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Wireless healthcare: the next generation

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These slides use concepts from my (Jeff Funk) course entitled analyzing hi-tech opportunities to analyze how wireless healthcare are becoming economic feasible. Improvements in microprocessor and transceiver ICs, MEMS, photo-sensors, and other electronic components are making wireless healthcare economically feasible. These slides show how improvements in these components are making capsule endoscopy, smart drug delivery, and digital pills economically feasible. Capsule endoscopy involves sending a small device through the body, particularly the digestive system, to take images. Further improvements in electronic components are needed to further reduce the size of these devices. Drugs can be dispensed through smart pills at programmed times or can be triggered by sensors that detect the correct location. Digital pills send signals to mobile phones or other devices when the pills have been taken. The slides conclude by discussing the role of mobile phones in increasing the number of wireless healthcare applications.

Published in: Business

Wireless healthcare: the next generation

  1. 1. The Next Generation of Wireless Healthcare MT5009: Analyzing High-Tech Opportunities Chen Weiming Alec Liu Asger Thomsen Eugene Wang Zhang Jianliang
  2. 2. Overview •Introduction –Future Trends –Enabling Technologies •Illustrations –Capsule Endoscopy –Smart Drug Delivery –Digital Pill System –M-Health •Conclusion
  3. 3. Healthcare Future Trends •Paradigm shifts •Greater participation of one’s health matters –Doctor’s office →home •Mobile devices will play a greater part in welfare –Desktops → mobile devices •Greater human-device interaction –Accuracy: inside body >> outside body •Medical records → electronic
  4. 4. Some Stats Have access to in the world: 4.2 b 4.8 b 140% greater survival rate for patients with pacemaker with high remote monitoring Patient Remote Monitoring almost doubles from 2012 to 2014 US will be short of 90,000 doctors next 4 years 30 million wearable health devices shipped in 2012 What if we could harness the potential of IT for the betterment of healthcare?
  5. 5. Enabling Technologies –Processing Capabilities Advances in integrated circuits drive the reduction of computing devices, and increase their functionality
  6. 6. Enabling Technologies –MEMs
  7. 7. Enabling Technologies –Power Consumption Computations per kWh have been increasing by a factor of 1.5 per year
  8. 8. 0 100 200 300 400 500 600 700 800 1990 1995 2000 2005 2010 2015 2020 Energy Density (Wh/l) Year Li-ion Energy Density Enabling Technologies –Batteries New materials continue to help elongate Li ion battery life
  9. 9. Enabling Technologies –Biomarkers Biomarkers have become more important indicators in recent years •Proteins, DNA, hormones Increasing number of approved biomarkers •400%, 2003 -2012
  10. 10. Presentation Theme •Next gen of wireless healthcare is for –Diagnosis –Effective regimen –Healthier lifestyle –Monitoring •In corpore, ex corpore, and corpus-silico
  11. 11. Capsule Endoscopy Diagnosis Effective regimen Healthier lifestyle Monitoring
  12. 12. What is Capsule Endoscopy
  13. 13. Why Capsule Endoscopy -explore the unexplored 5m 0.5m 1.5m Lower endoscopy Upper endoscopy
  14. 14. Capsule endoscopy •Photographic capsule •Collect 2 images per second •Moves by peristalsis •Images are collected and stored for later download •Capsule “working life” ranges 8-10hrs •Capsule passes from body naturally •Specific to examination of the Small bowel but other wireless device that exam remainder of GI tract
  15. 15. 1)Precheck up to see patient are eligible to take capsule endoscopy 2)Patient are required to fast for 12 hours before taking the capsule 3)Patient are mounted with antenna on the abdomen 4)Patient swallow the capsule 5)Patient bring back the data recorder to workstation for review the images/video Procedure
  16. 16. Technology for Improvement •Lens •LEDS •Camera •Batteries •RF transmitter •Antenna 27mm 11mm
  17. 17. Current limitations •Unable to control the speed of the capsule movement •Unable to perform biopsy •Risk of capsule retention •Time consuming to review thousands of photos download at the end of the inspection
  18. 18. Smart Drug Delivery Diagnosis Effective regimen Healthier lifestyle Monitoring
  19. 19. Future drug delivery •Imagine you automatically will get what you need •Monitors your body and gives you drug when needed Biosensor Drug reservoirs wireless Heart rate Hormones temperature Many different drugs Implant
  20. 20. Drug delivery today •Syringes •External pumps •Pens •Inhalers •Pills •Patches •Labor-intensive!
  21. 21. New drug delivery -Benefits •Lower cost of care •More data •Automatic release –Minimizing patient’s efforts –No human errors •Drug doses spread out in time •Constant monitoring
  22. 22. How close are we? •Not a single device that can do everything •However, devices are moving in that direction Biosensor Drug reservoirs wireless Omnipod Microchip Apple Watch
  23. 23. Example of a device –MicroCHIP (1) •Implanted by doctor with local anesthesia •20 reservoirs, each containing 600 nanolitre •Seal made of thin layer platinum and titanium –Melts when current are applied •Timer or wireless command (execute only) •Not yet any biosensors, no data <-3 cm -> <-5 cm ->
  24. 24. Example of a device –MicroCHIP (2) •Successfully tested with drug to treat osteoporosis patient –Needs daily injections •Price still to high –Same as delivered with injections •$10,000-12,000 per year <-3 cm -> <-5 cm ->
  25. 25. Example of a device -Omnipod •Insulin pump •Attach to skin (lasts three days) •Manage dose wirelessly –Intelligent system •Not an implant, separate controller
  26. 26. Example of a device –Apple Watch •Biosensor and data –Monitors pulse –Steps taken •Connected to smartphone •Not an implant and no drug Infrared sensor
  27. 27. Barriers •Reliability –Complete control of drug delivery •Security •Standards •Size •Price •Technology
  28. 28. Digital Pill System Diagnosis Effective regimen Healthier lifestyle Monitoring
  29. 29. What is Ingestible Digital Pill System •Daily tracking of exact medicine intake time –Noncompliance is a major healthcare issue •Smartphone app •Patch •Ingestible sensor –Size of a grain of sand (1 x 1 mm) –Silicon –Enclosed in pill –No battery required
  30. 30. A system for monitor and record medicine taken. Why Ingestible Digital Pill System
  31. 31. How is Ingestible Digital Pill System Work •Patient swallows pill •Stomach fluid activates sensor •Patch collects data •Patch sends data to smartphone •Smartphone notifies in case of non- compliance
  32. 32. Wearable patch sensor and Mobile App Store data in cloud. Loved ones and doctor can access these data. Wearable Technology Wireless technology Mobile App
  33. 33. Market Ready Edible technology for Ingestible sensors Composition Common reference Typical Nutritional Guidelines Copper: 0.0077 mg Magnesium: 0.0098 mg 2 mg in Centrum® tablet 50 mg in Centrum® tablet 1.5 mg per day via IV for nutrition 400 mg US RDA Ingestible Sensor approved as medical device -Unlimited use by patients ingesting up to 30 sensors per day
  34. 34. Improvements •Ingestible sensor –Further reduce size while maintain detectable signal (Current size: 1mm x 1mm) –Simple marker of ingestion to a multi- functional data collection platform •Wearable patch –Batter power efficiency (Currently lasts 7 days) –New materials to make patch re- usable –Be worn during all activities including showering and bathing –Tattoo type patch for easy use.
  35. 35. Potential Cost Savings $290billion in increased 2009 US medical costs 13% of total US health expenditures 50%do not take medications as instructed Daily tracks the exact medication taken time record monitor feedback Provide valuable feedback on effectiveness of pharmaceutical treatment Adds visibility into a patient’s actual behaviors for better care Waste due to missuse Value Proposition
  36. 36. M-Health Diagnosis Effective regimen Healthier lifestyle Monitoring
  37. 37. A recent trip to NUH
  38. 38. M-Health •M-Health uses mobile devices and/or communication networks for the provision of health services •Monitoring of health data •Three major dimensions: battery life, device capabilities/functionality, size/aesthetics
  39. 39. Basic Monitoring (1) •ECG, heart rate, respiration rate, activity level, blood pressure, weight, blood glucose •Remote monitoring of cardiac arrhythmias •Benefits –Reduced re-admissions, shortened hospital stays, improved clinical outcomes
  40. 40. Basic Monitoring (2) •Leading health apps do not monitor anything related to menstruation and reproductive health of half the world’s population •Menstruation patterns can reveal health problems –Premenstrual syndrome –Premenstrual dysphoric disorder –Polycystic ovarian syndrome –Menorrhagia –Hysterectomy •Other reasons for tracking –functionality of contraceptive methods –planning work and leisure activities •Basal temperature as indication for stage menstrual cycle and ovulation
  41. 41. Advanced Monitoring •Portable test kits + smartphone camera •Molecules to detect –Influenza A –Vitamin D (mood, anxiety, sleep quality) –C-receptive protein (inflammation) vs.
  42. 42. Scale Effects In biological molecule analysis, reduction in dimensions helps shorten analysis time This is further compounded by parallelization
  43. 43. M-Health Cost Savings •In Singapore, M-Health can save health costs by S$3 billion per year –By comparison, venture capital in M-Health reached ~ US$1 billion (2013) in the US •In the EU, savings of €99 billion in 2017 –Fewer complications: doctors and paramedical staff could save 472,000 doctor days –Other economic costs: worker absenteeism, early retirement costs
  44. 44. New Ways of Powering (1) •A major limitation to widespread use of mobile health is power with respect to size of device Power Sustenance Reduce power consumption Components Generation Human power Storage Batteries Based on 2013 Ultra Low Power Wireless ECG Sensor Tag 340 μW, 2V, 100m range Based on 2012, ultra low power implantable medical sensor
  45. 45. New Ways of Powering (2) Temporary Biofuel Cell Tattoo •Electricity from sweat •Can be twisted and stretched •Chemically generates electricity Currently 5 to 70 μW/cm2
  46. 46. New Ways of Powering (3) •Fibre-based nanotechnology generate electricity via piezoelectric effect •Textile fibers covered with zinc oxide nanowires •Nanowires generate electricity when stretched •6mm2generates about 20 mV, 0.8 μA (2.5 mW/mm2)
  47. 47. New Ways of Powering (4) •Implantable hydroelectric generator •Heart generates about 1-1.5 W of power •About 1mW power available for devices e.g. Pacemaker requires 10 μW
  48. 48. Conclusions
  49. 49. Entrepreneurial Opportunities •Consumer electronics •IT support •Healthcare sector •New software •Health insurance coverage policies •Developing countries
  50. 50. Conclusion •Advances in electronic components, biological molecule analysis, batteries signal the dawn for the next generation of wireless healthcare –New medical procedures (endoscopy) –Greater control of medicinal release –Digitizing our healthy habits (digital pill) –Strengthening patient/doctor dialog (M- Health) •Greater confidence to both patients and healthcare professionals •Better integration –Diagnostics and procedures –Medication –Payment •Wireless technology: 24/7, everywhere
  51. 51. Back-up
  52. 52. Back-up
  53. 53. Back-up Smartphone cameras are sufficiently specific and sensitive for diagnostics •Not statistical significant difference between smartphone cameras and conventional lab optic detectors
  54. 54. Back-up
  55. 55. Examples -Preventice •Remote monitoring of cardiac arrhythmias via algorithm •Doctors monitor key biometrics –Reduced re-admissions, shortened hospital stays, improved clinical outcomes •Components: bandage patch with battery and monitor sensor, mobile device •Data collected: ECG, heart rate, respiration rate, activity level, blood pressure, weight, blood glucose •Cloud-based platform collects real-time data from the mobile device •Physicians then review data •Support for numerous device connection types: cellular/smartphone, wi- fi, Bluetooth
  56. 56. M-Health Cost Savings (1) •Traveling to a central lab for testing: $10 per test •Also considering indirect cost of taking 0.5 day offto do testing: $200 •Transportation cost: $10 •If 10 tests are needed a year, it will cost $2200 per year per patient •If the testing cost can be halved, and test can be done at home, in Singapore, this can save $3 b per year (assuming 1.5 million people needing tests) •By comparison, venture capital in M-Health reached $900 million (2012), about $1 billion (2013) in the US
  57. 57. M-Health Cost Savings (2) •Savings of 99 billion EUR in the EU in 2017 •mHealth can help 9.4 million regular users at risk of developing chronic diseases to expedite diagnosis •815,000 patients can successfully detect chronic diseases early •These patients could avoid complications and seek medical attention earlier, reducing the need for hospitalization and saving 3.7 billion EUR in treatment costs •Doctors and paramedical staff could save 472,000 doctor days by having to treat fewer complications •Chronic diseases could lead to 718 billion EUR in lost wages in 2017 •Healthcare cost savings as a result of improving lifestyles, reducing risk of chronic disease, saving of hospital and doctor days, healthcare providers staying informed, reducing worker absenteeism, and avoiding early retirement costs

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