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Wireless Health: Technologies, Trends and Take-Up
Peter Lewis, Hydrix
A message from my sponsor:
Hydrix is the largest software & electronics design consultancy in Australia
Experienced : Desi...
Wireless Health or mHealth sits at the
intersection of traditional healthcare,
telecommunications & technology
Five different areas
are combining to
create a vibrant
wireless health
sector:
Devices
Connectivity & Networks
Consumer In...
Devices
Smartphones
Tablet PCs
PDAs
Sensors
= ultra portable
ultra small
ultra low power
ultra powerful
Connectivity & Networks
Short range Long range Wired
= easy to get data from the
patient to the device to the
doctor
Wifi / 802.11 / Wireless LAN
• Local Area Networking technology
• Wireless extension of ethernet (50m - 100m)
• 54MB/s - o...
Zigbee
• Mesh networking technology
• Control and monitoring (10-100m)
• Self -configuring & healing networks
• Topology: ...
Bluetooth
• Personal Area Networking technology
• Cable replacement btw devices (<100m)
• Standard for PCs and smartphones...
RFID (Radio Frequency Identification)
• Tracking technology
• Passive (3m) or active (100m)
• Topology: tag to reader
• Co...
Cellular
• Wide Area Networking (WAN) technology
• 10 - 15km
• Topology: Point to point
• Complexity: high
• Power: high
•...
Wired Cable
• Wide Area Networking (WAN)
• Fibre to every premises
• Topology: Point to point
• Complexity: high
• Power: ...
Consumer
Interest
Apps for:
iPhone
Android
Nokia
etc
Increased use of IT by Doctors
99% of doctors physicians use the
internet in their practices
80+% of nurses direct patient...
Rising Health Costs
Ireland
Denmark
S. Korea
UK
Germany
Netherlands
Finland
Spain
Italy
Sweden
Switzerland
France
Australi...
MediApps.com
Rising Health Costs
The combination of the five driving forces
of wireless health is causing a steady
migration of point of care from
the hosp...
As a result we are seeing innovation across many areas:
Monitoring
PERS
Telemedicine
Mobile Medical Equipment
Mobile Healt...
How Big is the Wireless
Health Opportunity ?
But what about the three 100 lb gorillas in the
corner?
And increasingly the
4th 100 lb gorilla:
So what are the sort of applications
and devices we are starting to see in
the market ?
University of Florida researchers have created
a pill capsule designed to signal when a patient
has swallowed it
The pill ...
Japanese firm Scalar Corp has developed a the
AirMicro wireless microscope that can transmit
video to the iPad or iPhone.
...
The AirStrip series of applications for
Smart phones are a collection of
mobile services that allow doctors to
monitor pat...
The NETRA tool from MIT provides eyesight tests on a smartphone
Technology – built in camera and image processing dsp
http...
An app invented by Peter
Bentley form London’s
University College turns an
Apple iPhone into a
stethoscope.
“…Experts say ...
The OsiriX Radiology App for
the iPhone was unveiled at
the end of 2009
Invented by radiologists, the
app allows doctors l...
Cough
Now A new iPhone App being developed by
Star Analytical Services is designed to
diagnose respiratory disease using t...
Thank You !
Peter Lewis
peter.lewis@hydrix.com
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Hydrix ausbiotech presentation wireless integration of medical devices 22-10-10

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An overview of the technologies, trends and take-up of wireless integrated medical devices.

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  • Who is this Hydrix group
    Why are we qualified to talk about biomedical devices or wireless ?
    Largest dedicated software and electronics design consultancy in Australia
    Focus on Biomedical, Industrial, Mobility/Wireless and Scientific instrumentation
    Clients across Australia, the US and Europe
    Well qualified having taken products through to FDA and TGA approval, as well as being ISO accredited in a number of areas including quality & environment.
    Only Apple accredited developer and manufacturer for software and electronics for the iPad and iPhone in Australia – the reason why will hopefully become clear over this presentation

  • So onto the topic of the presentation
  • The growth of the wireless medical device industry has 5 drivers, only some of which are technology related.

    And of course, that oil of industry ,money, plays a major role as we will see

    As the Chinese say may you live in interesting times - and for anyone playing at the intersection of these 5 drivers, as Hydrix is, they are interesting times indeed

    So lets look at the five areas in a bit of detail…

  • Hands up if you have a mobile phone – keep your hands up if it is a so-called smart phone

    smart phones and tablets really are very powerful mini-computers that just happen to also make phone calls
    Give it to your kids when your plan runs out in 2 years - there’s a relentless push to improve the speed, features and pricing of mobile phones.

    The wonderful side effect of all this innovation is all the spinoff technologies – longer lasting batteries, higher resolution screens, faster processors - …all of which plays right into our wireless medical device hands

    And these smart phones all already have significant diagnostic capabilities, and current application, BUT of course devices aren’t just phones – biological sensors and wireless enabled Point of care devices are also a huge area of growth in their own right. The Biomedical Wireless sensors network project in Scandinavia has already successfully integrated heart monitoring, ECG, Oximetery and other wireless sensors in a mesh network in a body and reporting data in real time via an encrypted cellphone link to a physician
  • Connectivity – this is all about how relevant medical or diagnostic information gets from the patient - to the medical device and from the device at the point of care – which increasingly may not be the doctor’s rooms or the hospital - to the healthcare provider

    What we are seeing is an integration of short range technologies that can capture patient data combined with long range ones that can send the data to the health care giver

    Some of these such as Wifi or Bluetooth you may have heard of but I have been asked by Scott our Chair today to explore each of the relevant enabling technologies in a little bit of detail - and don’t worry I promise not to be too geeky or technical.

    Other wireless technologies such as UWB, wireless USB and WiMAX which are about but little uptake and little ingress into Biomedical devices yet.
  • You probably have all heard of wifi or 802.11 if you’re engineering inclined. Invented by Australia’s CSIRO, this is the technology that lets our computers connect wirelessly to the internet or each other via a router.

    Can send lots of data relatively long distances very fast – up to 54 megabits a second - which makes it ideal to transmit tremendous amounts of information - perfect for sending large files, eg x-rays or other information

    Operates in the mostly globally unlicensed 2.4GHz, 3.6 and 5Ghz bands

    Due to power constraints is mostly used as a fixed wireless infrastructure

    Moderate price for chipsets
  • ZigBee® - A ‘Mesh Networking’ technology that is a key driver towards wireless automation and ubiquitous computing
    ZigBee® is optimised for very low current consumption – talk on the forums of batteries that will last 10 years
    It can form networks that self-configure and even self-heal in the event that a node fails and up to 256 or more devices
    Peak data rates to 250kbit/s and operates in the unlicensed 2.4GHz band, so ideal for monitoring or controlling small devices
    Very cheap
    The technology to watch


  • Bluetooth
    Operates in 2.4GHz license-free band
    Bluetooth version 4 combines UWB and low power to achieve data rate up to 24MBit/s
    Numerous profiles developed for file transfer, audio transfer etc
    Cheap chipsets about $2
    Mostly used to date by mobile phone manufacturers for ear pieces and car kits but standards group is actively pushing into other arenas
    .
  • RFID

    Mostly used for fixing to things that need to be tracked – eg hospital supplies etc
    RFID has a couple of basic types of tag. Passive tags have no power source of their own and only power up when quizzed by a powered reader at a distance of 3m typically
    Active tags are self-powered, usually by some type of battery ad can actively and intensively transmit and process data, and over considerable distances – up to 100m.
    Tags are pre-coded with small amount of information which is typically read only
    Very very cheap

  • Cellular
    A ‘Wide Area Networking’ (WAN) technology that is enabling the mobile phone revolution. Cellular systems depend upon a ‘basestation’ infrastructure managed by a third party. Nevertheless, cellular allows transmission over large distances without need to create an infrastructure (as long as it exists).
    Many flavours – GSM (Global System Mobile), CDMA (used in US), LTE – Long term evolution
    Long distance – several kilometres
    Data rates from 9.6kbits (old 2G) to 2Mb/s for 3G to 100Mb/s for LTE
    Used for very remote connection of device to device or database
    Chipsets expensive - $15 for 2G, $50+ for 3G LTE ?

  • NBN

    We’ve all heard the hype, the issue is will it live up to the hype

    Data rates to 100Mb/s for 93% of Aust or 12MBs if you’re the unlucky 7%

    Not wireless but ideal for transferring huge amounts if data very long distances, s perfect for providing the network backbone for all the poc devices

    Oh, and also, its only in Australia so it is a very good development platform but the bandwidth available cannot be relied on in other countries so if or your product or service needs this sort of bandwidth to work, think before your develop
  • More than 3000 apps on the Apple app store + many 1000’s under the heath and fitness heading + for iPad. + medical and health apps available on the other 12 (yes 12) app stores = many 10,000savailable and being used every day
    CTIA: 78% of US is interested in mobile health solutions. 40% said mobile health would supplement the medical care they receive from their doctor; 23% believe mobile health services could replace doctor visits altogether.
    PWC found 73% of US consumers would use biometric electronic remote monitoring services to track their chronic condition or vital signs.
    And in mid-2010 Best Buy announced that 40 of its stores in the U.S. had begun offering personal health solutions devices like pedometers, Bluetooth-enabled weight scales and blood pressure monitors.
  • Historically health care lags other sectors in terms of technology adoption (ie paper based medical records, pagers etc), but recent signs point to a sea change in this lag and a number of changes that will accelerate wireless health::

    Many facilities now use wifi to support initiatives such a IP telephony, data connectivity etc

    According to Manhattan Research of the US :

    99% of doctors physicians use the internet in their practices

    80+% of nurses direct patients to health-related websites


  • A graph of life expectancy vs % of GDP spent on health care.
    Most countries spend around 7-10%. Pretty reasonable.
    One Outlier – the US and its clear why there is so much interest in wireless medial devices and remote health care in the country
  • Influx of data from connected health devices and monitoring services could be like a fire hose of new data into an already overwhelmed healthcare system but 40 percent of all chronic conditions are attributable to our behavior. Wireless health solutions can monitor, analyze, encourage and ultimately change behaviour

    Verizon Wireless recently estimated that mobile broadband solutions improved U.S. health care productivity at a savings of almost $6.9 billion. That figure is expected to increase to $27.2 billion by 2016.

    According to Cambridge Consultants, 75 percent of healthcare providers, patients, payers and technology enablers believe that connected health preventative services could cut healthcare expenses by 40 percent.

  • Most areas of healthcare will be affected
  • Another reason why so many device manufacturers are interested

    And as the old saying goes, if I got just 1% of that market …
  • Some 3 months back the US Federal Communications Commission (FCC) and the FDA signed an MOU to work together to create an efficient regulatory process for wireless-enabled medical devices and services.
    Under the MOU, the FCC will oversee the efficient use of airwaves and the FDA will be responsible for the safety and efficacy of medical devices.
    The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) recently set up a Medical Device Technology Forum that is tasked with establishing regulatory best practices for new technologies.
    Given the regulatory uncertainty of a lot of wireless medical devices and the outright non-compliance of so-called diagnostic apps on consumer devices like an iPhone, despite the fact that they are in many cases being used for diagnosis by professionals, most wireless device designers and developers are either still in ‘research’ mode awaiting the day, or are branding their application as a ‘novelty’
  • The pill is needed because many patients fail to take their medication, exacerbating medical problems, causing unneeded hospitalizations and leading to an estimated 217,000 deaths annually.
  • It is a portable microscope with an Apple mobile device to view live images , freeze them and capture them to the Photo album of the device.
  • Airstrip Observer suite of products has a variety of applications available for smart phones
    The system taps into the hospital systems and securely delivers vital patient waveform data — for example the Airstrip OB which includes foetal heartbeat and maternal contraction patterns — in virtual real-time directly from the labour and delivery unit to a medical professional’s mobile wireless device wherever they may be
    Physicians can now closely monitor patients 24/7 when the demands of their day necessitate their periodic absence from L&D.
  • The Near-Eye Tool for Refractive Assessment (NETRA ) provides eyesight tests by utilizing the screen of a smartphone to display images while the NETRA sensors measure the optical distortion across different regions of the eye.

    This method eliminates the need for more expensive components found in traditional optical sensors
  • Apparently more than 3 million doctors have downloaded the $1.19 application -
  • Apparently scientists from Johns Hopkins University rallied formally behind the app when they presented the results of a study conducted at the University of Virginia in Charlottesville of patients suspected of having acute appendicitis.

    Reviewing nothing more than computed tomography (CT) scans over an encrypted wireless network using an iPhone 3G with the OsiriX app, researchers were able to diagnose acute appendicitis correctly in 99 percent of the scans of 25 patients, with one false negative.
  • Now this could be really interesting…
  • Transcript of "Hydrix ausbiotech presentation wireless integration of medical devices 22-10-10"

    1. 1. Wireless Health: Technologies, Trends and Take-Up Peter Lewis, Hydrix
    2. 2. A message from my sponsor: Hydrix is the largest software & electronics design consultancy in Australia Experienced : Design track record of safety-critical medical devices - Class I through to Class III Qualified : Clients :
    3. 3. Wireless Health or mHealth sits at the intersection of traditional healthcare, telecommunications & technology
    4. 4. Five different areas are combining to create a vibrant wireless health sector: Devices Connectivity & Networks Consumer Interest Increased use of IT by Doctors Rising Health Costs And these five factors are in massive collision right now …
    5. 5. Devices Smartphones Tablet PCs PDAs Sensors = ultra portable ultra small ultra low power ultra powerful
    6. 6. Connectivity & Networks Short range Long range Wired = easy to get data from the patient to the device to the doctor
    7. 7. Wifi / 802.11 / Wireless LAN • Local Area Networking technology • Wireless extension of ethernet (50m - 100m) • 54MB/s - optimised for Tx of large data files • Topology: Point to Hub • Complexity: High (device and app impact) • Power: High • Connection: 3-5 secs Cambridge Consultants, Wikipedia, Hydrix Analysis Connectivity & Networks
    8. 8. Zigbee • Mesh networking technology • Control and monitoring (10-100m) • Self -configuring & healing networks • Topology: Ad hoc, peer to peer, star or mesh • Complexity: Low • Power: Ultra-low • Connection: <30ms Cambridge Consultants, Wikipedia, Hydrix Analysis Connectivity & Networks
    9. 9. Bluetooth • Personal Area Networking technology • Cable replacement btw devices (<100m) • Standard for PCs and smartphones • Topology: Ad hoc, v. small networks (8) • Complexity: High • Power: Medium • Connection: up to 10 secs Cambridge Consultants, Wikipedia, Hydrix Analysis Connectivity & Networks
    10. 10. RFID (Radio Frequency Identification) • Tracking technology • Passive (3m) or active (100m) • Topology: tag to reader • Complexity: very low • Power: Zero or very low • Connection: v. fast Cambridge Consultants, Wikipedia, Hydrix Analysis Connectivity & Networks
    11. 11. Cellular • Wide Area Networking (WAN) technology • 10 - 15km • Topology: Point to point • Complexity: high • Power: high • Connection: slow Cambridge Consultants, Wikipedia, Hydrix Analysis Connectivity & Networks
    12. 12. Wired Cable • Wide Area Networking (WAN) • Fibre to every premises • Topology: Point to point • Complexity: high • Power: high • Connection: slow Cambridge Consultants, Wikipedia, Hydrix Analysis Connectivity & Networks
    13. 13. Consumer Interest Apps for: iPhone Android Nokia etc
    14. 14. Increased use of IT by Doctors 99% of doctors physicians use the internet in their practices 80+% of nurses direct patients to health-related websites Manhattan Research 2010
    15. 15. Rising Health Costs Ireland Denmark S. Korea UK Germany Netherlands Finland Spain Italy Sweden Switzerland France Australia Canada Japan United States US Health Care reached US$2.5Tn in 2009 (OECD, US Dept of Health Human Services, CSMG)
    16. 16. MediApps.com Rising Health Costs
    17. 17. The combination of the five driving forces of wireless health is causing a steady migration of point of care from the hospital the home the body
    18. 18. As a result we are seeing innovation across many areas: Monitoring PERS Telemedicine Mobile Medical Equipment Mobile Health Info RFID Tracking Health & Fitness SW
    19. 19. How Big is the Wireless Health Opportunity ?
    20. 20. But what about the three 100 lb gorillas in the corner? And increasingly the 4th 100 lb gorilla:
    21. 21. So what are the sort of applications and devices we are starting to see in the market ?
    22. 22. University of Florida researchers have created a pill capsule designed to signal when a patient has swallowed it The pill works by communicating from inside the body with a stand-alone device worn by the patient. Technology: Unknown – probably proprietary or RFID http://news.ufl.edu/2010/03/31/antenna-pill-2/antenna-pill-photo/
    23. 23. Japanese firm Scalar Corp has developed a the AirMicro wireless microscope that can transmit video to the iPad or iPhone. The microscope is equipped with a 50x lens for precise imaging, enabling users to examine skin textures and blemishes on one or more mobile devices. Technology: WiFi www.scalarco.jp/english
    24. 24. The AirStrip series of applications for Smart phones are a collection of mobile services that allow doctors to monitor patient status information remotely in real-time. Technology: Cellular, Bluetooth or Wifi http://www.airstriptech.com
    25. 25. The NETRA tool from MIT provides eyesight tests on a smartphone Technology – built in camera and image processing dsp http://web.media.mit.edu/~pamplona/NETRA
    26. 26. An app invented by Peter Bentley form London’s University College turns an Apple iPhone into a stethoscope. “…Experts say the software, a major advance in medical technology, has saved lives and enabled doctors in remote areas to access specialist expertise….” Technology: Software Smh.com 1/9/10
    27. 27. The OsiriX Radiology App for the iPhone was unveiled at the end of 2009 Invented by radiologists, the app allows doctors look at x- rays, ultrasounds, CT and MRI images on handheld devices or mobile phones with special software, enabling radiologists, for example, to diagnose acute appendicitis from remote locations. Technology: Cellular, Wifi http://news.cnet.com/8301-27083_3-10414983-247.html http://pixmeo.pixmeo.com/
    28. 28. Cough Now A new iPhone App being developed by Star Analytical Services is designed to diagnose respiratory disease using the sound of a cough Users cough into the microphone and the acoustic properties of the coughing sound are compared against a large database of coughs which can then indicate various diseases Technology: Inbuilt app probably with Wifi or cellular updates From PSFK, 2010
    29. 29. Thank You ! Peter Lewis peter.lewis@hydrix.com
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