CONVERGENCE


Embedded technology is changing the face of healthcare with electronic medical devices for improved patient monitoring and ailment diagnostics, says Sudhir Chowdhary

Posted online: Monday, April 24, 2006

A tiny computer placed near your heart that works on precisely programmed software to monitor the rhythmic movements of your heart muscles. Programmed non-invasively, with a handheld device that communicates with the implanted device through layers of skin, the programming can be repeated as often as necessary if the patient's underlying heart rhythm changes.
Reading the body signals remotely, it also allows the doctor to know exactly when a patient is due for a check-up. The above example proves that technology advances have closed the gap between science fiction and reality. Over a million humans carry an implanted electronic device of some kind that is programmed according to the specific needs of the individual. But how do such devices really work?

Enter the role of embedded technology. Simply put, says Ajay Chamania, senior vice-president (product engineering), Patni Computer Systems, embedded technology is software and hardware that is hidden — embedded— in a large device or system. It typically refers to a fixed function device, as compared with a PC, which runs general-purpose applications.

So, when a pacemaker is implanted, it is equally important to programme it. Current day pacemakers are extremely flexible devices, and can differ in their functionalities based on the defined needs of the patient.

The healthcare industry is increasingly acknowledging the use of embedded technology that forms the core of implanted electronic devices or implantable medical devices (IMDs).

Says Pradeep Nair, head of life sciences practice, HCL Technologies, "Implanted electronic devices are gaining acceptance as a mode for delivering therapy, patient monitoring or ailment diagnostics and complement other treatment techniques for treating a host of ailments."

He adds: "Implantable medical devices (IMDs) have a history of outstanding success in the treatment of many diseases, including heart diseases, neurological disorders, and deafness. Today's aging population is driving wide-scale demand for more-advanced healthcare treatments, including wireless implant devices that can deliver ongoing and cost-effective monitoring of a patient's condition."

While there are no estimates on the size of implanted medical devices market in India — nearly 80% of this is met by imports at very high costs — the overall market for medical equipment and supplies is pegged at $1.5 billion.

Analysts claim that a country where the sheer number of people, changing patterns of disease and high levels of unmet clinical need will create an environment where the medical device industry can thrive. There is already a strong demand for cardiac implants, orthopedic devices, and breast, drug, cochlear and retinal implants.

Today, facing clinical demand for much faster progress, medical device designers are drawing on innovations in numerous fields to improve the diagnostic, monitoring, and therapeutic capabilities of next generation devices. Implanted electronic products in use today include pacemakers, drug pumps, monitors and delivery systems, remote telemonitors, orthopaedic devices, nerve stimulators and swallowable imaging systems. Hence, demands on the embedded systems vary from highly optimised throughput to extreme fault tolerant and predictable real-time systems.

No wonder, there is an increasing role of semiconductors in the area of implanted devices. It is notable that medical applications, which utilise semiconductors, make up nearly 34% of the total medical device market, which is estimated at $174 billion (Source: Databeans study on semiconductor consumption). It is estimated that the revenues from these electronic applications is growing at an average annual growth rate of 18% over the next five years, resulting in a market worth $179 billion by 2009.

Mr Chamania says, demands on the embedded systems vary from highly optimised throughput to extreme fault tolerant and predictable real-time systems. Embedded technology contributes tens of thousands of instruments in hospitals, doctors and dentists offices ranging from blood analysers and body function monitors to radiation equipment, portable diagnostic imaging and home monitoring devices such as cholesterol monitors, blood glucose meters etc.

The benefits are aplenty too. Today, embedded applications are being utilised to reduce telemedicine costs by providing online video conferencing to transmit patient records over a telecom network, lowering infrastructure and bandwidth costs. Furthermore, medical records of the patients can be viewed over handheld devices such as PDA's - powered by embedded applications —by doctors to provide instant consultation to patients.

And since Indian technology firms - Wipro, Infosys, Patni, HCL Technologies and Cognizant have strong capabilities in product design, R&D and support, they are developing expertise in developing implanted electronic devices — drug pumps, monitors and delivery systems, cochlear implants, and neurostimulators. Analysts too claim there is a greater acceptance for implanted electronic devices as a mode for delivery therapy.

On the technology front, many components of medical design continue to impact the innovation and miniaturisation in this field - from the increasing popularity of MEMS technology to how battery design is changing long-term patient care. Consider the following:

MEMS sensors

Micro electro-mechanical systems (MEMS) technology is an important enabler of today's rapid expansion in the number and types of implanted devices available. Take for instance, the next generation implantable devices that extend the monitoring of events and responses within the human body far beyond the simple detection of bradycardia, or excessively slow heart-rate. Today's pacemakers use MEMS sensors to detect patient exercise levels and adjust the pacing rate to meet the increased demand for cardiac output.

System-on-chip IP

In order to realise the full potential of implantable device innovation, advances in additional supporting technologies are also required. Suitable signal conditioning electronics are required, as well as optimal implementation techniques either on the same chip or separately from the MEMS sensor.

RF communications

New ultra-low-power RF technologies are spurring the development of innovative medical tools, from endoscopic camera capsules that are swallowed, to implanted devices that wirelessly transmit patient health data.

Battery technology

Developments in electronic design and fabrication, as well as enhancements to implantable battery technologies are both vitally important in this context. Battery technologists are seeking new biocompatible solutions that will deliver greater energy density for longer battery life. The concept of rechargeable batteries for implantable applications is also now delivering workable solutions. A much longer-lasting source of power could be the human body itself.

Going forward too, embedded applications will increasingly get sophisticated as technology matures. In the near future, your heart may be well programmed to never skip a beat!

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