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Who will shoulder medical tech expenses?

Posted: 09 Jan 2009 ?? ?Print Version ?Bookmark and Share

Keywords:medical advance? Show Consumer Electronics? panel CES?

In a panel session on medical electronics Thursday morning (Jan. 8th) at the Consumer Electronics Show in Las Vegas, Howard Jay Chizek, a professor of electrical engineering at the University of Washington, posed!as one futuristic possibility in medicine!a scenario in which one doctor simultaneously directs robots doing several routine surgical procedures on different patients, without even washing his hands between operations.

These and other medical advances are within reach, according to the members of a panel called "Your Robot Will See You Now," except for one overshadowing issue: who pays and how.

Subtly, but repeatedly, panel members lamented the fact that technology holds amazing potential for gathering complex information from patients and applying it to prevention and treatment, but that the U.S. health care system inhibits or prohibits many of these available innovations.

Among the most prominent obstacles to technology-enhanced care is the absence of a unified medical records system that could follow a patient all over the world, at the touch of a keystroke.

Hindered advancements
Many IT advancements are hindered, moreover, by issues of liability. It's possible today, said panelist Marshall Stanton, MedTronic's vice president for clinical research, that a physician could read remotely a patient's blood pressure or heart rate from a device implanted in the patient's body.

However, the physician has no way to collect payment from an insurance company if he makes direct contact with the patient's heart. Moreover, if he makes a mistaken diagnosis based on that reading, he faces unexplored issues of malpractice liability.

Implantable electronic monitoring devices, with a current installed base of 5.5 to 6 million patients, are used far less effectively than they could be, because the health care system has no way to accommodate their speed, variety and functionality.

The panelists, however, were notably cautious in suggesting any changes in!or even finding fault with!the health care system, apparently preferring to wait and see what the future might bring politically.

Technologically, they were more sanguine toward the future.

'Self-care' options
Rajiv Mehta, CEO of Zume Life, went so far as to suggest that a health care system is superfluous to most patients' needs, if they can avail themselves of an array of technical and common-sense "self-care" options that involve personal monitoring of controllable factors like diet, exercise, medication, bio-metrics, anxiety, mood, pain, sleep and other personal health data.

"Humans have a great deal of sensitivity of their own," he said. "A lot of problems go away when the health care system is not a factor."

Panelist Mir Imran, an inventor and entrepreneur with a firm called InCube, discussed the vast potential of implantable devices, to monitor!and to treat, sometimes automatically!chronic diseases such as diabetes or epilepsy.

Stanton expanded on this theme, noting that a heart patient might wear an implanted device that sends a text message through a Bluetooth-equipped mobile telephone, to patient and physician, warning of fluid buildup in the lungs, an early sign of heart failure. The message would read, essentially: "Your lungs are calling."

The panelists readily expanded this vision into long-distance contact directly between lungs, heart, kidneys, joints and brain and their attending physician, with or without notification of the owner of the organs. A physician could check in randomly on every one of his patients' various parts, without bothering any of the patients.

RFID implants
Long-distance surgery would use similar technologies, with doctors on one continent guiding the work of emergency paramedics, for example, at an earthquake site 10,000 miles away.

Imran also touted the potential of implants using RFID technology, now used mainly in electronic bar codes. The advantage of RFID would be minimal power consumption.

The implant would only come alive and transmit information after activation by a near-range RFID reader. Besides Bluetooth and RFID, Wi-Fi technology also has potential for peeking into the human body and sending out data.

Nonetheless, the general air that pervaded the CES panel, moderated by EE Times editor-at-large Rick Merritt, was "Someday." In a comment that summed up the group's resignation about the possibilities before them, Imran said that the health care system is not set up to pay for monitoring health in real time and preventing illness ahead of time.

Footing the bill
He said, "Who pays for it? Most patients aren't going to pay for it. Are the doctors going to do it without being paid? The health care system has to pay. But payment, in the system as it is now, is determined by patient outcomes´So it has to be self-paid. That limits the market."

And without a market to buy up-front the technology that keeps people from being sick, the panelists concurred, not much technology comes to market.

- David Benjamin
EE Times

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