The Official blog of Dark Matter, Inc.

Source: ADAM BLUESTEINJanuary 9, 2012, Fat Company

The average auto refractor–that clunky-looking device eye doctors use to pinpoint your prescription–weighs about 40 pounds, costs $10,000, and is virtually impossible to find in a rural village in the developing world. As a result, some half a billion people are living with vision problems, which make it tough to read and work.

Ramesh Raskar knew fixing this problem would be tricky. It required a new way of thinking about eye tests–and a new kind of device, one powerful enough to support high-resolution visuals, cheap enough to scale, and simple enough to be used by just about anyone. The MIT professor briefly toyed with stand-alone options, which were complicated and costly. Then he reached into his pocket and pulled out an unexpected savior: his iPhone.

“The displays had gotten so good, thanks to people wanting to watch episodes of Lost in high definition,” Raskar recalls. “I was immediately energized.”

By creating an app and attachment for the popular smartphone, Raskar could tap into a huge existing user base and skirt millions in distribution and manufacturing costs. The result: a plastic clip-on eyepiece that uses an on-screen visual test to determine a patient’s “refractive error” (a number doctors then use to dole out prescriptions). When his startup, EyeNetra, begins market testing later this year in Brazil, India, and Mexico–and eventually in the U.S.–its tech will deliver all the functionality of an optometrist’s costly machine for less than $30.

What Dr. Smartphone can do for you

Click to enlarge 

This is the thrilling, disruptive potential of “mHealth,” the rapidly growing business of using mobile technology in health care. Leveraging the wonders of a device that’s fast becoming ubiquitous–two in three people worldwide own a cell phone–a new generation of startups is building apps and add-ons that make your handheld work like high-end medical equipment. Except it’s cheaper, sleeker, and a lot more versatile. “It’s like the human body has developed a new organ,” says Raja Rajamannar, chief innovation officer at Humana. Smartphones can already track calories burned and miles run, and measure sleep patterns. By 2013, they’ll be detecting erratic heartbeats, monitoring tremors from Parkinson’s disease, and even alerting you when it’s prime time to make a baby.

At stake is the future of health care–and a share of the $273 billion medical-device industry, which is dominated by the likes of GE and Philips. Although today’s mHealth market barely tops $2 billion, experts predict that number will skyrocket over the next decade as smartphones get smarter and patients lose, well, patience with the high costs and hassles of health care. “Why prescribe a $1,000 test in the hospital when all you need is a heart rate?” asks Leslie Saxon, a cardiologist who heads the University of Southern California’s Center for Body Computing. With inexpensive new technology, she notes, “I could tell a patient to go to the drugstore and buy an ECG [electrocardiogram] sensor for her phone.”

But can we really trust our phones to dispense medical data? That’s the question facing the FDA, which has spent the past year or so putting pioneering mHealth products through rigorous evaluations. “We had to show that our phone-computing platform and display quality were on par with existing devices,” says Sailesh Chutani, CEO of Mobisante, whose ultrasound attachment was sanctioned in January–after about a year of costly back-and-forth. With this first wave of devices approved and a mobile-specific set of guidelines to be finalized later this year, the FDA expects to streamline its approval process, which should juice the mHealth market. “Regulatory clarity almost always drives investment–provided it’s not a big, clear no,” says Joseph Smith, who helps run the West Wireless Health Institute.

Whether these tools actually make us any healthier, however, will depend on how we use them. Given the ability to record our snacks, thoughts, naps, movements, and more, “we will be overwhelmed with data,” warns John Moore, a lead researcher in the New Media Medicine group at the MIT Media Lab. “We need a holistic vision to make it all meaningful and motivating.” Among other advances, that vision will require a seamless flow of data across myriad devices and platforms–think how the MP3 format transformed the music industry–and a physicians’ movement to adopt electronic medical records. (Right now, only a third of them have.) And even then, there’s no guarantee these tools will change behavior. Will we stop eating sugary foods? Or, as Smith wonders, will we just be staring curiously at “phones that show glucose readings in three colors”? Corporate titans are racing to find out. Johnson & Johnson, the world’s largest medical-device maker, recently invested in sleep-monitoring technology from Zeo, a Massachusetts-based startup. Best Buy is funding earbuds that can monitor your heart rate. AT&T helped seed an employee-wellness program with WellDoc, whose apps help users manage diabetes, among other conditions. And Qualcomm, the renowned chipmaker, just launched a subsidiary that’s helping to develop all kinds of mHealth devices. “Will this nascent technology attract consumers, health-care providers, and health-care payers?” says Don Jones, a VP at Qualcomm. “The entire world is keeping its fingers crossed.”

Anatomy Of A Handheld Hospital

1 Processor that can power a pacemaker
Smartphones run superfast (in excess of 1 GHz) without consuming much power, much like top-notch pacemakers and cardiac defibrillators.

2 Display that can assess an ultrasound
The iPhone 4S’s resolution (300 pixels per inch) is on par with most hospital-grade ultrasound monitors, and small screen size won’t matter once projection tech takes off.

3 Camera that can capture cells
The HD video camera, which shoots 30 frames per second, is more advanced than some of the ones in colonoscopes, which doctors use to seek out potentially cancerous tissue.

4 Accelerometer that can guide physical therapy
The three-axis accelerometer captures the same subtle movements–tilts, shocks, rotations–as APDM motion sensors, which are used to monitor patients’ Parkinson’s disease and help them through physical therapy.

5 Microphone that can hear your heart
Because of its flat-frequency response rate–which drastically reduces noise distortion–a smartphone mic (with help from an amplifying attachment) can detect a heartbeat almost as well as a $500 electronic stethoscope.

Tech Crunch Josh Constantine, Sunday, January 1st, 2012

“In the future we might not prescribe drugs all the time, we might prescribe apps.” Singularity University‘s executive director of FutureMed Daniel Kraft M.D. sat down with me to discuss the biggest emerging trends in HealthTech. Here we’ll look at how A.I, big data, 3D printing, social health networks and other new technologies will help you get better medical care. Kraft believes that by analyzing where the field is going, we have the ability to reinvent medicine and build important new business models.

For background, Daniel Kraft studied medicine at Stanford and did his residency at Harvard. He’s the founder of StemCore systems and inventor of the MarrowMiner, a minimally invasive bone marrow stem cell harvesting device. The following is rough transcript of an interview I did with Kraft at the Practice Fusion conference, which I’ve arranged into 6 big ideas:

Artificial Intelligence

Siri and IBM’s Watson are starting to be applied to medical questions. They’ll assist with diagnostics and decision support for both patients and clinicians. Through the cloud, any device will be able to access powerful medical AI.

For example, an X-ray gun in remote africa could send shots to the cloud where an artificial intelligence augmented physician could analyze them. Pap smears and some mammograms are already read with some AI or elements of pattern recognition.

This has the potential to disintermediate some fields of medicine like dermatology which is a pattern based field — I look at the rash and I know what it is. Soon every primary care doctor is going to have an app on their phone that can send photos to the cloud. They’ll be analyzed by AI and determine “oh that mole looks like a dangerous melanoma” or “it’s normal”. So the referral pattern to the dermatologist will slow down.

On the plus side, there are consumer apps likeSkin Scan where for $5 you can take a picture of lesion and send it to the cloud, and it will at least give you an idea if it’s dangerous or not. If it is, it can help you find a nearby doctor, which could help dermatologists get more business. Many fields are going to change because of artificial intelligence, pattern recognition, and cheaper tests.

Big Data

We’re gaining the ability to get more and more data at lower and lower price points. The primary example is the human genome and genomic sequencing. It cost a billion dollars or more 10 years ago to get a complete human sequence. However, the cost and speed of getting that data has dropped faster than Moore’s law to the point where it’s less than $5,000 when ordered online. From23andMe you can now get a cheap SNP test, and it has a pilot program for $999 for a whole exome.

Maybe there were 10,000 patients sequenced last year. Next year it could be 100,000 and soon millions. A genome sequence could be the cost of a blood count today.  When that information becomes queryable in an a crowdsourced and cloudsourced way we can be more predictive about what you’re more likely to get based on your genomics. You can then take preventative steps or get screened more often.

So we’re pulling in huge data sets from low-cost genomics to proteomics (analyzing the proteins in the blood) to quantifiable self. The challenge is to make sense of that data and make it actionable information without making the patient or doctor overwhelmed.

I think we need to make smart dashboards like they have for fighter pilots. They would piece together data from ubiquitous sensors, like those made by GreenGoose, and Microsoft Kinect that can measure your activity around the house. It would be like the OnStar for your body that could give you clues about when you’re about to get in trouble, and it could call for help or guide you to appropriate therapy.

3D Printing

3D printing has been around for a while but now it’s being applied to medicine in ways such as being able to scan the remaining leg of a patient that’s missing one from an accident. It can then build a prosthetic leg with skin and size that matches. 3D printing is integrating with the fast-moving world of stem cells and regenerative medicine with 3D ink being replaced by stem cells. In the future we’ll probably use 3D printing and stem cells to make libraries of replacement parts. It will start with simple tissues and eventually maybe we’ll be printing organs.

Social Health Network

Social networks have the ability to change our behavior. When you wireless weight scale shares metrics with your friends, you get praised for success and pressured if you’re not maintaining your diet. Social networks are also quite powerful for tracking and predicting disease. James Fowler, co-author of the book Connected is now working with Facebook to look at health data. Not surprisingly, the more friends you have, the earlier in the flu season you’ll get influenza. This could help predict when you’ll get the flu and let you take steps to avoid it.

We’re in the Facebook era, and are more open to sharing information in the healthcare spectrum. Individuals will share their whole history through services including PatientsLikeMe andCureTogether where patients with similar problems from migraines to Lou Geghrig’s disease will consolidate health information. This will enable improvements in clinical trials.

Genomera is trying allow for low-cost web-based clinical trial around any question. Practice Fusioncan also crowdsource that data from its electronic medical records. By collecting data from all the patients within a hospital or a region you can see trends and almost run clinical studies on the fly. For example you could see all the patients that have this gene and that are taking this drug, and determine if that drug is effective for them or not.

Communication With Doctors

New communication platforms similar to a Skype or FaceTime will help you communicate differently with your clinician. Many of these things are basically already here. The challenge is often not the technology but the regulatory and reimbursement markets around them. If you’re going to be talking with your clinician on your iPhone you may need to do that in a HIPAA privacy protected way. The physician is also going to want to be paid for that in some way. They’re not going to want to get all your data every time you have a hiccup or look at your iPhone pictures of your rash unless there’s a way to get paid.

The regulatory system needs to adapt towards to becoming Accountable Care Organizations, which reward clinicians and healthcare plans for keeping patients healthy opposed to paying them to do extra procedures. This contrasts with a model of paying them for service like putting in stents and doing things after a problem has already progressed. Incentives need to be aligned and reimbursement needs to change to enable some of these new technologies to actually enter the clinic.

Mobile

The ability to have your phone tie to your healthcare record and track medical metrics will have vast repercussions. Though some aren’t cleared for sale in US yet, devices like the Alivecor electrocardiogram can monitor your heart in realtime, send the data to the cloud, and allow your cardiologist to look at it instantly. Other devices are turning phones into otoscopes for looking in your ears, or glucometers for monitoring blood sugar.

Quantified self devices like the Fitbit, Jawbone Up, and more medically themed devices will take what you used to do dsin a clinic or hospital and bring it home. This will allow therapies to be tuned much more effectively than scribbling data on a piece of paper and bringing it in to your doctor months later.

Eventually these devices will converge into the equivalent of Star Trek tricorder that can perform a wide variety of medical functions. There’s even an $10 million X Prize proposed to reward the inventor of the first functional tricorder.

Unfortunately, the strict regulatory system and entrenched, interested of the United States are pushing innovation offshore. A lot of the work for using mobile phones for health care is happening in Africa and India. Since there are few physicians in some of these areas mobile health and telemedicine are taking off. For example, microfluidics allows multiple tests to be done on a small chip at pennies per test, with the ability to connect to the web for analysis. The US will need to find a way to solve these regulatory problems while keeping patients safe, otherwise jobs and revenue could slip abroad.
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To learn more about what’s happening next in healthtech, check out Singularity University’sFutureMed 2020 program, watch Daniel Kraft’s Ted Talk, and browse our healthtech channel.

[Image Credits: Shutterstock, koya979, Guiacirugiaestetica.com, shopping.com]

Source: ScienceDaily (Sep. 6, 2011)

Many older adults lose their independence as their health declines and they are compelled to move into assisted care facilities. Researchers at the University of Missouri and TigerPlace, an independent living community, have been using motion-sensing technology to monitor changes in residents’ health for several years. Now, researchers have found that two devices commonly used for video gaming and security systems are effective in detecting the early onset of illness and fall risk in seniors.

Marjorie Skubic, professor of electrical and computer engineering in the MU College of Engineering, is working with doctoral student, Erik Stone, to use the Microsoft Kinect, a new motion-sensing camera generally used as a video gaming device, to monitor behavior and routine changes in patients at TigerPlace. These changes can indicate increased risk for falls or early symptoms of illnesses.

“The Kinect uses infrared light to create a depth image that produces data in the form of a silhouette, instead of a video or photograph,” said Stone. “This alleviates many seniors’ concerns about privacy when traditional web camera-based monitoring systems are used.”

Another doctoral student, Liang Liu, is collaborating with Mihail Popescu, assistant professor in the College of Engineering and the Department of Health Management and Informatics in the MU School of Medicine, to develop a fall detection system that uses Doppler radar to recognize changes in walking, bending and other movements that may indicate a heightened risk for falls. Different human body parts create unique images, or “signatures,” on Doppler radar. Since falls combine a series of body part motions, the radar system can recognize a fall based on its distinct “signature.”

“Falls are especially dangerous for older adults and if they don’t get help immediately, the chances of serious injury or death are increased,” said Liu. “If emergency personnel are informed about a fall right away, it can significantly improve the outcome for the injured patient.”

Both motion-sensing systems provide automated data that alert care providers when patients need assistance or a medical intervention. The systems currently are used for monitoring residents at TigerPlace in Columbia. Skubic says the system allows residents to maintain their independence and take comfort in knowing that illnesses or falls may be detected early.

Stone’s study, “Evaluation of an Inexpensive Depth Camera for Passive In-Home Fall Risk Assessment,” won the best paper award at the Pervasive Health Conference, in Dublin, Ireland in May. Liu’s study, “Automatic Fall Detection Based on Doppler Radar Motion,” received the best poster award at the conference. Liu’s paper was a collaboration with GE Global Research and co-authored by Tarik Yardibi and Paul Cuddihy. TigerPlace is a joint project of the Sinclair School of Nursing and AmErikare, a long-term care company.

The research is part of Mizzou Advantage, the five unique areas that set MU apart from other universities. The project contributes to the “Managing Innovation: Navigating Disruptive and Transformational Technologies” initiative that will touch on virtually every part of the university to explore areas in which existing technologies are changing rapidly.