctors are notoriously poor scribblers so dictating prescriptions can also reduce other medication errors.

Of course, as with accounts payable, you can also have a 4 way match by introducing cross-check with an inspection report. My wife who works part-time at a hospital tells me about the four-way match in health care: The patient who asks "how come my pill today is pink. It was blue yesterday" . Inspection report indeed.

Healthcare: Back to the Future

I spent some time at the McKesson booth at HiMSS this week.

Mike Myers, SVP told me about the excitement in the industry about DNA markers and how they could revolutionize early detection of disease and also help customize solutions to each patient. Since the Human Genome Project was completed in 2003, there has been growing progress towards predictive medicine. Mckesson has teamed with Proventys which "translates predictive data from traditional and emerging diagnostic tests, including genomics, proteomics, and metabolomics, into clinical decision support solutions."

Then I walked over to see their "1080p, diagnostic image quality" front end to their Horizon Medical Imaging products. The touch-screen technology allows physicians to highlight and enhance images for viewing. Physicians have always loved to look at images this way and that. I know John Madden gets credit for popularizing the telestrator but you should see what physicians do to mark up images on the touch-screen.

Then, with a neat application of unified communications, with a sweep of the hand, they can send an image to a colleague’s iPhone. And using a bluetooth headset, also discuss it. There are plans to also integrate with billing and other applications.

Old genes - and old practices. Brand new technology.

Diabetes Devices

BusinessWeek

"Medical-device manufacturers and industrial designers alike are increasingly using popular consumer electronics, from MP3 players to cell phones, as inspiration for easy-to-use and unobtrusive diabetes-management tools. The goal is to provide diabetics with equipment that fits as seamlessly into their lives as, say, an iPod, complete with an intuitive interface and a "cool" design factor that encourages patients to monitor their health and self-treat the disease."

A camera for Alzheimer's?

"An entire day's events can be captured digitally on a memory card and downloaded onto a PC for subsequent viewing. Using specially designed software, the Microsoft researchers can convert the pictures into a short movie that displays the images at up to 10 frames per second, allowing a day's events to be viewed in a few minutes."

"All Alzheimer's patients have a deep anguish due to their perceived, although usually not confessed, inability to remember their recent past. Being able to go through the recent events may have a reassuring effect."

MIT Technology Review

The Cutting Edge of Medicine

This article in Discover is a bit gruesome, but fascinating

"Located at the University of Miami/Jackson Memorial Medical Center, Ryder is one of only three freestanding facilities in the United States designed from the ground up as a trauma center, making it a model of streamlined efficiency. Housed within the structure is everything needed to do the job: resuscitation bays, operating rooms, CT scanners, an intensive care unit, a burn unit, and a rehabilitation department. On the building’s roof is a helipad (40 percent of its patients come by air). Ryder owes much of its success to the fact that Florida was among the first states to have a coordinated 911 system and was at the forefront of setting up regionalized networks for transporting patients quickly to hospitals with the equipment and expertise to treat their injuries. Florida invested heavily in both Ryder and in a community-based system of care—and it paid rich dividends. Trauma is the leading killer of people aged 1 to 44, and Florida’s system has reduced preventable deaths from serious injury by half."

St. Petersburg Times adds

"For two weeks, 28 Army medics, nurses, doctors and nurse anesthetists have been learning trauma medicine and teamwork under pressure at the Ryder Trauma Center at downtown Miami's Jackson Memorial Hospital, a place that sees such carnage it often resembles a war zone."